Younger people are increasingly diagnosed with cancer in recent years. Figures show that 8-10 per cent of cancer patients are below 40 years and 1 per cent is below 20. Cancer in this reproductive age group is a matter of great concern among doctors and patients alike.
Cancer and its treatments ? including surgery, chemotherapy and radiation therapy ? can adversely affect the patient's ability to conceive a baby. In surgical procedures, reproductive organs are removed when cancer is diagnosed in any part of the reproductive tract, thereby affecting fertility. Chemotherapy has a toxic effect on the oocyte (germ cell involved in reproduction). The extent of damage varies with the dose, the type of drugs used and the patient's age. The risk of infertility from radiation therapy varies with the radiation dose and the area of the body exposed to radiation.
In an attempt to address this double agony of cancer and infertility, doctors are increasingly scouting for fertility preservation techniques for women with cancer.
One of my young patients with ovarian cancer was devastated when she came to know that the treatment could adversely affect her fertility. Fortunately, however, the cancer was in an early stage and we were able to preserve her fertility through the use of conservative treatments (Unilateral Salpingo-Oophorectomy, Omentectomy, and preservation of uterus and opposite ovary). Today her cancer is under control and she is the proud mother of a healthy baby girl.
Unilateral Salpingo-Oophorectomy: Removal of only the fallopian tube and ovary on one side. The uterus and the fallopian tube and ovary on the other side are preserved.
Omentectomy: The partial or complete removal of the abdominal lining, which reduces the risk of cancer cells spreading from nearby organs to the stomach.
Conisation: This involves removing the lesion on the cervix in the form of a cone and testing the margins to confirm that the patient is disease-free. Hence, only the cells affected by the disease are removed.
Radical Trachelectomy: The parametria (tissue adjacent to the cervix) and vaginal cuff (the vagina end close to the cervix) are excised along with the cervix. This surgical procedure is generally accompanied by laproscopic pelvic lymphadenectomy. As the uterus is preserved along with the ovaries, this technique is considered conservative and found effective in ensuring conception and childbirth.
Conservative surgeries are recommended for patients who are young and in the early stage of the disease. Surgeries like conisation and radical trachelectomy are used for cervical cancer, while in endometrial cancer a high dose of hormone is used instead of surgically removing the uterus. For patients undergoing chemotherapy, low-risk drugs are used to help reduce toxicity in the oocyte.
Other methods of fertility preservation in cancer patients include Ovarian Tissue Cryo Preservation, where cortical strips from the ovary are removed laproscopically and cryo-preserved.
This tissue is later implanted in the pelvis to facilitate pregnancy. Cryo-preservation of embryos and oocytes in recent times have yielded satisfactory results.
Despite the progress achieved, preservation of fertility in cancer patients is still an emerging discipline; more awareness is required among oncologists, immunologists and endocrinologists to ensure that patients have the option of fertility preservation at the onset of treatment.
The author is a Senior Consultant, Gynae?Oncology, Action Cancer Hospital
See more here:
lf03 Fertility Cancer
Source: http://www.fertilityportal.com/fertility-female-reproduction/lf03-fertility-cancer.php
nfl schedule nfl scores nfl scores jesus montero hiroki kuroda kuroda pineda
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.