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The New World of Oncofertility
Cancer used to be an old people's disease. No longer: we all have friends and colleagues — young people, in their 20s, 30s, 40s — who've been on the receiving end of a scary diagnosis. The good news is that a verdict of cancer is no longer the death sentence it once was. Survival rates are on the rise, accompanied by a wave of survivors of child-bearing age who want to have children. But can they?
The answer often lies in whether they were offered fertility preservation techniques — the subject of a recent article I wrote in TIME Magazine. Consider Lindsay Beck's story, for example. Inspired by the frustration she experienced when trying to preserve her fertility before treating her tongue cancer, Beck, 34, founded Fertile Hope in 2001, dedicated to helping cancer survivors start families.
Only 24 when she learned treatment would leave her with a 90% chance of infertility, Beck was given zero guidance on how she might safeguard her fertility. Her reaction was immediate and visceral; she refused treatment. “Why fight so hard to live if you are going to rob me of all of my dreams?” she demanded.
Soon enough, she reconsidered and decided to start chemotherapy, albeit with a plan: Men could freeze sperm, she knew; why couldn't women freeze eggs? In the six weeks she had left before treatment began, Beck called scores of fertility clinics around the Bay Area, where she lives. None of them offered egg cryopreservation. Finally, she phoned Stanford, which had just launched an experimental egg-freezing program for cancer patients. Twelve days later, Stanford froze 29 of Beck's eggs.
Women commonly describe trips to the fertility clinic as harrowing; Beck loved them. “They were my favorite doctor visits because I felt I was doing something active to survive,” she says. Now the mother of a 4-year-old daughter and a 2-year-old son born via IVF due to an unrelated genetic abnormality in her husband's sperm, Beck continues to evangelize about the importance of raising awareness about fertility preservation. She's witnessed significant advances since she was diagnosed a decade ago when, as she puts it, “essentially patients were being sterilized without their knowledge or permission.”
“It's not perfect now,” says Beck, who helped write the guidelines issued by the American Society of Clinical Oncology in 2006 advising physicians to inform patients of their options, “but it is so much better.”