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Husband in need of advice

Scott962
Posts: 1
Joined: Feb 2014

My wife was diagnosed with breat cancer about a year and a half ago. She was 28, almost 29 at the time, and we were trying to start our family. Since she was young the oncologist we were referred to wanted an agressive treatment and she started chemo one week later. When we first met with him to discuss the treatment plan, we were told that the chemo would effect her cycle, but everything would go back to normal. After her first chemo cycle, we found out from the oncologist that there was actually a 50/50 chance her fertility could be affected, but not once did the discussion ever move to perserving any of her eggs in case she couldn't have childern down the road. Also we were told it would she would need to be on the Tamoxifen 2-3 years before we could have the conversation about trying to have kids again. After chemo and radiation, that became 3-5 years, and recently the same oncologist just told her it would be 7-8 years!

My wife has wanted nothing more than to be a mother, and hearing all of this has made her depressed. Like me, she is to proud to seek advice or a support group, but one of us needs to reach out and ask for advice from those who have been where she is, so here I am. I'm honestly not sure what I can say or do anymore to try to cheer her up and make her feel better. To make matters worse, we were doing our taxes today, and found we have to pay some this year, which put her into tears because she now feels like we are being penalized for not having children. All I could to was tell her it is ok, and one way or another I will make sure she gets to be a mom.

Has anyone else been in a similar situation and how did you cope with it? It breaks my heart to see her like this, after the strength she showed and not letting having cancer change her life. Sometimes I feel like I'm somehow failing her by not being able to make everything better like it was before her diagnosis. Advice from any one is greatly appreciated. Thank you in advance.

VickiSam's picture
VickiSam
Posts: 8470
Joined: Aug 2009

Breast Cancer.Org

 

Fertility After Chemotherapy


Many women want to know if they'll be fertile after chemotherapy. Fertility after chemotherapy depends on two things: your age and the types and doses of chemotherapy medicines you get.

Your age: As every woman ages, her ovaries produce fewer fertile eggs. When you go into menopause, your ovaries stop making fertile eggs.

  • Women who are treated for cancer younger than age 30 have the best chance of becoming pregnant after chemotherapy. Overall, the younger you are, the more likely it is your ovaries will produce fertile eggs after chemotherapy.
  • The closer you are to menopause (the average age is 51), the more likely it is that you'll be in menopause after chemotherapy and won't be able to become pregnant.
  • Women who are 40 or older when they get chemotherapy are more likely to be in menopause after chemotherapy.

The types and doses of chemotherapy drugs you get: We know that certain chemotherapy medicines are more likely than others to cause infertility, including Cytoxan (chemical name: cyclophosphamide). Platinol (chemical name: cisplatin) and Adriamycin (chemical name: doxorubicin) carry a medium risk of losing fertility.

On the other hand, certain chemotherapy medicines are less likely to cause infertility:

  • methotrexate (brand names: Mexate, Folex, Rheumatrex)
  • fluorouracil (also called 5-fluorouracil) (brand name: Adrucil)
  • vincristine (brand names: Oncovin, Vincasar PES, Vincrex)

The taxanes:

  • Taxol (chemical name: paclitaxel)
  • Taxotere (chemical name: docetaxel)
  • Abraxane (chemical name: albumin-bound or nab-paclitaxel)

are a relatively new group of chemotherapy medicines. Few studies have been done on how these medicines may affect fertility and the results aren't clear yet.

Because research in this area is limited, it can be difficult to give an individual woman an accurate idea of her chances of keeping her fertility. It's a good idea to talk to your doctor, a fertility expert, or both about the potential risk of infertility with your chemotherapy treatment plan.

Here's what we do know:

  • Early menopause brought on by chemotherapy may be temporary. In other words, your menstrual periods may stop and then start again after chemotherapy is over. It can take a few months or as long as a year or more for your periods to return.
  • Periods don't always mean fertility. Even if your periods start after treatment, your fertility may be uncertain. You may need to see a fertility expert to help you find out if you're actually fertile.
  • Women who get relatively high overall doses of chemotherapy may be more likely to be infertile after treatment than women on lower-dose regimens.
  • Chemotherapy medicines are usually given in combination, not each one by itself. When used in combination, the medicines' effect on fertility may be different. It's also important to know that the same medicine may be given in different doses in different combinations.
  • Some women who have normal periods after chemotherapy may be able to get pregnant with no difficulty while others may have trouble getting pregnant. This is because chemotherapy can damage the immature eggs in the ovaries.
  • When your periods return after chemotherapy, it means that some eggs are maturing. But the number of eggs available may be smaller than it was before chemotherapy.
  • Because chemotherapy may cause birth defects, doctors advise using birth control -- but not birth control pills -- throughout chemotherapy so you don't become pregnant during treatment.
  • It's important to wait at least 6 months (or longer) to get pregnant after chemotherapy ends. You don't want to get pregnant with an egg that was damaged by chemotherapy.
  • After chemotherapy, fertility may be short-lived. This means that even women whose periods start again after chemotherapy are at some risk of early menopause.

