What about fertility?

 

This amazing image is by photographer David Jay whose SCAR project celebrates the journeys of young breast cancer patients. You can find out more at the Facebook page https://www.facebook.com/pages/The-SCAR-Project/255064983743?ref=ts&fref=ts
This amazing image is by photographer David Jay whose SCAR project celebrates the journeys of young breast cancer patients. You can find out more at the Facebook page

Yesterday we talked about breast cancer in younger women. You can read that post here.

For young patients, there are some extra factors to consider, Apart from the immediate management of the breast cancer which includes a combination of surgery, radiotherapy, chemotherapy, hormonal therapy and biological treatment.

Fertility

Current breast cancer drugs (e.g. chemotherapy) can make some women infertile. This may not be an issue for women who are beyond child-bearing age or who already have children. It’s a greater problem for younger women, who plan future pregnancies. The impact of the treatment should therefore be discussed with the patient before it is commenced, as the response of each patient is different and so is the effect of the drugs on fertility.  Current guidelines for the treatment of breast cancer in the young recommend the use of chemotherapy for all but the earliest cancers and the vast majority of young breast cancer sufferers will have chemotherapy as part of their treatment.

This is an important factor for women, as the chance of suffering premature ovarian failure is as high as around 50% of women who have chemotherapy before the age of 40.  After that, the proportion rises rapidly to 95%+.

Lack of age appropriate treatments

Breast cancer in younger women can be more aggressive than in older women, and treatments are not designed for the younger population. Since young women have more aggressive tumours most guidelines recommend in addition to surgery, they also need chemotherapy.  Hormonal therapy regimens also differ as ovarian function has to be taken into consideration. Researchers’ focus on fine-tuning methods of fertility preservation fuel optimism about its increasing viability, but ovarian failure needs to be taken into account, along with the increased risk of miscarriage.

Work and career paths

Prolonged treatment regimes can impinge on the work and/or daily functioning of a young woman who is still active in the mainstream market place. Special consideration needs to be given to the patient regarding prolonged sick leave etc.

It is therefore paramount that these women be treated in a dedicated breast unit, by a multi-disciplinary team that can address the issues in an individualized fashion in this subset of patients afflicted by breast cancer.

Breast health management according to age.

Age 20-39:

*Monthly breast examination

*Clinical breast examination by a healthcare professional every 3 years

Age 40 and over:

* Monthly breast examination

*Annual clinical breast examination by a healthcare professional

*Annual mammography

Lifestyle do’s and don’ts

DON’T eat too many saturated fats. Avoid anything fried, including junk food.

DO go green. Stock up on fresh fruit and vegetables.

DO watch your weight. Increased body fat is linked to a raise in oestrogen levels.

DON’T drink more than two alcoholic drinks per day.

DO exercise more to decrease your breast cancer risk by 30%.

 

Dr Karin Baatjes, Specialist Surgeon and Professor Apffelstaedt, Associate Professor-University of Stellenbosch and Head: Breast Clinic, Tygerberg Hospital

 

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