Asian woman with a headscarf sits laughing with her legs bent in a living room. Lettering: "desire to have children and cancer", "medimentum".

Desire to have Children and Cancer

Can­cer the­ra­pies can limit fer­ti­li­ty. This app­lies to all gen­ders. In this post, we exp­lain the woman’s per­spec­ti­ve and why it is very important to take fer­ti­li­ty pre­ser­va­ti­on mea­su­res befo­re can­cer tre­at­ment. If the­re is a desi­re to have child­ren, it should be con­si­de­red that can­cer the­ra­py can have an impact on fami­ly planning.

Thanks to medi­cal advan­ces, modern can­cer tre­at­ment opti­ons are now avail­ab­le that signi­fi­cant­ly impro­ve the long-term out­co­mes of can­cer pati­ents. This also rai­ses ques­ti­ons about the desi­re to have child­ren. About 10 per­cent of women with can­cer are under the age of 40. So, medi­cal­ly, they are of child­bea­ring age. Howe­ver, many can­cer the­ra­pies are asso­cia­ted with a direct or indi­rect reduc­tion in or even loss of fer­ti­li­ty. The latest deve­lo­p­ments in the field of repro­duc­ti­ve medi­ci­ne enab­le effec­ti­ve, fer­ti­li­ty-pre­ser­ving mea­su­res in the con­text of can­cer therapy.

Important facts

Immedia­te­ly after the dia­gno­sis, young can­cer pati­ents are often con­fron­ted with the ques­ti­on of whe­ther they want to start a fami­ly or have more child­ren. This is becau­se the tre­at­ment that hel­ps you beat can­cer may also affect your abi­li­ty to repro­du­ce. This leads to a situa­ti­on in which time is of the essence. The­re­fo­re, it is important to deal with the sub­ject of the desi­re to have child­ren befo­re star­ting therapy.

Can­cer cells divi­de uncon­troll­ab­ly and grow bey­ond the natu­ral bounda­ries of the organ. Sub­se­quent­ly, many indi­vi­du­al cells tog­e­ther form what is known as a tumor, which can also be refer­red to as a tumour. A woman’s fer­ti­li­ty can be affec­ted for a varie­ty of rea­sons. On the one hand, tumors can affect the sex organs direct­ly (e.g. in ute­ri­ne or ova­ri­an can­cer). On the other hand, the cor­re­spon­ding the­ra­py can have a nega­ti­ve effect on fer­ti­li­ty. Not only the che­mo­the­ra­py, but also the ope­ra­ti­on or any radia­ti­on or hor­mo­ne the­ra­pies can cau­se direct (e.g. dama­ge to egg cells) and indi­rect effects such as phy­si­cal weak­ness (fati­gue). Psy­cho­lo­gi­cal fac­tors also play a spe­cial role in dealing with a can­cer diagnosis.

Influence of cancer therapy on family planning

What are the effects of can­cer tre­at­ments, such as sur­ge­ry, radia­ti­on or che­mo­the­ra­py, on fer­ti­li­ty? In par­ti­cu­lar, ope­ra­ti­ons on the fema­le repro­duc­ti­ve organs (womb, cer­vix or ova­ries) can impair a woman’s fer­ti­li­ty and, in the worst case, also mean that pregnan­cy can no lon­ger occur. The influ­ence depends on the can­cer and the requi­red the­ra­py. In princip­le, ope­ra­ti­ons in the abdo­men and pel­vis that do not direct­ly affect the fema­le geni­tal organs can also have a nega­ti­ve impact on repro­duc­ti­ve capa­ci­ty. In women, for examp­le, scar­ring and adhe­si­ons can pre­vent pregnan­cy and lead to pre­ma­tu­re birth or miscarriage.

The drugs used in che­mo­the­ra­py, so-cal­led cyto­sta­tics, inter­vene more or less direct­ly in cell divi­si­on. Sin­ce the cyto­sta­tics do not dis­tin­guish bet­ween healt­hy and affec­ted cells, not only the can­cer cells are des­troy­ed, but also inta­ct cells. For examp­le, the ova­ries can be affec­ted. The drugs have dif­fe­rent effects on fer­ti­li­ty. In addi­ti­on to the sub­s­tance, the dose is also decisi­ve for the effect on fer­ti­li­ty. The bio­lo­gi­cal fac­tor of age also plays a role: the older a woman is, the more likely it is that she will beco­me infer­ti­le as a result of the treatment.

