Current Practice Patterns Surrounding Fertility Concerns in Stage I Seminoma Patients: Survey of United States Radiation Oncologists (original) (raw)
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ecancermedicalscience
With reduced cancer mortality in recent years, increased efforts must be put into safeguarding cancer survivors' long-term quality of life (QOL). Fertility preservation is recognised as a key component of QOL in survivorship. Concerns about fertility have been seen to significantly impact cancer patients' emotional and mental health as, generally, both malignancy and its treatment may cause a temporary or permanent reduction in infertility. This article reviews the primary effects of radiation therapy on male and female gonads and has further highlighted procedures through which the functioning of these organs can be protected before or during radiation treatment. We have also emphasised the importance of the establishment of multidisciplinary tumour boards and patient education regarding future reproductive function which is an important component of the care of individuals with cancer. This article highlights that infertility is a persistent and major concern that can add to long-term stress in cancer survivors, and education about fertility preservation before the initiation of any treatment is especially important.
Fertility of testicular cancer patients after anticancer treatment – experience of 11 years
Pharmazie
Testicular cancer affects men mostly in their reproductive age with a cure rate over 90%. Preserved fertility is one of the main concerns of the survivors. To further elucidate the question of fertility after anticancer treatment for testicular cancer, we performed a survey among patients who underwent sperm cryopreservation procedure in our department. A structured questionnaire was designed to collect data on demography, anticancer treatment, histological type of cancer, family planning intentions and fertility prior to and after treatment. During a period of 11 years 86 men underwent semen cryopreservation before starting chemoor radiotherapy. Fifty-nine of them consented to participate in the study. The average length of follow up was 4.6 ± 3.8 years. In case of 11.9% of the patients their banked sperm was used, which led to live birth in 57% of the couples. The partners of 6 patients became pregnant after in vitro fertilization (IVF) resulting in 4 live births and 2 miscarriage...
BJU international, 2018
To determine the impact of testicular cancer and its treatments on fertility and to review the current management options for the infertile, testicular cancer patient, both before diagnosis and after treatment, with the aim to provide practical recommendations to update contemporary guidelines and standardise clinical practice. Searches for relevant articles on Pubmed and Google Scholar between 2000-2017, with additional articles sourced from reference lists of included publications. At time of diagnosis, 6%- 24% of testicular cancer patients are azoospermic and 50% are oligozoospermic. Without conducting semen analysis at diagnosis, these patients cannot be identified and may be at further risk of subfertility. Gonadotoxic therapies cause an overall decrease in male fertility by 30% and there is currently no method to predict which patients will become azoospermic after treatment. However, patients with larger, more invasive tumours are at greater risk of infertility from local tum...
Contemporary Management of Stage I Testicular Seminoma: A Survey of Canadian Radiation Oncologists
Current Oncology, 2008
Recently published studies clearly indicate that there are now several acceptable options for managing stage I testicular seminoma patients after orchiectomy. We therefore decided to survey Canadian radiation oncologists to determine how they currently manage such patients and to compare the results with previous surveys. Our results demonstrate that adjuvant single-agent chemotherapy is being considered as an option by an increasing proportion of radiation oncologists (although it is not considered the preferred option), the routine use of radiotherapy is declining, and surveillance is becoming increasingly popular and is recommended most often.
Fertility after testicular cancer treatments
Cancer, 2004
BACKGROUND. Patients with testicular cancer have an excellent survival rate, and fertility is one of the main concerns of survivors. The authors investigated fertility status after treatment for testis cancer in long-term survivors.
Fertility preservation in patients receiving chemotherapy or radiotherapy
Missouri medicine
The preservation and restoration of fertility are key aspects for enhancing quality of life in cancer survivors. Cytotoxic agents and radiation can produce gonadal dysfunction in both men and women. Survival rates for cancers that occur before or during reproductive age have improved dramatically. Current fertility preservation options are available but limited in males and females. Referral to a reproductive endocrinologist around the time of diagnosis is important to optimize treatment options.
