Being diagnosed with cancer can be devastating in itself, but the knowledge that cancer can also have adverse effects on a person’s ability to bear children, may make it even more difficult to handle. There is a strong link between cancer and fertility; unfortunately infertility is one of the side-effects of certain types of cancer.
Not every type of cancer leads to infertility, and though fighting cancer is paramount, it is also essential to know about circumstances that may affect fertility. This is more so for people who wish to have children in future. Understanding the effect of cancer on fertility would allow them to explore the many options available today to preserve fertility before treatment begins.
More than cancer itself, it is mostly its treatment which is responsible for causing infertility.
Cancer may or may not affect sperm quantity and quality, but its treatment including chemotherapy, radiation, surgery or hormonal therapy definitely affects male fertility in some way. While some affect sperm production, others affect erection and/or ejaculation.
Chemotherapy, for example, can slow down (sometimes even stop) sperm production and lower sperm motility. Whether the effect is temporary or permanent depends upon the type of chemotherapy drug and the dose. Sometimes even if effects are temporary, it could take almost two years for sperm production or fertility to get back to normal.
Some types of cancer need radiation therapy but this could affect sperm production and testosterone levels. Reduction in testosterone levels can kill sex drive and the person can experience difficulty in getting an erection. Fertility can be hampered especially when radiation is given close to the pelvic area, testicles, or pituitary gland. The pituitary gland controls all the endocrine glands andis responsible for all hormone production, and radiation to this part can inhibit normal hormone production.
The dose of radiation again determines the effect of radiation on fertility. Certain cancers, like leukemia| or lymphoma involve total body radiation. This normally causes permanent infertility.
Prostate cancer (also breast cancer in men) may sometimes be treated with the help of hormonal therapy. This therapy can limit sex drive and cause erection problems. This effect is usually temporary.
Cancer surgeries which affect fertility include testicular cancer surgery. Though it’s rare to remove both testicles, sometimes it is necessary to do so and this could lead to perpetual infertility. Even if only one testicle is removed, sometimes not enough testosterone is produced in the other testicle, thereby affecting fertility.
Another surgery called retroperitoneal lymph node dissection, which too is sometimes used to treat testicular cancer can cause a disorder called retrograde ejaculation. When this happens, the semen instead of ejaculating out of the penis retreats backwards towards the bladder.
In women suffering from cancer, fertility may be affected if treatment, surgery, chemotherapy and/or radiation are targeted at the reproductive organs or the abdomen.
Breast cancer is the most common type of cancer in women and it can also occur in women who are still in their childbearing years. Though it is difficult to ascertain how and how much, breast cancer treatment will affect fertility, usually women over 40 are most likely to be affected.
Although many a times the breast is removed, chemotherapy will still be required to kill cancerous cells, and it is this chemotherapy that does the most damage.
Chemotherapy may affect the reproductive system in many ways. It can temporarily or permanently influence menstrual cycle; it can hinder production of estrogen resulting in irregular ovulation cycles;it can decrease number of eggs or destroy the eggs or it can even lead to premature menopause.
The effects of chemotherapy or radiation on the reproductive organs depend upon a person’s age, the dose and type of medicines.
Some chemotherapy medicines are more dangerous than others. Alkylating agents are considered to be the worst.Chemotherapy drugs like cyclophosphamide, cholarambucil, melphalan and busulfan, for instance, which are used to treat certain types of cancer, pose high risk to the ovaries.
Radiation can be harmful depending upon the area of radiation. If it is directed at the pelvic area, it could damage reproductive organs like the ovaries or uterus, but chest radiation may not do much harm. However, radiation to the pituitary gland can lead to infertility.
Surgery resulting in removal of reproductive parts naturally affects fertility. For instance, if diagnosed with endometrial cancer or cervical cancer, surgery to remove the uterus, fallopian tubes or ovariesmay become mandatory, thereby leading to permanent infertility. Even bone marrow and stem cell transplants can damage the ovaries and uterus, mainly because of the combined effects of radiation and chemotherapy involved in these transplants.
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