Fertility in Women with Mesothelioma
Mesothelioma is a heavy burden, but losing your dream of having children to this terrible cancer adds even more weight. While many people diagnosed with mesothelioma are older men, women are not immune to this type of cancer. In fact, young women have been diagnosed with peritoneal mesothelioma, a type more common in women than in men.
Cancer can threaten fertility several ways and can leave a woman infertile. It may be the cancer, the metastatic tumors, the treatments, or a combination of all of these that limit fertility. Any woman diagnosed with cancer should talk to her medical team about her fertility and how to ensure she can still have children if she wants to.
Infertility in Women
Infertility means not being able to conceive a child. Both men and women can be infertile temporarily or permanently. Fertility may be limited, making conception challenging, but not impossible, or a person may become completely infertile, making pregnancy impossible. A woman may become infertile several ways: her ovaries do not produce mature, viable eggs; her eggs cannot be fertilized because of some damage to the reproductive organs; or her eggs may become fertilized, but will not implant inside the uterus.
How Cancer Can Cause Infertility
Cancer treatment, rather than cancer itself, is the likliest threat to a woman’s fertility. But some cancers impact fertility directly, regardless of treatments. For example, cancers of the reproductive organs may affect fertility, as may metastatic tumors in these organs that originated as mesothelioma. Tumors affecting the glands producing fertility hormones may also cause infertility in women.
Chemotherapy and Fertility
Most people with mesothelioma will undergo chemotherapy. It is the most common treatment for most cancers and is often very effective at shrinking tumors. Chemotherapy drugs kill fast-growing cells, including cancer cells. Certain chemotherapy drugs are more likely than others to destroy eggs in a woman’s ovaries: busulfan, carboplatin, carmustine, chlorambucil, cisplatin, cyclophosphamide, dacarbazine, doxorubicin, ifosfamide, lomustine, mechlorethamine, melphalan, procarbazine, and temozolomide.
A woman only has a fixed number of eggs and when they are destroyed, they cannot be recreated. Not all women will become infertile because of these chemotherapy drugs, but the risks are high. Other chemotherapy drugs carry a much lower risk of infertility. Chemotherapy-caused fertility is more likely in women treated over the age of 35. For younger women who are not infertile after chemotherapy, fertility may not last as long as normal.
Surgery and Fertility
Surgical treatment for mesothelioma is only likely to put fertility at risk if it is done near the reproductive organs. Certain types of cancer, such as uterine or ovarian cancer, may require the removal of these organs, which leads to infertility. Any surgery in the abdomen has the potential to cause damage to reproductive organs. This could include surgery to remove abdominal tumors in women with peritoneal mesothelioma.
Radiation and Fertility
Radiation may also be a fertility concern. This treatment aims a beam of high energy radiation at tumors to kill cancer cells. While carefully targeted, this radiation can nevertheless hit and damage other organs. When the targeted tumors are in the abdomen, near the reproductive organs fertility may be affected. Radiation for peritoneal tumors may damage organs, limiting fertility. Radiation on metastatic brain tumors can also affect fertility if it damages the pituitary gland, which makes some of the hormones involved in conception.
Peritoneal mesothelioma is the type most likely to affect fertility in women, since it affects the lining of the abdominal organs. Women of child-bearing age have been diagnosed with peritoneal mesothelioma, and since the cancer occurs in the same part of the body as reproductive organs, fertility is a significant concern. Yet one group of researchers found it was possible to preserve fertility in young women undergoing surgery and heated intraperitoneal chemotherapy (HIPEC) for peritoneal mesothelioma.
Surgeons removed as much of the tumors as possible, then HIPEC was used to inject heated chemotherapy drugs directly into the abdominal cavity. Seven out of seven women studied conceived and gave birth within two years of such treatments, a hopeful outcome for other women diagnosed with peritoneal mesothelioma.
Speak up about Fertility, Before Treatment
According to research, women are less likely than men to know infertility risks when in cancer treatment. So women must speak up and ask for information about how the cancer and its treatments may affect fertility. They should also ask what can be done to preserve fertility before going ahead with treatments. Young women living with mesothelioma are not common, but they do exist and they may want to have children if they can beat their cancer. If this sounds like you, speak up and ask for help. Don’t wait for information that may not come until it’s too late.
Steps can be taken to ensure a woman will be able to have a baby after undergoing mesothelioma treatment. Mature, viable eggs can be harvested from her ovaries before a woman starts cancer treatment. The eggs can be frozen indefinitely and fertilized later. Embryos can be implanted into the woman’s uterus or in the uterus of a surrogate if the mother can’t carry a child to term.
Fertility is an important health issue for women. While few women of child-bearing age are diagnosed with mesothelioma, some face this and other cancers that could prevent them from having children. From the tumors to the treatments, cancer impacts fertility in several ways. If you have mesothelioma and you want the option of having children, talk to your doctor and oncologist and find out what your risks and options are for preserving fertility.
Page edited by Dave Foster
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