Oncofertility: Ethical, Legal, Social, and Medical Perspectives

517 Pages·2010·6.93 MB·English

by  Clarisa R. Gracia (auth.)

Cancer Treatment and Research
SeriesEditor
StevenT.Rosen
RobertH.LurieComprehensive
CancerCenter
NorthwesternUniversity
Chicago,IL
USA
Forfurthervolumes,goto
http://www.springer.com/series/5808

· ·
Teresa K. Woodruff Laurie Zoloth
·
Lisa Campo-Engelstein Sarah Rodriguez
Editors
Oncofertility
Ethical, Legal, Social, and Medical
Perspectives
1 3
Editors
TeresaK.Woodruff,Ph.D. LaurieZoloth,Ph.D.
FeinbergSchoolofMedicine FeinbergSchoolofMedicine
NorthwesternUniversity NorthwesternUniversity
Chicago,IL,USA Chicago,IL,USA
[email protected] [email protected]
SarahRodriguez,Ph.D.
LisaCampo-Engelstein,Ph.D.
FeinbergSchoolofMedicine
FeinbergSchoolofMedicine
NorthwesternUniversity
NorthwesternUniversity
Chicago,IL,USA
Chicago,IL,USA
[email protected]
[email protected]
ISSN0927-3042
ISBN978-1-4419-6517-2 e-ISBN978-1-4419-6518-9
DOI10.1007/978-1-4419-6518-9
SpringerNewYorkDordrechtHeidelbergLondon
LibraryofCongressControlNumber:2010932405
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Preface
Cancer affects millions of Americans annually. Men’s lifetime risk of developing
cancerforallsitesis50%;women’slifetimeriskisjustover33%[1].Whilegener-
ally cancer is perceived as a condition affecting the elderly, nearly 10% of those
diagnosed are under the age of 45, which are typically considered prime child-
bearing years [2]. Indeed, many of those diagnosed with cancer are still children.
In 2006, an estimated 9,500 new cases of pediatric cancer were diagnosed in the
UnitedStates[3].Becauseofrecentbreakthroughsandmoreaggressivetreatments,
thesurvivalrateofthosediagnosedwithchildhoodcancerhasrisentoalmost80%
[4]. One estimate is that by 2010 one of every 250 adults will be a survivor of
childhoodcancer[5].
But while more aggressive treatments have meant more young people survive
cancer, these treatments have also resulted in impaired fertility for some. Given
thenumbersofchildrenandadultswithintheirchild-bearingyearsdiagnosedwith,
treated for, and surviving cancer, the ability to biologically reproduce has become
animportantissuewithinoncology.Oncofertilityhasemergedasawaytoaddress
potential lost or impaired fertility in those with a history of cancer, with active
biomedicalresearchthatisdevelopingnewwaystohelpthoseafflictedwithcancer
preservetheirabilitytohavebiologicalchildren[6].
Fertility concerns have begun to emerge as a quality of life issue important
to patients. In one study of cancer survivors, 76% of those who were childless
expressedadesiretohavechildreninthefuture[7].Impairedfertilityasaresultof
cancer treatment has negative psychological as well as physical effects. The exist-
ingliteratureonwomenwhosefertilitywasimpairedasaresultofcancertreatment
revealsanintensepsychologicaldistress;forthesewomen,“psychologicaldistress
mayresultfrom,notonlythelossofthephysicalabilitytoconceive,butalsoasym-
bolic loss of the option or idea of fertility, regardless of whether this would have
beenacteduponorachievable”[8].Studiesonmenhaverevealedsimilarlevelsof
long-termdistressovertheirimpairedfertilityasaresultofcancertreatments[9].
The previous book, Oncofertility: Fertility Preservation for Cancer Survivors,
primarily concentrated on the medical and technological aspects of oncofertility
[10]. What differentiates this book from the first edited collection is the focus on
perspectives from those outside of “hard” science. To move beyond oncofertility
as a science and medical technology and begin to address the social, legal, and
v
vi Preface
ethical ramifications of this emerging field, we must give voice to scholars from
thehumanitiesandsocialsciencestoengageinaninterdisciplinarydiscussion.This
book,wehope,willbeginsuchadiscourse.
Oncofertility: Ethical, Legal, Social, and Medical Perspectives emerged from a
robustsummitthatoccurredinthesummerof2009,whichbroughttogetherschol-
arsfromthehumanities,socialsciences,andthelaw,toexaminethecomplexissues
raisedbyrecentdevelopmentsinthefieldofoncofertilityandtoprovideinterdisci-
plinaryperspectivestohelpshapetheunderstandinganddeliveryofthisnewfield.
The book opens with some background information on the science and technol-
ogy of oncofertility. The majority of this book addresses the ethical, legal, and
socialaspectsofoncofertilityandisdividedintofivesections:HistoricalandLegal
Perspectives;ClinicalandTheoreticalEthics;ReligiousPerspectives;Ramifications
forEducationandEconomics;andRepercussionsofOncofertilityforPatientsand
their Families. The final section is titled Health Care Provider Stories and Final
Thoughts. Our first book highlighted patients’ stories of facing cancer and poten-
tial infertility while being young. This book provides first person stories from the
providers’ side of the equation. In remarkably honest prose we are given insights
into the impact oncofertility is having on the health care professionals drawn into
thisemergingfield.
BothcancerandinfertilityplayprofoundrolesinAmericansocietybeyondtheir
existenceasmedicaldiagnoses.Itisourhopethatthisbookwillbeusefulforpeople
notonlywithinthehumanitiesandsocialsciencesdisciplinesbutalsoforthosewho
areconfrontedwithcancerandthepossibilityofimpairedfertilityandthemedical
practitionerswithinoncologyandreproductivemedicinewhoareatthefrontlines
ofthisemergingfield.
As with any book, there are many people to thank. We are grateful to Shauna
Gardino, Jacqueline Kestler, and Bryan Breau for their organizational efforts and
constructivecriticism.WealsowishtothankinternDanielBascoforhelpingwith
necessary but tedious paperwork and Ehren Fourier for helping with the devel-
opment logistics of this book. Finally, this book is an outcome of the summer
humanitiesconference,andthisconferencecouldnothavetakenplacewithoutthe
help of interns Amanda Fleetwood, Andrew Russell, Kiran Screenivas, and Victor
O’Halloran.
Chicago,Illinois TeresaK.Woodruff
LaurieZoloth
LisaCampo-Engelstein
SarahRodriguez
References
1. American Cancer Society. 2009. Cancer statistics 2009 presentation. http://www.cancer.org/
docroot/PRO/content/PRO_1_1_Cancer_Statistics_2009_Presentation.asp(October12,2009)
2. HornerMJ,RiesLAG,KrapchoM,NeymanN,AminouR,HowladerN,AltekruseSF,Feuer
EJ, Huang L, Mariotto A, Miller BA, Lewis DR, Eisner MP, Stinchcomb DG, Edwards
Preface vii
BK, Eds. SEER cancer statistics review, 1975–2006. Bethesda: National Cancer Institute:
(http://seer.cancer.gov/csr/1975_2006/, based on November 2008 SEER data submission,
postedtotheSEERwebsite,2009).
3. AmericanCancerSociety.Cancerfactsandfigures2006.Atlanta:AmericanCancerSociety;
2006.
4. ClaymanML,GalvinKM,ArnstonP.Shareddecisionmaking:fertilityandpediatriccancers.
In: Woodruff TK, Snyder KA, Eds. Oncofertility: fertility preservation for cancer survivors.
NewYork:Springer;2007.
5. Kinahan KE, Didwania A, Nieman CL. Childhood cancer: fertility and psychosocial impli-
cations. In: Woodruff TK, Snyder KA, Eds. Oncofertility: fertility preservation for cancer
survivors.NewYork:Springer;2007:191(Quote).
6. Synder KA. Oncofertility and the social sciences. In: Woodruff TK, Snyder KA, Eds.
Oncofertility: fertility preservation for cancer survivors. New York: Springer; 2007:137
(Quote).
7. Schover LR, Rybicki LA, Martin BA, Bringelsen KA. Having children after cancer: a pilot
surveyofsurvivors’attitudesandexperiences.Cancer.1999;86:697–709.
8. Carter J, et al. Gynecologic cancer treatment and the impact of cancer-related infertility.
GynecolOncol.2005;97:90–5(Quoteonp.93).
9. GreenD,GalvinH,HorneB.Thepsycho-socialimpactofinfertilityonyoungmalecancer
survivors:aqualitativeinvestigation.Psychooncology.2003;12:141–52.
10.WoodruffTK,SynderKA.Oncofertility:FertilityPreservationforCancerSurvivors.Springer,
2007.

