There are nearly half a million cancer survivors of reproductive age in the U.S., and new research finds that very few of them are taking steps to make sure they will retain the option of having children before starting treatment.
The study -- which focuses specifically on young women -- also reveals sweeping racial, economic and demographic gaps in terms of which women have access to fertility preservation services, as well as who gets counseled about the possible long-term effects on fertility in the first place. (According to the National Cancer Institute, radiation therapy and chemotherapy agents can damage immature eggs, impact the body's hormonal balance or result in injuries to the reproductive organs.)
"Let's say you're diagnosed with breast cancer. Your doctor might say, 'The treatment might affect your fertility, but let's figure out how we're going to go ahead and save your life,'" said Dr. Mitchell Rosen, director of the University of California at San Francisco's Fertility Preservation Program and an author on the study.
"That brief sentence might be considered counseling -- and the depth of your counseling can have a real impact on your quality of life as a survivor," he added.
In the new study, published Monday in the journal Cancer, more than 1,400 women age 18 to 40 answered questions about their health and history. The women had several different types of cancer: leukemia, Hodgkin disease, non-Hodgkin lymphoma, breast cancer and gastrointestinal cancer.
Overall, 61 percent of respondents said their oncologists had counseled them on the possible risks that cancer treatments posed to their future fertility.
This, according to the researchers, represents an increase in the prevalence of counseling in the U.S. -- an increase that may be a result of American Society of Clinical Oncology [ASCO] recommendations that all women be offered reproductive counseling before beginning cancer therapy. Those guidelines were issued in 2006.
Nonetheless, the new research still uncovers significant gaps between those women who were told about possible infertility and those who weren't: Those who had gone to college were 20 percent more likely to be counseled than those who had not.