Wednesday 25 April 2018

Cancer experts 'failing women'

Doctors lack knowledge on protecting fertility in chemotherapy, says study

Eilish O'Regan Health Correspondent

IRISH specialists treating younger women for cancer have a poor knowledge of modern techniques that can prevent infertility, a new study has warned.

Women who undergo chemotherapy are in danger of being left unable to have children afterwards -- but modern treatments are available to reduce the risks.

However, a survey of leading specialists has found that doctors have a low awareness of how to manage women of childbearing age who require chemotherapy.

Doctors at the department of medical oncology at St James's Hospital, Dublin, sent out a questionnaire to 94 cancer specialists in Ireland, including 28 medical oncologists, 32 haematologists and 34 breast surgeons.

The doctors wanted to establish the specialists' knowledge of the success rates of current techniques that help preserve a female patient's fertility.

The doctors pointed out that as treatments improved, physicians treating patients with cancer are becoming increasingly aware of the long-term effects.

"This is a widespread issue with 22pc of patients with breast cancer under 50 years of age at diagnosis.

"Chemotherapy treatment carries a significant risk of ovarian failure as well as premature menopause in women of childbearing years," they wrote in 'The Irish Medical Journal'.

"The most important factor in this risk is the age of the patient at the time of treatment, but the type of chemotherapy agents used also has an effect," they added.

Men who require chemotherapy can preserve sperm ahead of their treatment. However, this process is more complex for women and involves the freezing of embryos, eggs or ovarian tissue.

There were 50 responses to the questionnaire and, of these, 31 were aware of some of the available international guidelines on the preservation of fertility in young patients undergoing chemotherapy.

The survey found that 82pc of respondents routinely referred male patients for sperm banking. All physicians who responded would see women of childbearing potential but only 42 (84pc) would routinely discuss fertility with these women.

"International guidelines suggest that all patients should have fertility discussed before treatment," wrote the doctors.

Nearly one in two specialists reported using drugs to prevent damage to the ovaries. But their awareness of current outcomes for assisted fertility was poor, with just 42pc knowing about the success rates of conventional fertility treatment.

A smaller number knew about the success rates for freezing embryos or eggs. And while 85pc correctly estimated the costs at around €5,000, just 2pc were aware of the seven sites offering such treatment in Ireland.

Irish Independent

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