Principles of Cancer Treatment: Impact on Reproduction
Principles of Cancer Treatment: Impact on Reproduction
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DOI：
10.1007/978-94-007-2492-1_1
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发表时间：
2012-01-01
期刊：
影响因子：
--
通讯作者：
Rodriguez-Wallberg, Kenny A.
中科院分区：
文献类型：
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作者：
Rodriguez-Wallberg, Kenny A.
在科学、技术和生殖方面已经取得了很多进步，但我们仍然不能肯定谁会或不会因为癌症或治疗而暂时或永久不育。所以我认为最好是和所有育龄期的病人讨论一下。这不是一个容易的讨论。你刚刚告诉别人他们得了癌症，现在你告诉他们他们可能不能生孩子。有些人不在乎，或者至少他们认为他们当时不在乎。有些人对不孕不育的消息比对癌症的消息更不安。你不能因为你看了病人的病历就认为你知道他们对生育的看法。即使他们已经有了孩子，或者他们还没有结婚，或者他们在经济上挣扎，这也是必须讨论的事情。当我和他谈论生育能力时，他非常兴奋--他说这是他来医院以来听到的最有希望的事情。然后我想知道我是否给了他虚假的希望，因为他的机会不太好，事实上，他们非常沮丧。但是那个家伙一想到精子银行就高兴得跳到墙上，我想也许他会从思考一些快乐的想法中受益。他确实存了精子，这似乎让他精神振奋，但最终，他没能从癌症中幸存下来。我有一个患有GU癌症的女病人，她说她不想参与关于保持生育能力的讨论。她只有25岁，但她说她知道她不想要孩子，也从来没有想要过。所以我就不再提了。她考得很好，现在在读研究生，刚刚结婚。在她最后一次检查时，她告诉我她希望她听了我关于生育的话。现在她过得很好，结婚了，她对孩子有了新的看法，刚刚得知她不能生育。她和她的丈夫正试图收养孩子，但对于一个癌症幸存者来说，这不是一个容易的过程。这给了我一个教训。我现在坚持让我的病人听不孕症的谈话，即使他们说他们不想要孩子，我试图解释说，很多人在治疗结束后会有不同的感觉，他们继续他们的生活。我甚至告诉他们山姆的事，以及精子银行在他最后的日子里给了他多少希望。我认为作为肿瘤学家，我们不仅要讨论如何控制疾病，还要讨论如何为生存做准备。有时候，我们也会谈到生命的终结。这一切都不容易，但这一切都是值得的。A医生，肿瘤学家
A lot of advances have been made in science, technology and reproduction but still we can't say for sure who will or will not be temporarily or permanently sterile from cancer or the treatment. So I think it's best to discuss it will all patients who are of reproductive age. It's not an easy discussion to have. You've just told someone they have cancer and now you tell them they may not be able to have kids. Some people don't care, or at least they think they don't care at the time. Some people are more upset about the news of infertility than they are about the cancer. You can't assume because you look at a patients chart that you know how they feel about fertility. Even if they already have kids or they aren't married or they are struggling financially, it's something that has to be discussed.I had a testicular cancer patient, Sam, a few years ago with late stage disease. When I talked to him about fertility he got very excited -he said it was the most hopeful thing he'd heard since he came to the hospital. Then I wondered if I had given him false hope, because his odds were not too good, In fact they were pretty dismal. But that guy was bouncing off the wall with joy at the thought of banking sperm, and I thought maybe he would benefit from thinking some happy thoughts for a while. He did bank sperm, and it seemed to lift his spirits but in the end, he didn't survive the cancer.I had a female patient with a GU cancer who said she wanted no part of a discussion about preserving fertility. She was only 25, but she said she knew she didn't want kids, and had never wanted them. So I stopped trying to talk about it. She did well and she's in graduate school now and just got married. At her last check-up, she told me she wished she had listened to me about the fertility. Now that she's doing well and married she has a new perspective on children and just learned she is infertile. She and her husband are trying to adopt but it's not an easy process for a cancer survivor. That taught me a lesson. I now insist my patients listen to the infertility talk, even if they say they don't want kids I try to explain that a lot of people feel differently when the treatment is over and they go on with their lives. I even tell them about Sam and how much hope that sperm banking gave him in his last days. I think as oncologist we have to not only talk about how to manage the disease, but how to prepare for survivorship. Sometimes we have to talk about end-of-life issues too. None of it is easy, but it's all worth it. Dr. A, Oncologist