Here are some common concerns that are often raised by people affected by cancer, in relation to fertility.
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- Should I have a child after I’ve had cancer?
- How long should I wait to conceive after treatment?
- Will having children cause the cancer to come back?
- If I’ve had cancer, will my children get cancer?
- What if I was already pregnant at diagnosis?
This is a very personal decision. A cancer diagnosis may affect the way you think and feel about having a child. If you have a partner, you may want to discuss your family plans together. Fertility clinics often have counsellors who can talk through the pros and cons of your situation.
I was given a good prognosis, but we’re still nervous about what happens if it comes back and we leave a child without a parent. That’s my biggest concern.
This depends on many factors, including the type of cancer and type of treatment. Some specialists advise waiting two years after treatment ends. This may be to allow your body to recover, and to ensure you remain in good health during this time. It’s best to discuss the timing with your doctor.
For some fertility treatments, you will need to take extra hormones or stimulate your hormones. Discuss the potential risks of particular fertility treatments with your cancer or fertility specialist. Taking hormone receptor blockers during egg collection will help reduce the risks.
Research shows that pregnancy does not increase the chances of cancer coming back (recurring). However, studies have mainly focused on women with breast cancer. Research is continuing, so it’s best to discuss this issue with your specialist.
Studies to date also suggest that survival rates for people who have children after cancer treatment are no different from people who don’t have children after treatment.
If I’ve had cancer, will my children get cancer?
Studies show that if one or both parents have a history of cancer, their child is at no greater risk of getting cancer than anyone else.
However, a small percentage of certain cancers (up to 5%) are due to an inherited faulty gene from either the mother or father. This is known as familial cancer. The faulty gene increases the risk of cancer, but even then it does not mean that a child will inherit the gene and develop cancer.
A genetic counsellor is the most qualified person to give you up-to-date information about the genetic risks of cancers for family members.
What if I was already pregnant at diagnosis?
Being diagnosed with cancer during pregnancy is uncommon – it is estimated that one in every 1000 pregnant women is diagnosed with cancer.
It may still be possible to have cancer treatment during pregnancy. It’s best to discuss the potential risks and benefits with your oncologist before treatment begins. In some cases, treatment can be delayed until after the birth. If necessary, chemotherapy can be safely used after the first trimester (12+ weeks).
Some women diagnosed with cancer in the early weeks of pregnancy decide to terminate the pregnancy so they can start treatment immediately, while others who are diagnosed later in the pregnancy choose to deliver before the due date.
My oncologist wanted to start treatment as soon as possible, so it was a case of my obstetrician and oncologist deciding on a day to deliver my son, then starting my cancer treatment. He was delivered safely at 32 weeks.
You will be advised not to breastfeed during chemotherapy as drugs can be passed to the baby through the breastmilk. It may not be possible to breastfeed during other treatments. For support, call the Australian Breastfeeding Association on 1800 686 268.
Dr Yasmin Jayasinghe, Paediatric Gynaecologist, Royal Children’s Hospital Melbourne, Co-chair Fertility Preservation Taskforce, Melbourne, and Senior Lecturer, Department of Obstetrics and Gynaecology, University of Melbourne, VIC; Dr Peter Downie, Head, Paediatric Haematology-Oncology and Director, Children’s Cancer Centre, Monash Children’s Hospital, and Director, Victorian Paediatric Integrated Cancer Service, VIC; Carmen Heathcote, 13 11 20 Consultant, Cancer Council Queensland; Aaron Lewis, Consumer; Pampa Ray, Consumer; Dr Sally Reid, Gynaecologist, Fertility SA and Advanced Gynaecological Surgery Centre, Visiting Consultant, Women’s and Children’s Hospital, and Clinical Senior Lecturer, School of Paediatrics and Reproductive Health, The University of Adelaide, SA; A/Prof Kate Stern, Head, Fertility Preservation Service, The Royal Women’s Hospital and Melbourne IVF and Head, Endocrine/Metabolic Clinic, Royal Women’s Hospital, and Co-chair, AYA cancer fertility preservation guidance working group, VIC.
Fertility and Cancer was developed as part of a research study into the experience of fertility after cancer led by Prof Jane Ussher at the Centre for Health Research, Western Sydney University. We acknowledge the input of Dr Amanda Hordern and Prof Jane Ussher, who collaborated on the original draft. We thank CanTeen Australia and the American Cancer Society for permission to draw on their resources. We also thank the cancer survivors who took part in the Western Sydney University research project on fertility and cancer, and whose accounts have been quoted in this booklet.
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