Researchers are looking at ovarian suppression -- stopping ovarian function using medicine -- to help protect a woman's eggs during chemotherapy. But this is very controversial because large studies looking at ovarian suppression aren't completed and there is limited information available.

Some doctors are concerned that the medicines used to suppress ovarian function, called GnRH (gonadotropin-releasing hormone) agonists, may interfere with chemotherapy's ability to kill cancer cells when the cells are actively growing. GnRH agonists are hormones, and besides suppressing ovarian function, they may also stop or slow the growth of breast cancer cells. This would make the cancer cells less sensitive the chemotherapy.

The GnRH agonists used in ovarian suppression include:

  • Zoladex (chemical name: goserelin)
  • Lupron (chemical name: leuprolide)
  • Trelstar (chemical name: triptorelin)

These medicines block GnRH, a special hormone made in the brain that tells the ovaries to get ready for ovulation. Ovulation happens when a mature egg is released from the ovary, ready to be fertilized. When GnRH is blocked, no ovulation occurs.

 

Expert Quote

In general, all women with breast cancer who are in their reproductive years should be counseled regarding fertility preservation. Chemotherapy affects fertility in every woman, regardless of age.

Kutluk Oktay, M.D.

 

=====================================

Fertile Hope.com

Timeframe for Getting Pregnant

Most oncologists recommend waiting 2 to 5 years after cancer treatments finish before trying to achieve pregnancy.  The majority of cancers recur during this time, so they want to make sure that you are healthy before allowing you to try to get pregnant. However, everyone’s medical situations are different—some survivors have to wait longer and others are approved for pregnancy much earlier.

For women, it is usually recommended that you wait a minimum of 6 months after treatment. This is because your eggs may be genetically damaged from their exposure to chemotherapy and radiation while they were in the process of maturing. The time required for those eggs to leave your body is approximately 6 months.

For men, it is usually recommended to wait a minimum of 2 years after treatment.  Sperm exposed to chemotherapy and/or radiation may suffer genetic damage and this damage is believed to repair itself within 2 years.

Many survivors are confused by the two conflicting answers they get when looking into how long to wait.  This highlights the need for your cancer and reproductive doctors to work together to best determine what timeframe is safe for you from both perspective.

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Pregnancy & Recurrence

Current available research on this subject is limited, but findings to date suggest that pregnancy after cancer does not cause recurrence, even after breast cancer.

 

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CypressCynthia's picture
CypressCynthia
Posts: 4017
Joined: Oct 2009

Katherine was just 4 when I was diagnosed and I had suffered a miscarriage a few months before diagnosis.  At the time, (I was 33)  I wanted another child, but had a tubal ligation at the strong recommendation of my oncologist.  I am now 60, nearly 61 and still battling the blasted disease after an 18 year remission.  My younger sister always wanted 3 children and she stopped at 2 after a similar diagnosis about 18 years ago.

Much has changed since 1987 and your wife is still very young. 

I will share, for what it is worth, that I thought I was fertile after tamxifen and I was 40 (7 years of treatment just because no one could decide how long I should take the drug).  I can't say for sure, because I obviously did not try to become pregnant again, but I did go back to regular periods and normal ovulatory type of cervical mucus.  Maybe that was because, back then my chemo was cytoxan, methotrexate and 5FU (CMF).  That regimen is not used much anymore and it may have left my fertility more intact, but I am just guessing.  Maybe some more recently diagnosed young survivors can share more.

Your wife has an extremely difficult decision to make and a very unfair, crappy diagnosis.  Young women tend to have more aggressive breast cancer.   Please let her know she is most welcome here (when she is ready) and is likely to find a few women in a similar situation.  Sending cyberhugs and prayers. 

New Flower
Posts: 4128
Joined: Aug 2009

I am very sorry and glad that you are reaching out. Please do not rule out an adoption path as an option for parenthood

24242
Posts: 1417
Joined: Mar 2001

I too am sorry that your wife and you have to go through this.  Cancer can do allot of things to families even split them up because of the pain the wollows within.  LOVE is an amazing healer in itself and being there is the best that you can truly do.  Sometimes comfort is hard to come by since there are so many things that we worry inside.  Being there is truly more than most men are able to do...

Tara

 

disneyfan2008
Posts: 5504
Joined: Oct 2010

NO advice...just sending good thoughts...I hope you get some advice...

 

Denise

2ndxyvonne
Posts: 41
Joined: Nov 2013

It sounds to me like you and your wife have a lot of love and out there somewhere is a child who would love to be a part of that and would appreciate it.  I had a son from a previous relationship when I met my husband, he was nine at the time I met Tom.  Tom would tell you emphatically that boy is his son in every sense.  I don't think they could love each other  any more.  And Dan, our son, would tell you fast, the love they have for each other is genuine and special because they "chose" to love each other.  They didn't "have" to love.  Just a thought and hope it does ease your burden.  You and your wife have a lot of love, it would be a shame not to share that but I know better than most it's a very personal decision  Pray about it and let the Lord guide you - He's never wrong.  I will pray for you both.  Yvonne

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