Approximately 10 percent of people diagnosed with cancer each year in the United States — some 126,000 patients — are between the ages of 20 and 44. Many of them will want to have children in the future, but some cancer treatments
may jeopardize their plans.
For example, surgical procedures may require the removal of reproductive organs or alter their structure and function. Chemotherapy can destroy eggs or sperm, as can radiation therapy delivered to the pelvis. Surgery or radiation therapy involving the brain may disrupt hormone function, interfering with egg maturation during a woman’s menstrual cycle or with a man’s sperm production.
According to clinical nurse specialist Joanne Frankel Kelvin, leader of Memorial Sloan-Kettering’s new program Fertility Preservation and Parenthood After Cancer Treatment, multiple studies show that many cancer patients feel they are not adequately informed that their treatments may put them at risk for infertility, or that there are options to preserve fertility before treatment by banking sperm or having eggs or embryos frozen for later use. Additionally, Ms. Kelvin says, clinicians report that a lack of knowledge about these options, inadequate resources to educate patients, and not knowing where to refer are significant barriers to discussing fertility issues with their patients.
To address these matters, Memorial Sloan-Kettering established the fertility preservation program within the Center’s Cancer Survivorship Initiative. Launched in June 2009, the program has two goals. The first is to provide information and resources to clinicians to help them initiate discussions with patients about fertility preservation. The expectation is that this will fulfill the second goal: to ensure patients receive information early enough to allow them time to explore the options if they wish.
The program consists of a number of components, including research and administrative initiatives. The first is resources for patients, including a new fertility-oriented Web site and printed educational materials for clinicians to offer patients. In March 2010, the program piloted twice-monthly information classes for breast cancer patients at the Evelyn H. Lauder Breast Center on East 66th Street. Ms. Kelvin also plans to begin offering the classes online in the summer of 2010.
The second component involves providing resources for clinicians. An internal Web site provides information for making referrals to fertility experts, applications for financial assistance from the nonprofit organization Fertile Hope and articles on fertility preservation and cancer.
The third component relates to continuing education for clinicians. In addition to in-house presentations to nurses, social workers, and physicians at Memorial Sloan-Kettering, the program will hold a daylong conference on October 8, open to oncology physicians, nurses, and social workers in the tri-state area.
Finally, Ms. Kelvin is available to consult with clinicians and provide education and counseling directly to patients. She also serves as a liaison to reproductive centers in the New York area so referrals to these specialists can be expedited, preventing or minimizing treatment delays. “Clinicians throughout the Center have been extremely supportive of this new program,” she said. “We hope to make it easier for them to discuss these issues with their patients so that more patients will be informed and referred for fertility preservation if they are interested.”