Giving Male Cancer PatientsBetter Odds at Being a Dad
By KEVIN HELLIKERNovember 13, 2007;
Before David Goodack underwent cancer treatment at age 20, nobody suggested he preserve a sample of his sperm. Mr. Goodack himself didn't think of it, even though his physician warned that the necessary surgery could render him infertile -- as it did. "I was just thinking about surviving," says Mr. Goodack, a Kansas City, Mo., press foreman, now 44 and childless.
Since Mr. Goodack's surgery, hundreds of thousands of babies have been conceived with preserved samples of sperm. Yet a September article in the journal Cancer found that during the decade ended in 2005, only 18% of 821 young, male cancer patients had chosen to freeze samples of their sperm before undergoing treatment. Experts say the problem is that amid the terror of a cancer diagnosis, the only immediate concern too often is survival. At a time when survival is more the rule than the exception for young cancer patients, child-bearing options are an unnecessary casualty of treatment.
Now, two advocacy groups are teaming up with a for-profit sperm bank to make sperm-collection kits available across the country. The kits -- which will be distributed to oncology professionals nationwide starting this month -- contain the materials and instructions necessary for patients to produce a usable sperm sample at home or in the hospital. It includes a postage-paid package for fast delivery to Cryogenic Laboratories Inc., a Roseville, Minn., sperm bank, so no ice is needed for transport. Cryogenic Laboratories will charge $625 for processing and freezing the specimen for one year. The storage cost of each subsequent year -- frozen sperm can remain potent for decades -- is $280. In some cases, insurance will help defray that cost.
Of the 35,000 young men diagnosed with cancer each year, about 90% risk losing their fertility to chemotherapy, radiation or surgery. Cancer treatments sterilize men and women alike, but preserving the fertility of women is more complicated and expensive -- and more publicized.
The kit's arrival in oncology offices is designed to raise awareness. Major academic cancer centers are likely to offer fertility options. And men can on their own seek out one the many other storage facilities available -- particularly in big cities -- if they think of it. But about 80% of young men receiving cancer treatments do so in community hospitals, often in cities that lack sperm banks, says Lindsay Beck, founder of nonprofit Fertile Hope and the creator of the new kit. She adds that 20 states lack sperm banks altogether. In 2002, the Journal of Clinical Oncology published two surveys -- one showing that only 51% of 201 young, male cancer patients had been offered sperm banking, the other showing that 48% of 162 oncologists either never broached fertility with eligible male patients or did so less than 25% of the time.
"A lot of oncologists out there will see only a handful of adolescents or young adults a year, so they're not thinking about fertility," says Brandon Hayes-Lattin, an Oregon Health & Science University oncologist specializing in young-adult issues.
The kit, called Live:On, is also designed to eliminate a dilemma facing some men: whether to postpone treatment while pursuing sperm preservation. Gathering information about sperm preservation -- where and how to do it, how to ship off a specimen if no bank is nearby -- can take a few days. That could delay treatment of some fast-growing cancers. Armed with the kit soon to be available in oncologists' offices, however, a patient could preserve his child-bearing options in a matter of hours.
Cryogenic Laboratories will donate an unspecified percentage of its storage fees to its two partners in the effort, the Lance Armstrong Foundation and Fertile Hope, an organization dedicated to increasing fertility options for young cancer patients. Through Fertile Hope, financially strapped patients can apply for discounts.
Success rates for conceiving babies with preserved sperm vary according to technique. The September journal of Cancer article reported that of those young men who tried using their specimens for procreation, 36.4% succeeded with intrauterine insemination and 50% succeeded with two more-expensive techniques -- in-vitro fertilization and intracytoplasmic sperm injection. The Lance Armstrong Foundation says that its namesake, the world-renowned cyclist, owes his three children to sperm samples preserved before he underwent cancer treatment.
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