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Fertility & Cancer

Cancer and/or its treatment can affect fertility in both women and men. With current advances and anticipation, the risk of infertility after cancer can often be reduced. It is essential to discuss this subject with your health care team before starting treatment, whether or not you have a defined parental project. This is because the effects of treatment are potentially irreversible.

Cancer-related fertility disorders

In most cases, reduced fertility is a consequence of treatment, but sometimes, as in the case of testicular cancer, it is the disease itself that can cause hypofertility.

Treatment-related fertility disorders

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 without targeting a particular area. This may include chemotherapy, targeted therapies, hormone therapy or immunotherapy. All these treatments can lead to fertility problems, which are not always reversible.

Contraception

Most systemic treatments, especially chemotherapy, as well as radiotherapy, can have so-called "teratogenic" effects, i.e. they can cause foetal malformations. It is therefore essential to maintain effective contraception throughout the treatment period and for several months after it has ended. This applies to both men and women. The choice of contraception must be discussed with the gynaecologist or oncologist for women with hormone-dependent cancer.

Solutions

The most appropriate fertility preservation strategy for you should be discussed prior to treatment with your oncologist, in conjunction with the reproductive biologists.
This is an important issue, but it should not (or as little as possible) delay the management of cancer.
Most of the time it is a matter of collecting and freezing reproductive cells (sperm samples in men, oocytes in women). In rarer cases (especially in children), it is the germinal tissue that 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.

To find the CECOS nearest you:

CECOS

Sexuality & Cancer

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.

Libido disorders

Decreased libido is the most common disorder in cancer patients, affecting about one in two. It is most often multi-factorial, linked to the anxiety generated by the disease but also to 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.

Changes in body image

After major surgery (mastectomy, ostomy, etc.), body image is altered and it is 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.

In women

Depending on the primary tumour and the treatments received, there may be different specific symptoms: pain during sexual intercourse, vaginismus, lack of pleasure or difficulty in achieving orgasm.

In humans

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.

Solutions exist, particularly with professionals who are qualified in onco-sexology. It is also essential to discuss these issues with your partner as much as possible. Communication within the couple is an essential element in overcoming these profound changes.

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