This month, the American Society of Clinical Oncology (ASCO) published its guidelines on fertility preservation in the blue journal. No surprises here but, in the age of evidence-based medicine and net-surfing patients, its a good review to quote, at last.
Back in the days before high-dose treatments were locally available, one had to MOPP a relapsed Hodgkin's, resulting in a fair number of cures at the cost of almost certain infertility. It's one of life's stranger ironies that these patients were largely good-looking young singles. You learned to schedule a separate talk with patient & fiancee, (excluding family), to lay out the facts. Options were detailed before commencing cancer treatment– from adoption to cryopreservation.
These briefings were always more complex and emotional than the BiCNU side effects discussion with the parents of minors in a Neuro-Onco ward. ("Just save him.") Sadly, the personal costs were also less predictable for young adults.
**Thanks again to Mr Buck Cash for the use of his cartoon.