World Cancer Day: Highlighting The Impact of Cancer on Fertility

Cancer is an increasingly common challenge faced by both men and women of all ages. Thankfully, almost all types of cancer can be treated. However, people with certain types of cancer, or who are receiving cancer treatment, may have fertility problems. Cancer treatments often affect the ability of men and women to have their own biological children through normal sexual activity and without medical assistance.

The American Cancer Society provides in-depth information about how various cancer treatments can impact fertility for men and women, which we briefly overview below.

Remember, however, that every person is unique and different types of surgeries and treatments can have different effects on a person’s fertility. For example, the risk of infertility resulting from cancer and/or cancer treatment will depend on a person’s age and development stage (such as puberty or menopause), the type of treatment, and the extent thereof. The only way to know for certain if and how cancer treatment will affect your fertility, is to speak to your oncologist, as well as to a reproductive specialist, who will be able to provide information about suitable fertility preservation options.

Just some of the cancer treatments that are widely used include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, immunotherapy and stem cell transplants. Because these treatments can affect the functioning of reproductive organs in both men and women, they can temporarily or permanently impact a person’s fertility.

The impact of cancer surgery on fertility

One of the most common cancer treatments is surgery, in which tumours are surgically removed. These surgeries may affect fertility, especially if the tumour is removed from or near a reproductive organ, or where a reproductive organ is surgically removed.

In women, this may be surgery on or near an ovary or fallopian tube, or the uterus or cervix, or the surgical removal of the one of these organs, such as a hysterectomy in which the uterus is removed. The removal of the uterus is done for uterine cancer, cervical cancer, and often for other female reproductive system cancers. In a trachelectomy, only the lower part of the uterus, called the cervix, is removed so a woman may still have a chance to carry a pregnancy later.

The ovaries may be removed during surgery called oophorectomy, and this is done for ovarian cancer, and often to prevent other cancers, such as breast and uterine cancers.

Sometimes cancer surgery that’s done for other types of tumours in the abdomen or pelvis can cause scarring in and around reproductive organs, such as the ovaries, fallopian tubes, or uterus, which can prevent a pregnancy.

Certain surgeries may also affect a man’s fertility, including surgery for a tumour in or near an organ in the pelvis, or even for a tumour in or near the brain or spinal cord.

Surgery for testicular cancer involves the surgical removal of a testicle and is called an orchiectomy. If one testicle is not removed and it is healthy, the man might continue to make sperm after surgery.

Prostate cancer surgery – also called a bilateral orchiectomy – involves the removal of both testicles. Where the prostate cancer has not spread, surgery to remove only the prostate gland and seminal vesicles is may be an option. Either way, removing the prostate gland means no semen production and no ejaculation of sperm after the surgery. However, there are other ways to get sperm from the testicle or its sperm storage area.

A few types of cancer surgery can damage nerves that are needed to ejaculate semen, such as removing lymph nodes in the belly.

The impact of radiation on fertility

Radiation therapy uses high-energy rays to kill cancer cells.

If this radiation is aimed at or around a woman’s reproductive organs, it can affect fertility. For example, radiation aimed at or around the ovaries, will damage them enough to affect their function. High doses can destroy some or all of the eggs in the ovaries and might cause infertility or early menopause.

Radiation to the uterus can cause scarring, which decreases flexibility and blood flow to the uterus. It results in an increased risk of miscarriage, low-birth weight infants, and premature births.

Radiation to the brain can also affect the pituitary gland, which regulates hormones made by the ovaries. This can affect ovulation and therefore fertility. Radiation can harm a fetus in future, so be sure to consult a professional.

Similarly, radiation therapy’s high-energy rays aimed directly at testicles, or to nearby pelvic areas, can affect a male’s fertility. This is because radiation at high doses kills the stem cells that produce sperm. Even radiation to the pelvis may still see the testicles getting enough radiation to harm sperm production. Radiation to the brain could affect the hypothalamus and pituitary gland that work together to produce two important hormones for fertility: LH and FSH which make testosterone and produce sperm.

The impact of chemotherapy on fertility

Chemotherapy can lead to a loss of important hormones that affect female fertility, sometimes even causing premature or early menopause. It’s also very important to avoid getting pregnant during chemo because many chemo drugs can hurt a developing fetus, causing birth defects, miscarriages or other harm.

Sperm cells are an easy target for damage by chemo. Certain chemotherapy drugs given during childhood can damage testicles and affect their ability to produce sperm. Certain types of chemotherapy later in life can also affect sperm production. After chemo treatment, sperm production slows down or might stop altogether. Some sperm production might return, but can take many years, and sometimes does not return at all. The risks of permanent infertility are even higher when men receive both chemo and radiation therapy to the pelvis.

The impact of hormone therapy and other treatments

Hormone therapies are often used to treat breast cancer or other cancers and can affect a women’s fertility temporarily or permanently, depending on the type and length of treatment.

Some hormone therapies used to treat prostate or other cancers can affect the hormones that help a man to develop sperm. The lower sperm production and lower sperm numbers will affect fertility.

The effects of targeted therapy and immunotherapy drugs on fertility or pregnancy are not well known, while a bone marrow or stem cell transplant usually involves receiving high doses of chemo and sometimes radiation to the whole body before the procedure, which can result in lifelong infertility.

How to protect your fertility

If you would like to have children after cancer treatment, it is very important to speak to your oncologist about the impact of your cancer treatment on your fertility before any treatment starts.

Fortunately, there are ways to preserve your fertility if you are facing cancer treatment, but it is crucial that you speak to a reproductive specialist as soon as possible about the best option for you.

Arranging your initial consultation is as simple as contacting us here… At Cape Fertility, we value each individual patient, making quality fertility treatment affordable, while delivering individualised and personalised care and always striving for higher success rates.