Most men who try to father a child after testicular cancer treatment eventually succeed, new research shows.
More intensive chemotherapy treatments may lengthen the process, Norwegian researchers report in the Journal of the National Cancer Institute.
Many testicular cancer survivors fathered children without using sperm they had banked before cancer treatment.
However, “all patients with testicular cancer who wish to maintain fertility (and who do not require emergent treatment) should be counseled and offered the option of sperm banking,” states an editorial in the journal.
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The cure rate for early-stage testicular cancer “approaches 100 percent,” writes editorialist Scott Saxman, MD, FACP, of the National Cancer Institute.
Testicular cancer is usually diagnosed in young men. About 8,000 new cases are expected this year. Around 185,000 living U.S. men have a history of testicular cancer, Saxman notes.
Many of those men want to have families, he adds.
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The new study was done in Norway. Researchers tracked fatherhood in more than 1,800 testicular cancer survivors.
The men completed surveys about their marital status and family plans. They were followed for 11 years, on average.
A total of 554 men said they tried to father a child after their cancer treatment. More than two-thirds (68 percent) succeeded at becoming biological fathers.
Most did so without medical assistance. However, 12 men used banked sperm.
Many men had fathered children before testicular cancer (90 percent of those who had tried).
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Treatment Type Mattered
The men had gotten different types of treatment after initial orchiectomy (removal of testis): low- or high-dose chemotherapy, additional surgery of lymph nodes, radiation therapy, or medical surveillance.
It took 6.6 years, on average, for the men to become biological fathers after cancer treatment.
The results varied by treatment type. The best odds and shortest time frames were seen in men who hadn’t gotten high-dose chemo.
Some men became fathers through adoption or when their wives or girlfriends became pregnant through sperm donation and reproductive technology.
The study didn’t track fertility problems in the men’s wives or girlfriends.
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Then and Now
The results might not directly apply to today’s patients.
The men had been treated in the late 1980s and early 1990s. Treatments have changed since then, Saxman notes.
“Clearly, the impact of therapy on fertility, as well as other long-term complications, for men with testicular cancer needs to be better categorized and understood,” he writes.
“However, this will be a moving target as treatment approaches continue to change and improve,” Saxman continues.
Saxman didn’t work on the Norwegian study. The researchers included Marianne Brydoy, MD. She works in Bergen, Norway, in Haukeland University Hospital’s oncology and medical physics department.
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By Miranda Hitti, reviewed by Louise Chang, MD
SOURCES: Brydoy, M. Journal of the National Cancer Institute, Nov. 2, 2005; vol 97: pp 1580-1588. Saxman, S. Journal of the National Cancer Institute, Nov. 2, 2005; vol 97: pp 1557-1559. News release, Journal of the National Cancer Institute.
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