Contents
PartI TheScienceandTechnologyofOncofertility
1 ReproductiveHealthAfterCancer . . . . . . . . . . . . . . . . . 3
ClarisaR.Gracia
2 DesigningFollicle–EnvironmentInteractionswithBiomaterials . 11
RachelM.Smith,TeresaK.Woodruff,andLonnieD.Shea
3 GametePreservation . . . . . . . . . . . . . . . . . . . . . . . . . 25
SusanL.BarrettandTeresaK.Woodruff
4 ToTransplantorNottoTransplant–ThatIstheQuestion . . . . 41
ShermanJ.Silber,TeresaK.Woodruff,andLonnieD.Shea
5 ClinicalCasesinOncofertility . . . . . . . . . . . . . . . . . . . . 55
LaxmiA.Kondapalli,FanzhenHong,andClarisaR.Gracia
6 Cancer Genetics: Risks and Mechanisms of Cancer
inWomenwithInheritedSusceptibilitytoEpithelial
OvarianCancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
LeeP.ShulmanandJeffreyS.Dungan
7 ProtectingandExtendingFertilityforFemalesofWild
andEndangeredMammals . . . . . . . . . . . . . . . . . . . . . . 87
PierreComizzoli,NucharinSongsasen,andDavidE.Wildt
PartII HistoricalandLegalPerspectives
8 PlacingtheHistoryofOncofertility . . . . . . . . . . . . . . . . . 103
SarahRodriguez
9 Medical Hope, Legal Pitfalls: Potential Legal Issues
intheEmergingFieldofOncofertility . . . . . . . . . . . . . . . . 111
GregoryDolin,DorothyE.Roberts,LinaM.Rodriguez,
andTeresaK.Woodruff
ix