“Reemphasizing the Significance of Fertility Preservation in Cancer Patients Needing Chemotherapy and/or Radiotherapy - A Case Report"., 2024
Introduction With the greater advancements in field of survivors treatment, the survival rates have escalated remarkably, thus the need arising for the fertility preservation in the survivors with regards to oocyte/embryo/ovarian tissue/Cortical tissue/testicular tissue transplantation/sperm cryopreservation has assumed great importance particularly for those receiving chemotherapy that too with alkylating agents. Earlier we have extensively detailed however still we come across akin patients who never received any counselling keeping longterm fertility in mind. The case report we present here highlights this issue. Here we present a case report of how a couple presented With a previous child having diagnosis of type II Arnold Chiari malformations. Later husband gave history of certain axillary mass which was surgically removed in addition to got chemotherapyx 6 cycles and radiotherapy for4 cycles although the nature of chemotherapy was not known he later told diagnosis was non Hodgkin’s lymphoma. Despite his semen parameters were normal 10 years subsequent to chemotherapy and radiotherapy couple was not willing to go for Intracytoplasmic sperm injection (ICSI) with blastocyst transfer subsequent to preimplantation embryo genetic testing (PGT) for aneuploidy (PGT-A), and particular congenital abnormalities. Thereby here we re emphasize the role of counselling for sperm cryopreservationor testicular tissue preservation as per age prior to administration of chemotherapy and radiotherapy for cancer treatment
Journal of andrology
The treatment of seminoma with radiation therapy risks transient infertility. We have prospectively followed eight patients with stage I seminoma of the testicle. All patients underwent radical orchiectomy of the affected testis. The mean age of the patients was 32.9 years (range 24-40). Each patient was treated with megavoltage radiation with a 10- or 18-MV linear accelerator. The remaining testicle was shielded using a standard lead enclosure, and the mean testicular dose was 44 cGy (range 20.8-78.2). Semen specimens were delivered to the lab within 30 minutes of ejaculation. All specimens were analyzed using a computer-assisted sperm analyzer. Pretreatment parameters were within normal limits for all but one patient; one patient presented with a borderline normal sperm count at 18 and 22 x 10(6)/ml. Following treatment, there was a decrease in sperm count, detected at 3 months, to < 10 x 10(6)/ml (range 4.4- 8.6 x 10(6)) in all patients except one, who presented with an initia...
Fertility among testicular cancer survivors: a case-control study in the U.S
Journal of Cancer Survivorship, 2010
Introduction-Testicular germ cell tumors (TGCT) disproportionately affect men between the ages of 15 and 49 years, when reproduction is typical. Although TGCT treatment directly affects gonadal tissues, it remains unclear whether there are long-term effects on fertility. Methods-To examine post-TGCT treatment fertility, study participants in a previously conducted case-control study were contacted. The men were initially enrolled in the US Servicemen's Testicular Tumor Environmental and Endocrine Determinants (STEED) study between 2002 and 2005. A total of 246 TGCT cases and 236 controls participated in the current study and completed a self-administered questionnaire in 2008-2009. Results-TGCT cases were significantly more likely than controls to experience fertility distress (OR 5.23; 95% CI 1.99-13.76) and difficulty in fathering children (OR 6.41; 2.72-15.13). Cases were also more likely to be tested for infertility (OR 3.65; 95% CI 1.55-8.59). Cases, however, did not differ from controls in actually fathering children (OR 1.37; 95% CI 0.88-2.15). These findings were predominantly observed among nonseminoma cases and cases treated with surgery only or surgery-plus-chemotherapy. Discussion-While expressing greater fertility distress, higher likelihood of fertility testing, and difficulty fathering children, these data suggest that TGCT survivors are no less likely to father children than are other men. It is possible that treatment for TGCT does not permanently affect