Cancer & Fertility

We are fortunate to live in an era where cancer survival rates are upwards of 75% for young men and we can begin to think about long-term quality of life issues for cancer survivors such as fertility and management of ongoing stress and fatigue. This article focuses on the impact of cancer on fertility, the toxicity of various cancer treatments and options for fertility preservation.

According to the American Cancer Society, there are about 50,000 new cancer cases reported in the United States each year for men under age 45. The most common forms of cancer diagnosed in young men include testicular cancer, brain cancers, leukaemia, and lymphomas. Fortunately, about 80% of these men and boys will go on to live full and healthy lives. While most of the impact of cancer on fertility comes from the cancer treatment, rather than the cancer itself. Certain cancers, such as testicular and brain cancer can have a direct impact on sperm production.

Checking yourself for cancer

The biggest indicator for surviving cancer is early detection. While much media attention has been paid to build awareness around self-exams for breast cancer, there has been very little awareness built about the signs and symptoms of other forms of cancer.

Testicular cancer: Though it only impacts 1 out of every 270, testicular cancer is the most common form of cancer diagnosed in young men. A monthly testicle exam enables not only early detection of testicular cancer but can help men become aware of other conditions that may impact their fertility such as varicoceles, testicular atrophy (shrinkage) or infections. Learn what to look for in a monthly self-exam.

Brain cancer: Brain tumors can be both cancerous or benign. In either case, they can impact a man’s hormones and other functions. Malignant brain cancer is much more dangerous and warning signs should be brought to a physician’s attention. Things to watch for include recurring headaches that won’t go away, dizziness, blurred vision (without the aid of alcohol), changes in speech, hearing or vision.

Skin cancer: Occupations that involve a large amount of exposure to sunlight – construction, lifeguards, etc – are at higher risk for developing skin cancer. The Skin Cancer Foundation reports that 90% of skin cancer cases are due to UV light exposure. Screening yourself for skin cancer involves a thorough examination of the skin looking for:

  • A skin growth that increases in size and appears pearly, translucent, tan, brown, black, or multicolored
  • A mole, birthmark, beauty mark, or any brown spot that: changes color, increases in size or thickness, changes in texture, is irregular in outline, is bigger than 6mm or 1/4″, the size of a pencil eraser or appears after age 21
  • A spot or sore that continues to itch, hurt, crust, scab, erode, or bleed

    An open sore that does not heal within three weeks

How cancer impacts fertility

Testicular cancer: This is the most prevalent form of cancer to impact young men. Commonly diagnosed between 15-30 years of age, testicular cancer can have a dramatic impact on fertility. The incidence of testicular cancer tends to coincide with the onset of puberty. Because the cancer develops in the sensitive sperm producing tissues of the testicle, it can hinder sperm production. Additionally, the most common form of treatment for testicular cancer is to remove the testis, and in some cases both testis from the body.

Brain cancer: Depending on the location of the tumor, brain cancer can directly impact fertility by changing the amount of hormones produced by the pituitary gland. Tumors on or near the pituitary gland can inhibit the production of FSH or LS which support the creation of sperm or the impacting testosterone levels which inhibits sperm’s ability to mature.

Cancer Treatments

Most of the damage to fertility during a battle with cancer is not caused by the cancer itself, but rather by the treatments that are used to kill the cancer. Cancer has a lot in common with the germ cells that divide to create sperm. Because of this, it has been difficult to develop treatment options that don’t impact fertility. This said, medicine is continuing to advance and cancer treatment continues to be at the forefront of medical research. Newer treatment regimens have been found to be less toxic to the reproductive system while providing equal or better rates for curing cancer. It is important to speak with your oncologist about

Chemotherapy:

Radiation:

Fertility Preservation

If you have been diagnosed with cancer, it is a good idea to look into the options for freezing some sperm prior to treatment. Cryopreservation (freezing sperm) has been around since 1949 when Christopher Polge discovered that adding glycerol to animal semen protected the cells and enabled them to be used for insemination after being frozen and thawed. Since then, scientists have been working to perfect techniques to preserve various tissues by freezing them at incredibly low temperatures. Learn more about cryopreservation and your options.