Page 3508 - Week 10 - Wednesday, 18 September 2019
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After receiving her cancer diagnosis, Beth was referred to Canberra obstetrician and gynaecologist Professor Steve Robson. It was Professor Robson who discovered Beth had severe endometriosis and needed to have one of her ovaries removed. As Beth says, it was a miracle that she had even got pregnant in the past, let alone had three children. It was Professor Robson who discussed Beth’s options to preserve her fertility as best she could in a supportive way, but also in an urgent way.
This is the nub of the issue—this urgency. There is a very small window between cancer diagnosis and the beginning of treatment for decisions to be made and actions to be taken about fertility preservation. Often younger cancer patients have more aggressive cancers, and these require quick and comprehensive treatment. Delays in starting cancer treatment are associated with a worse prognosis.
The question of making a decision about fertility preservation, then the actual procedures in doing so, also take time. For the decision, the pressure is enormous. As Professor Robson says:
Decisions about treatment are daunting, placing an almost overwhelming burden even on the most resilient and well-supported of us. Yet, unspoken, is the fear that treatment will take away chances of becoming pregnant once treatment is over and a cure is realised.
The technologies exist—and are available—to help preserve fertility. This is a key message of comfort at a time when young cancer patients are at their most vulnerable.
Luckily for Beth, Professor Robson was there at a time of immense vulnerability. They discussed her options and Beth decided to take injections that essentially switched off her hormonal system, not only to give her body a break, as she puts it, but to act as a temporary chemical menopause so that her fertility would not be compromised. The alternative would have been a hysterectomy.
It has not been easy. Not only does Beth have menopausal symptoms like hot flushes, feeling down and struggling to keep up with her kids, but also she has the knowledge that she still may struggle to conceive in the future. But Beth says she is lucky—lucky to have children, lucky to be able to afford treatment and lucky to be in a position in which she can make informed decisions about her health. Not every person always gets this choice.
There are people like Amy Hemsworth. Amy was 30 when she was diagnosed with breast cancer, but it was not a simple diagnosis. She was experiencing what she describes as “excruciating pain” in her right breast. She saw a doctor but they could not find a lump. She was told not to worry, but she knew something was not right.
About two weeks later, Amy did discover a lump. She revisited the doctor and underwent a mammogram. Again she was told not to worry, but she still knew something was not right. Amy then underwent an ultrasound which finally identified a cyst. She was told this was common, but the pain continued.
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