When Cancer Threatens a Woman's Fertility
New research out this month from the American Cancer Society and published in the online journal Cancer, finds cancer survivors carry a greater financial burden compared to people without a personal history of cancer. The study involved nationally representative samples of 10,354 cancer survivors and 124,436 individuals without a cancer history.
Given the high cost of many cancer treatments, this isn’t shocking. What deserves attention is that younger survivors experience a greater financial burden than older survivors as the financial impact of cancer on adolescent and young adult survivors is particularly long-lasting.
Approximately 70,000 young Americans are diagnosed with cancer each year. Adolescent and young adult cancer survivors are often completing their educations and launching their careers, and many have relatively low financial reserves.
A cancer diagnosis and subsequent treatment disrupt their lives in many ways, including the emergence of psychosocial needs that require appropriate resources. Adding in fertility concerns is an additional burden for some.
I know this firsthand. I was 30 years old and five weeks pregnant in 2017 when I learned I was receiving a career development grant from the National Institute of Mental Health to fund my research and continued training. It was also when I found a lump in my breast.
Diagnosed with early-stage breast cancer approximately a month later, I was very lucky to have a relatively easy treatment course, an otherwise healthy pregnancy and the ability to continue working in a job that I’m passionate about. While I’ve been fortunate in many ways, I am continuously aware that many other young adult cancer survivors aren’t so lucky.
During my training as a clinical psychologist, and before my own diagnosis, I worked with young adults with new cancer diagnoses and saw firsthand how disruptive these diagnoses and subsequent treatments could be on their lives.
Fertility preservation is a unique concern for some of these patients, and it also can come with a tremendous financial burden at an otherwise stressful time of making treatment decisions.
While several funds have been established to help ease the financial burden of cancer for these patients, policies and programs on fertility preservation continues to be an area for significant improvement.
Fertility preservation can range from (but is not limited to) freezing sperm, creating and freezing embryos or surgically moving one’s ovaries to an area that won’t be receive radiation. These procedures can cost from hundreds to tens of thousands of dollars depending on the treatment or type of preservation.
Last August, Illinois became the fifth state to require insurance coverage for fertility preservation. Unfortunately, 45 states do not have this requirement.
Surely, not all young adult cancer survivors want to have children; some of those survivors who do want to have children may choose to focus on adoption instead. Yet the argument that young patients should solely focus on building families through adoption is unwise.
My husband and I, having dated since we were 18, had long considered the pros and cons of starting a family of our own. After I finished graduate school and we were both nearing 30, we began to explore adoption as a method for building our family.
Feeling intimidated by the costly and lengthy process, as private agency adoptions typically range from $20,000 to $45,000, we decided to first try for a biological child. Being pregnant at the time of diagnosis came with challenges, but it wasn’t until months later that I learned how much more challenging it may have been if we had been in the middle of trying to adopt a child.
Challenges to cancer survivors adopting have been well-documented. Certainly there are agencies willing to work with cancer survivors, but many adoption agencies require that potential parents submit letters from their physicians indicating that they have been cancer-free for at least five years.
Pressing for widespread fertility preservation insurance coverage is a small step. However, it is a worthy step to support whole patient care and ensure that young adult survivors are supported in making fertility decisions based on their own values and wishes, rather than on their finances.