Teen cancer patients not told about fertility risks

The Teenage Cancer Trust (TCT) has recommended that the negative effect of cancer treatments on fertility needs to be better communicated to patients.

In response to a government green paper, the UK charity surveyed 242 cancer patients aged 16 to 24 about what they were told about the risk of losing their ability to have children, and whether they were informed of the options available for fertility preservation.

'We found that over a quarter (29 percent) of young people who were treated for cancer did not have a conversation about fertility with a health professional, while 44 percent of young people were not satisfied with the information they were given,' said Dr Louise Soanes, director of services at the trust. 

'This is not acceptable and that's why we're calling for every young person with cancer to have their fertility options explained to them by a health professional,' she said.

Cancer treatments can impact fertility in multiple ways: chemotherapy can affect hormone production, radiation can damage the womb lining, and cell damage can result in a reduction in quality and quantity of sperm produced.

The TCT estimates that 15 percent of young people with cancer have a high risk of future fertility problems as a result of their treatment and is calling for egg and sperm cryopreservation to be fully funded by the NHS, as well as programmes such as ovarian tissue freezing for pre-pubescent girls, who are not yet producing mature oocytes (see BioNews 983). 

The TCT is also urging the UK Department of Health and Social Care to research why geographical inequalities exist in cancer care. NICE guidance stipulates that all patients should have the opportunity to discuss the impact of cancer treatments on their fertility when they are diagnosed and have fair access to fertility services. 

However, access to fertility preservation services is determined by a patient's local Clinical Commissioning Group (CCG), and so in practice, access is currently dependent upon where patients live.

Approximately 1600 new cases of cancer are diagnosed in children under the age of 15 every year. There has also been a rise in cancer diagnoses among 13 to 24-year-olds from 233 to 299 per million (28 percent) since 2001.

'Teenagers and young adults who have lived through cancer have had so much taken away from them already,' said Dr Soanes. 'They should not lose the ability to start a family of their own too.'