It should be noted that fertility can be restored spontaneously.
It is therefore useful to maintain contraception after treatment if you do not have an immediate desire to have children.
Cancer and/or its treatment can affect fertility in both women and men. Current progress and anticipation often make it possible to reduce the risk of infertility after cancer. It is important to discuss this with your health care team before starting treatment. This should be done whether or not you have a defined parental plan. This is because the effects of treatment are potentially irreversible.
In most cases, reduced fertility is a consequence of treatment.
Sometimes, as in the case of testicular cancer, it is the disease itself that can cause hypofertility.
Surgery
When the surgery concerns an organ of the reproductive system (uterus, ovary, testicle, prostate) or located close to it (bladder, rectum, certain abdominal lymph node curings, etc.), there is a risk of permanently altering fertility.
Radiotherapy
Similarly, if the area to be irradiated concerns or is close to the organs of the reproductive system and/or if the dose is high, fertility may be impaired.
Systemic treatments: A systemic treatment is any treatment that is intended to treat the body as a whole. This is done without targeting a particular area. These may include chemotherapy, targeted therapies, hormone therapy or immunotherapy. All these treatments can lead to fertility problems, which are not always reversible.
Most systemic treatments, including chemotherapy, as well as radiotherapy, can have so-called “teratogenic” effects. This means that there is a risk of causing foetal malformations. It is therefore essential to maintain effective contraception throughout the treatment period and for several months afterwards. This applies to both men and women. The choice of contraception should be discussed with the gynaecologist or oncologist for women with hormone-dependent cancer.
The most appropriate fertility preservation strategy for you should be discussed before treatment. This discussion should be carried out with your oncologist, in conjunction with the reproductive biologists. This is an important subject but it should not (or as little as possible) delay the management of the cancer.
Most of the time it involves collecting and freezing reproductive cells. This is done by collecting sperm from men or oocytes from women. In rarer cases (especially in children), the germ tissue is preserved (testicular or ovarian tissue).
These samples are taken and stored by freezing at the CECOS (Centre d’Etude et de Conservation des Oeufs et du Sperme) after a dedicated consultation.
When the treatment is completed and the parental project defined, these samples can be used with the help of a team specialised in reproductive biology.
It should be noted that fertility can be restored spontaneously.
It is therefore useful to maintain contraception after treatment if you do not have an immediate desire to have children.
The help of a specialised team and the use of samples at the CECOS are therefore not necessarily necessary to carry out your parental project.
After a cancer diagnosis, sexuality can be affected in many ways, sometimes even after treatment. While some cancers have an obvious impact on sexuality, any cancer can cause sexual dysfunction during and after treatment.
Decreased libido is the most common disorder in cancer patients. It affects about one in two patients. It is most often multifactorial. It is linked to anxiety generated by the disease, secondary fatigue due to the disease and the treatments.
Hormone therapies also have a specific impact on libido.
In order to improve these difficulties, all possible causes should be addressed. Communication within the couple is a key element, as the disease can affect the partner’s libido as well.
After a major surgery (mastectomy, ostomy etc), the body image is modified. It is then difficult to accept one’s new body and therefore even more difficult to reveal it. Drug treatments, chemotherapy and targeted therapies, can also change physical appearance.
Numerous solutions, from surgical reconstruction to external and hair prostheses, cosmetics and tattoos, exist to restore the self-image or enhance a new image.
Depending on the primary tumour and the treatments received, there may be different specific symptoms. These may include pain during intercourse, vaginismus, lack of pleasure or difficulty in achieving orgasm.
Depending on the primary tumour and the treatments received, there may be various specific symptoms: erectile difficulties, premature or delayed ejaculation, lack of pleasure or difficulty in reaching orgasm, regression in size of the external genitalia.
Despite these difficulties, sexuality is still possible.
Whatever the disorder, we recommend that you first discuss it with your partner but also with your doctor.
There are solutions, particularly with professionals who are qualified in onco-sexology. It is also important to discuss these issues with your partner as much as possible. Communication within the couple is an essential element in overcoming these profound changes.
