Coping With Emotions

When Cancer Treatment and Fertility Issues Collide, Emotions Run High

For patients who want to have children, the potential loss of fertility can be upsetting. Here's what you need to know about managing your emotions during this time.

Facing a cancer diagnosisis an overwhelming experience, and there are many decisions to make in those first few days. But there’s one aspect that’s often overlooked — cancer treatment and fertility.

For patients who want to have children, and even for those who may not, the potential loss of fertility can be upsetting. “It’s hard for a patient who’s often petrified to step back and think about preserving [his or her] fertility,” says Jess Keim Malpass, an assistant professor at the UVA School of Medicine and School of Nursing.

Here, Malpass offers tips on how to address questions about cancer treatment and fertility with your doctor and how to manage your emotions during this trying time.

Talk About Fertility Options Early

Timing is critical, Malpass says. That’s why it’s important to discuss cancer treatment and fertility at the same time that you’re discussing potential treatment options with your doctor.

“It wasn’t uncommon 10 or 15 years ago for a cancer survivor to find out about the impact of chemotherapy or radiation on fertility … after the fact. That’s a devastating experience,” she says. “We’ve found that when people didn’t know [that they may not be able to have children] until after treatment, it takes a lot of empowerment and decision-making away from them,” says Malpass.

Ask questions about how the proposed cancer treatment might affect your fertility and what your options are. How cancer affects your fertility depends on your age, current fertility status, cancer type and treatment plan. Ask your doctor which options are low-, medium- or high-risk for affecting your fertility.

Consult With an Oncofertility Specialist

Even if your proposed therapy is low-risk and may not affect your fertility, Malpass says that it’s still a good idea to speak with an oncofertility specialist. “This will help you make an informed choice about what you want to do before starting treatment,” she says. “Knowing is better than not knowing.” They can help you better understand your options and connect you to resources like grant programs that can help with the cost of fertility preservation.

Lean on Others

While you may feel alone in this process, family and friends can offer much-needed support. They can act as a sounding board, rally around you as you go through fertility treatment or simply lend a listening ear or a shoulder to cry on.

Online advocacy and support groups — such as Facebook groups and blog forums — can be a good resource for your questions and concerns. “Knowing there are these groups out there and that you’re not alone is really helpful,” says Malpass, in regards to managing the emotional ups and downs of dealing with the potential loss of fertility.

Seeking Counseling

A trained cancer therapist can also help you manage the swell of emotions and provide extra support as you navigate this trying time. Not only can she help you develop coping skills, she can also help if you’re experiencing symptoms of anxiety or depression. It may also be helpful to research the cost and processes for alternative family planning, such as speaking with adoption agencies and looking into surrogacy.

Whether you’ve always wanted to start a family or not, facing the potential loss of fertility can bring many different emotions to the surface. You don’t have to go through it alone. Reach out to your healthcare team, family, friends and support groups to help you get through this stage of your cancer journey.

If fertility issues trouble you during cancer treatment, make an appointment to meet with a fertility specialist at UVA.

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Christine Yu