When your 2-year-old son is diagnosed with a fast-growing cancer, the last thing you worry about is whether treatment could prevent him from becoming a father one day. Yet, when the dust settles, it’s comforting for parents to know that new advances in technology might be the key to preserving fertility in the youngest male cancer patients and could keep parenthood a viable option for the their future.
“That didn’t really seem a big deal to me at the time,” says one mom, who told the TODAY Show about her reaction to learning that the treatment her then 2-year-old son, Sam, was about to undergo for an aggressive tumor in his prostate would probably leave him infertile.
But on the same day she received the news about Sam’s cancer 10 years ago, she also learned about a new study looking to preserve fertility for young cancer patients. “After the diagnosis that we got that day, I thought ‘Wow, there’s hope that he’s going to make it through this’,” she said.
New hope for preserving fertility for young cancer patients.
Dr. Jill Ginsberg, a pediatric oncologist at Children’s Hospital of Pennsylvania (CHOP), invited Sam to be a part of a study she was helping to pioneer, which would develop potential methods to avoid future infertility in boys who undergo treatment with chemotherapy and radiation for childhood cancer.
“We have never had any fertility preservation options for prepubescent boys, said Ginsberg, who directs CHOP’s Cancer Survivorship Program in a release. “These findings are a great first step forward for our youngest patients.”
While Sam’s future fertility wasn’t an immediate concern for his mom, she was heartened that someone was looking at a life for him after cancer. “What seemed to be a big deal was that Jill was looking to my son’s future,” she said.
Hoping to restore fertility after cancer treatment
Banking sperm prior to undergoing cancer treatment is the go-to move for men who want to be able to have a baby after radiation or chemotherapy, which can damage testicles and impair the body’s ability to produce sperm. Because men don’t start producing sperm until puberty—at around 13 or 14 years old—up until recently, a cancer diagnosis for a young boy had pretty much been an infertility sentence.
Ginsberg and her team’s experimental efforts at CHOP 10 years ago took a small biopsy from Sam’s testis before cancer treatment, and stored the frozen testicular tissue in case it might be useful in the future as scientific knowledge advances.
The study came about because of the high rate of success found treating young cancer patients. According to the TODAY Show report, the cure rate for treating childhood cancer has reached 85 percent, especially when chemotherapy is the treatment of choice.
The research team at CHOP discovered that in animal models, they’re able to restore fertility using frozen testicular tissue. “We wanted to see if we could translate that to humans,” said Ginsberg. The hope is that someday, that frozen tissue could be re-implanted in the now-cancer-free patient and prompt his body to start producing sperm.
The roadblock to that final outcome has been that the frozen sample hasn’t contained enough sperm stem cells and researchers needed to figure out how to make more in the lab. “That’s the step we think we’ve overcome now,” said Ginsberg, who added that she thought scientists were within 10 years of finding a way to successfully implant those frozen stem cells—which had been multiplied in the lab—to encourage healthy-sperm production in the patient.
Adult male fertility after chemotherapy
While chemotherapy is a proven weapon used to fight cancer, it employs a take-no-prisoners attack on the body and assaults not just cancer cells but all cells in the body that are dividing quickly. Sperm cells happen to fall into that quick-dividing category, making them an easy target for chemo, according to the American Cancer Society. If those spermatogonial stem cells are damaged by chemo and are no longer able to produce mature sperm cells, permanent infertility can result. For male cancer patients who are past puberty, there are a few factors that could affect future fertility:
- Age of patient: patients over 40 are more likely to struggle with infertility following chemotherapy
- Type of chemo administered: some drugs are more likely to affect fertility than others
- Dosage employed: the higher the chemotherapy dose, the harder it is for the body to resume sperm production following treatment
If you have undergone treatment for cancer and are unsure if it has affected your fertility, you can use SpermCheck—an over-the-counter kit—to test your sperm count and help assess whether production has been impaired by your treatment.
Giving young cancer patients something to hope for
In the 10 years since Sam underwent the experimental treatment to preserve his fertility, other medical centers in the U.S. have begun to perform testicular tissue cryopreservation, including Children’s Hospital of Pittsburgh—which performed 58 procedures in 2018. When seven-year-old Frankie Knowles was diagnosed with cancer last March, he traveled there from his home in Downingtown, Pennsylvania to undergo the minimally-invasive procedure to freeze his testicular tissue.
His mom, Erica Avello, 33, told The Charlotte Observer that when first approached by hospital staff about trying to save Frankie’s fertility, she recalled thinking she was too young to worry about becoming a grandmother.
“Then we thought, ‘Well this cancer is going to take so much from this kid, there’s so much he’s not going to be able to do,” Avello said. “If he does live…I want him to be 30, propose to a partner, and say ‘I can have kids.'”