Preservation of fertility in the case of cancer

Until a few years ago, the­re were almost no fer­ti­li­ty-pre­ser­ving opti­ons for women. Mean­while — due to rapid pro­gress in repro­duc­ti­ve medi­ci­ne — the­re are ways to ful­fill the desi­re to have child­ren des­pi­te can­cer. For­tu­n­a­te­ly for women up to the age of 40 the­re are dif­fe­rent opti­ons depen­ding on the begin­ning and type of can­cer tre­at­ment for the pati­ent. For examp­le, fer­ti­li­zed egg cells or remo­ved ova­ri­an tis­sue can be fro­zen and thus pre­ser­ved. If the con­di­ti­ons are right, several fer­ti­li­ty-pre­ser­ving mea­su­res can even be car­ri­ed out to incre­a­se the chan­ce of having a child. In addi­ti­on, sup­por­ti­ve mea­su­res such as nut­ri­ti­on should also be taken into account.

Nutrition and Fertility

In gene­ral, can­cer pati­ents do not requi­re a spe­cial diet. The­re are indi­ca­ti­ons of unfa­vor­able influ­en­ces from nut­ri­ti­on, e.g. exces­si­ve con­sump­ti­on of refi­ned sugar and fat, which can play a role in the deve­lo­p­ment of can­cer. Howe­ver, the­re is no clear stu­dy on this yet. In princip­le, howe­ver, affec­ted women should pay atten­ti­on to their diet. For examp­le, con­si­de­ring the fol­lowing five points:

  1. Plea­su­re & time — You should take enough time to eat in a com­for­ta­ble atmo­s­phe­re. Spi­ces and fla­vors should also be expe­ri­en­ced consciously.
  1. Alco­hol and Nico­ti­ne — Alco­hol should be con­su­med in mode­ra­ti­on at most. Nico­ti­ne should be avoided entirely.
  2. Weight — Over­weight and under­weight should be avoided.
  3. Ser­ving Size — If you are of nor­mal weight or tend to be over­weight, you should eat 3 main meals with no snacks in bet­ween. If you are losing weight, snacking bet­ween meals can be useful.
  4. Food pyra­mid — The food pyra­mid from the Federal Cen­ter for Nut­ri­ti­on offers a use­ful orientation.

Conclusion

The dia­gno­sis »can­cer« is always an extre­me situa­ti­on for tho­se affec­ted and their rela­ti­ves. This leads to count­less ques­ti­ons for tho­se affec­ted about pro­gno­sis, dia­gnostics, the­ra­py and after­ca­re. The­re are also many ques­ti­ons on the usual­ly taboo sub­ject of wan­ting to have child­ren with can­cer, but too litt­le time is often given to them in ever­y­day cli­ni­cal prac­ti­ce. In the mean­ti­me, the­re is expe­ri­ence on the sub­ject of the desi­re to have child­ren for almost all types of gyne­co­lo­gi­cal can­cer. Nevertheless, the data situa­ti­on is very limi­ted, sin­ce the dise­a­ses are very rare and the cases are usual­ly very com­plex. You need indi­vi­du­al advice. The­re­fo­re, the­re is still a gre­at need for research.

Sources

Federal Cen­ter for Nut­ri­ti­on
bzfe.de

krebsgesellschaft.de
https://www.krebsgesellschaft.de/

Dr. med. Andre­as Jant­ke
KINDERWUNSCHÄRZTE BERLIN

Gyne­co­lo­gy Cli­nic and Poly­cli­nic
Uni­ver­si­ty Hos­pi­tal Hamburg-Eppendorf

Health City Ber­lin
https://www.gesundheitsstadt-berlin.de/

Deut­sche Krebs­hil­fe e.V.

Fer­ti­pro­tekt
http://www.fertiprotekt.de

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