During the last four decades the estimated survival rate for pediatric cancers has increased from about 10 percent to nearly 90 percent. For the survivors, issues related to infertility are among the most common and life changing complications.
“A lot of the treatments that kids get for cancer will affect their fertility potential,” said Stacy Tanaka, MD, MS, FACS, professor in the Division of Pediatric Urology Surgery at Vanderbilt University Medical Center. “These concerns are relevant for urologists treating postpubertal adolescent patients who are not thinking about their fertility potential, and for urologists who see young men in their late teens or early 20s who are not in a stable relationship or even thinking about starting families.”
Dr. Tanaka will moderate a panel discussion titled Fertility Preservation in the Pediatric Cancer Patient during Sunday morning’s Next Frontier plenary session. The 20-minute discussion begins at 7:55 am in Hall E at Moscone North.
Fertility preservation is a multidisciplinary issue, requiring input from a multitude of health care professionals, including urologists.
“Patients should be seen by a urologist who can talk about the options available to them in terms of sperm preservation and other assisted reproductive technologies,” Dr. Tanaka said.
Guidelines released in 2006 by the American Society of Clinical Oncology and in 2008 by the American Academy of Pediatrics recommended offering cryopreservation of sperm to all male patients of reproductive age.
“There are a lot of treatment options that are validated for postpubertal patients. However, everything for prepubertal patients is experimental. That is really the next frontier,” Dr. Tanaka said. “It’s difficult to explain or advise a prepubertal patient and their family about what is available and that these techniques have not yet been proven.”
Dr. Tanaka will be joined in the presentation by three panelists. Nicholas Cost, MD, assistant professor of Surgery-Urology at the University of Colorado, is trained in urologic oncology and pediatric urology.
“Dr. Cost will bring a unique perspective, specifically about adolescent pediatric patients with cancer,” said Dr. Tanaka, noting that his research interests include testicular cancer in adolescents and the long-term effects of treatment.
The other panelists are Richard Yu, MD, PhD, Director of the Fertility Preservation Program at Boston Children’s Hospital, and James Smith, MD, MS, Director of Male Reproductive Health at the University of California, San Francisco. Dr. Smith is trained in andrology and will discuss the most recent research related to the ethical concerns of fertility preservation.
“For pediatric urologists this session should convey the importance of offering fertility perseveration to patients and families, and how to set up a multidisciplinary program to address these issues,” Dr. Tanaka said. “The session is also important for adult urologists who see older teenagers and young adults who may not have fertility preservation on their mind because we will discuss how to introduce this topic.”