The Road to Parenthood After Cancer
This article has been co-authored by Brian and Julie Simmons, Samfund grant recipients.
The path to parenthood after cancer in young adulthood is different for everyone. But what all young adults have in common is uncertainty (whether cancer treatment will affect fertility, and/or whether they can preserve fertility before treatments), higher cost (in vitro fertilization, adoption, surrogacy, and any other way to start a family that doesn’t involve the traditional route carries astronomical costs that are rarely covered by insurance), and a general lack of guidance (unfortunately, conversations about family building rarely occur for myriad reasons).
There is a lack of consensus on how to treat adolescent and young adult (AYAs) with cancer. Unfortunately, although fertility preservation and family building remain 2 of the issues that are most universal to this age group, they are still not commonly or adequately addressed. Ultimately, it is our hope that sharing stories like Brian and Julie's (below), mine, and others, will raise awareness that,
- This is a common challenge among AYAs
- It is equally important for AYAs to ask questions and for providers to address the issue proactively
- With open communication and sufficient information and guidance, AYAs can feel empowered and hopeful about becoming parents after cancer
Julie and Brian are a Georgia couple who received a Samfund grant to fund their adoption homestudy. They write here about their experience as a couple that faced uncertainty on their way to parenthood due to cancer:
“Can I hold you?” That’s how our toddler frequently greets us in the morning as he sleepily wanders into our bedroom. No matter how the morning is going, when an adorable 3 year-old asks for morning cuddles, the answer is a resounding “YES!” This is especially true when parenthood came after much tribulation.
When we married, we envisioned a future filled with our children’s laughter. There was no question for us—parenthood was part of the ideal. Unfortunately, biology had a different idea. Two years before our wedding, Julie was diagnosed with ovarian cancer. While all cancer diagnoses come with a certain level of fear and dread, reproductive cancers are uniquely hard for a young adult because of the uncertain impact they will have on future fertility and the fact that it’s a topic many don't discuss. At only 23 years old, our ability to fulfill a lifelong goal of parenthood was in question.
When Julie met with her doctors, fertility wasn’t on her mind. It seemingly wasn’t on her doctors’, either: the first doctor didn’t mention any fertility issues, despite the loss of 1 ovary. The second doctor was the first to say the word “cancer” but didn’t mention fertility. It was only after Julie asked was the topic introduced. The response: “It will depend on the chemo, but we can never know for sure.” The third doctor answered simply: “We don’t know." But what options do you have? Do you delay treatment and risk the cancer spreading? Do you attempt some sort of preservation in the short window you might have? What if you can’t afford it? There are so many unknowns, but all of them are shadowed by CANCER. So, you dive into treatment.
Julie is one of the fortunate cancer survivors. Thanks to treatment by fantastic medical professionals, she survived. However, survival often comes at a price—for Julie, part of that price was impaired fertility. We were cautiously optimistic when we married, hoping for a miracle but expecting a fight. We went through a battery of tests, still to be told that there was no way to know if the chemo had damaged the eggs, or if Julie could even ovulate. They best we heard was that we should try, that it might happen.