Hello everyone and welcome back! You know, it’s always nice to report positive news in our continuing battle with cancer. And, we have a bit more this month for which we can be thankful. Now, those of you who have taken The Course are aware of the problems that cancer treatments can pose for young women of child-bearing age. In Volume 2 we discuss the side effects that so commonly accompany surgery, radiation and chemotherapy — of which one of the most serious is sterility.
For a woman, sterility is defined as the inability to become pregnant and have children. When younger women are diagnosed with cancer this condition can result from several factors, the first of which is surgery. Clearly, any surgery that involves the removal or partial removal of a woman’s reproductive organs may leave her unable to conceive and become pregnant. Yet, other surgeries as well may result in the same inability. You see, every major surgery has a significant impact upon the entire body. Recovery requires a great amount of energy which forces the body’s immune system and restorative processes to work overtime. As a result, sometimes the body will shut down in one area to save energy for another. And, in times of crisis and stress a woman’s reproductive processes may be considered by her body to be non-essential. Accordingly, ovulation and menstruation may cease — either temporarily or permanently. When cessation is permanent, the condition is known as surgical menopause — a phenomenon I experienced personally as a result of my first cancer surgery.
The second factor we’ll discuss is radiation. Radiation is a powerful therapy that often destroys not only cancer cells, but healthy body cells as well. Of course, radiation to the abdominal area for cancers such as bladder, colon or kidney may “overshoot” and inadvertently strike a woman’s reproductive organs. Her fallopian tubes, ovaries and uterus may be “burned” by the radiation rendering them non-functioning. Indeed, even radiation that has no proximity to one’s reproductive organs may adversely affect a woman’s fertility.
And, the third factor is, of course, chemotherapy. Now, the possibility of reproductive damage from this therapy will depend primarily upon the type and strength of the anticancer drugs used in the treatment — or as we say — in one’s “chemo cocktail.” The risk of reproductive damage also may depend upon the woman’s age and her ovarian cycling at the time of chemotherapy.
The subject of infertility is one we discuss in detail in Volume 2. It is a complicated issue of which women (and men) should be aware before beginning any type of cancer treatment. When it comes to chemotherapy, however, and this significant side-effect, we have new information and new hope for preventing it!
According to the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting which was held in May , a federally funded clinical trial reported that the hormone suppressor goserelin — also known as Zoladex — helped preserve female fertility when combined with chemotherapy. This specific trial involved women who had been diagnosed with early stage breast cancer.
Now, goserelin is a luteinizing hormone-releasing hormone (LHRH) that temporarily shuts down ovarian function. Some of you may be familiar with the LHRHs because they are used widely to control ovulation during infertility procedures such as in vitro fertilization. The LHRHs essentially put a woman into a postmenopausal state. As a result of this ovarian shut down, it is believed goserelin — when administered with potentially damaging chemotherapy — protects the follicles from harm. Once the treatment is completed, the ovaries return to normal function.
Indeed, the women who received goserelin in this trial demonstrated they were more likely to experience successful pregnancies and deliver healthy babies than women who did not receive goserelin. Furthermore, those who received the hormone increased their odds for disease-free survival over a four year period.
For women of child-bearing age this is welcome news that holds great promise. Once again, we have another item to add to our Cancer Toolbox! Please read more at several online sources, including:
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