Page 9 - FSANZ Update Spring 2022

New focus on fertility in cancer treatment
Australian guidelines on fertility preservation for patients with cancer include new information for young people facing treatment that may impact on their chances of parenthood.
Thousands of Australian children, adolescents and young adults are diagnosed with cancer each year.
The good news is that survival rates from cancer treatment have increased significantly over the past decade. But the downside is that cancer diagnosis and treatment – such as radiation, chemotherapy or surgery – may result in loss of reproductive function.
Associate Professor Kate Stern, head of the fertility preservation program at the Royal Women’s Hospital in Melbourne, said as cancer survival rates continued to improve there was an increasing expectation among patients and clinicians to preserve fertility whenever possible.
The new guidelines – www.cancer.org.au/clinicalguidelines/ cancer-fertility-preservation – have been produced by the Clinical Oncology Society of Australia in collaboration with FSANZ and Canteen, the not-forprofit organisation that provides tailored support for young people with cancer.
For the first time they include information on fertility preservation for children including pre-pubertal ovarian tissue freezing for girls and testicular tissue biopsy for boys.
“Ovarian tissue cryopreservation for later transplantation should be considered for pre-pubertal girls and young women at severe risk of premature ovarian insufficiency resulting from cancer treatments,” Associate Professor Stern said.
“This is still experimental, and research is continuing, but we do expect future success of this treatment.
“Extraction and use of stem cells from testicular tissue biopsies from pre-pubertal boys is still experimental, but health
Violet Kieu
professionals should consider discussing this option with boys facing cancer treatment and their families.”
The guidelines on fertility preservation for cancer patients and health professionals includes information on a range of treatment options, referral pathways and psychological support.
They also cover issues such as contraception during and after cancer treatment, interrupting hormone treatment to conceive, assisted reproduction and the risk of cancer recurrence.
Associate Professor Stern said loss of reproductive capacity was one of the most distressing consequences of successful cancer treatment.
Meanwhile, a new Victorian Public Fertility Program will include support for fertility preservation, as well as a public egg and sperm bank. An education campaign was also launched in late September to raise public awareness about onco-fertility issues and fertility preservation options.
Western and Central Melbourne Integrated Cancer Service has produced and funded patient education videos – www.fertilityaftercancer.org – co-created with fertility experts from the Royal Women’s and Royal Children’s hospitals, as well as onco-fertility clinicians and patients.
Dr Violet Kieu, fertility specialist at the Royal Women’s Hospital, said: “I’m really excited about the new Fertility After Cancer campaign. It is timely and responds directly to the updated Australian guidelines on fertility preservation for patients with cancer.”
https: //www.mja.com.au/journal/2022/217/11/australianfer tility preservation-guidelines-people-cancer-2022-review-and
https: //theconversation.com/starting-cancer-treatment-you should-discuss-fertility-first-190531
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