Cancer and Fertility

For young adults with cancer, facing decisions about treatments, including surgery, chemotherapy and radiation therapy can be overwhelming. Adding to that burden is the fact that the same treatments helping to extend survival may come with the trade-off of not being able to bear children in the future. This can occur for both men and women receiving cancer treatment.

For men, some treatments cause damage to the testes and/or interfere with sperm production. For women, some treatments can result in premature ovarian failure, early menopause, genetic damage to egg cells or difficulties maintaining a pregnancy. Not all cancer treatments will affect fertility and every person’s situation is different. Some of the factors include:

  • the type of cancer
  • which standard therapies are recommended
  • the location and stage of the cancer
  • the type and dose of chemotherapy
  • the dose and location of radiation therapy

Other factors depend on the person, such as fertility status before treatment, as well as age, since risk for infertility increases with age for both men and women.

Fertility issues can also arise for young patients who have not had a cancer diagnosis, but are at high risk based on a known hereditary cancer syndrome within the family, such as:

  • Hereditary Breast and Ovarian Cancer syndrome (related to BRCA1 and BRCA2 mutations)
  • Lynch syndrome (high risk for cancers of the reproductive organs)

Patients face options such as preventive removal of the ovaries and uterus before cancer develops.   Patients may also have the option of pre-implantation genetic diagnosis (PGD). PGD uses advanced reproductive technology and in-vitro fertilization to prevent passing a genetic risk factor on to future children.

For patients diagnosed with cancer, as well as patients considering preventive surgery, it is important to know there may be ways to preserve fertility. These options should be discussed with your doctors as early in your treatment planning as possible. The U-M Comprehensive Cancer Center Fertility Preservation Program is a resource for patients to learn more about these issues and options.

Continue learning about cancer and fertility preservation

Skin Cancer and Genetics: More Than Meets the Eye

Many factors can increase the risk of developing melanoma and other skin cancers.  Some of these factors are due to behaviors, like exposure to the sun.  However, some risk factors for skin cancer are inherited in families.

Melanoma is a type of skin cancer that affects about 59,000 people every year in the United States.  People who have a parent or sibling who has had melanoma are at about double the risk of the general population.  This is because family members may have similar histories of sun exposure and may share inherited physical features like fair skin or light hair.  In some families, there is an inherited risk for melanoma related to genes that are passed from parents to their children.

If you or a family member has had melanoma, it may be worth talking with your doctor about the rest of your family history.  Some clues to inherited risk include:

  • Individuals with more than one melanoma
  • Other cancers in family members including:
    • Pancreatic cancer
    • Head and neck cancer
    • Breast cancer
    • Ovarian cancer
    • Cancers diagnosed at earlier ages than typically expected

People who have a family history of multiple relatives with cancers could benefit from meeting with a genetic counselor to talk about possible genetic testing, personal cancer risk, and cancer screening options.

For people who have an increased risk of melanoma, there are important steps that can help to reduce the chance of developing melanoma.

Limit sun exposure

  • Find shade when possible
  • Avoid exposure between 10 a.m. and 4 p.m. when UV light is strongest
  • Wear protective clothing
  • Use sunscreen with SPF 15 or higher daily

Check your skin

  • Learn how to do a skin self-exam and check your skin once a month
  • Have regular skin exams by a doctor
  • Talk to your doctor if a mole or spot on the skin is changing in size, shape or color, or if it is persistently itching, bleeding, or growing

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Lynch Syndrome: The Genetic Side of Colorectal Cancer

Michigan Gov. Rick Snyder has designated March 22 Lynch Syndrome Awareness Day.

Her aunt died of colon cancer at age 72.  Her cousin died of colon cancer at age 49.  When her mother was diagnosed with colon cancer at age 70, three years after being treated for uterine cancer, Paula realized it was time to act.  She had her first colonoscopy at age 41.  While the colonoscopy was normal, her doctor recognized that the pattern of cancer in the family was concerning and suggested genetic counseling.  Genetic testing in Paula’s mother found a mutation in a gene called MSH6, confirming that their family has Lynch syndrome.

Lynch syndrome is an inherited condition caused by mutations in any one of 5 genes: MLH1, MSH2, MSH6, PMS2 and EPCAM/TACSTD1.  For people who have a mutation in one of these genes, the risk for certain cancers is increased.  Colorectal cancer is the main feature of Lynch syndrome. Other cancers that can be found in families with Lynch syndrome include:

  • uterine or endometrial
  • ovarian
  • stomach or small intestine
  • biliary tract
  • sebaceous skin tumors
  • urinary tract, such as kidney

Identifying families with Lynch syndrome allows us to intervene with screening and preventive options.  Colonoscopies every year beginning at age 20 can dramatically reduce the risk of colon cancer in people with Lynch syndrome. Continue reading