Filter Applied » 2009 October

Pregnant with Cancer-One woman’s story

Image: Travis Hugget for CNN.com

Image: Travis Hugget for CNN.com

Writing for parenting.com, Erin Zammett Ruddy wrote an article1 today about her experiences of getting pregnant while being on Gleevac as a way to treat her chronic myelogenous leukemia (CML). Her first hand account really sums up many of the choices we’ve discussed from a clinician’s point of view: is it ok to halt cancer treatment for the duration or remainder of a pregnancy? How do the patient and clinician come to the right decision on this topic? I think we will all be happy to read that Erin’s team of doctors included endocrinologists, fertility specialists, and oncologists, and Erin herself says that her doctor’s support was instrumental in her decision to continue her pregnancy. I highly encourage you to read Erin’s story; it very nicely outlines many of the issues that the Oncofertility Consortium was designed to address.

1. Pregnant with cancer — One woman’s choice to put treatment on hold

It’s safe…right? Possible risks of IVF

Mouse 2-cell embryo   Photo: Miranda Bernhardt

Mouse 2-cell embryo Photo: Miranda Bernhardt

The options available to couples facing infertility are increasing, whether or not a cancer diagnosis is involved.  Assisted reproductive technologies (ARTs), such as in vitro fertilization (IVF), are becoming more and more common, and millions of healthy babies have been born with their help.  With all this success, we might start to forget about the biology of it all–that the “in vitro” part of IVF litterally means “in glass”–IVF embryos go through fertilization and the first few days of embryonic development outside of their mother’s body.  We need to make sure we consider the effects that growing an embryo outside the body for a few days might have.

An article from the New York Times, “Picture Emerging on Genetic Risk of IVF,” highlights recent studies looking at the impact of IVF.  These studies have shown slight increases in the rates of certain birth defects and specific rare diseases related to abnormal gene expression in children that were conceived using IVF. (The changes in gene expression in these disorders are caused by problems in a process called ‘imprinting,’ which has to do with clusters of genes expressed differently based on whether they came from your mother or father.)  Research using mouse embryos grown under different conditions also shows that there are differences in the behavior of adult mice produced from these embryos.  It looks the very early experience of an embryo matters, but the reasons why are just beginning to emerge.
I think the most important impact of research like this is that it helps us realize that we have more work to do.  It’s important to keep in mind that these disorders are still very rare in babies conceived using assisted reproduction, but it’s starting to look like the risk is slightly higher than in the general population, so it’s definitely something we need to think about and research.  For the health of future generations, we want to make sure assisted reproductive techniques (ARTs) are as safe as possible.

You can access the original article from the Centers for Disease Control on risk of birth defects here and a review article on assisted reproduction and imprinting syndromes here.

UN Taking on Women’s Issues

A few weeks ago world leaders came together for a meeting at the United Nations building in New York to discuss a whole host of issues facing the global community ranging from the proliferation of nuclear weapons to climate change.  While, weeks later, the conference still may be most famous for its discussion of mushroom clouds the meeting also yielded a less covered but equally important fallout for the way policy makers address women’s issues.

The UN, at the conference, consolidated four separate agencies focussed on women’s issues into one much more powerful group, UNIFEM.  In addition to improving organizational efficiency, the new über-agency hopes to more quickly and effectively address global issues that disproportionately affect women.  Chief among these issues are health concerns.  UNIFEM cites, among other statistics that women in sub-Saharan Africa aged 15-24 are 6 times more likely than their male counterparts to test positive for HIV.

UNIFEM, though, is extending its sights far beyond HIV and even beyond addressing sexual assaultspoverty, and political representation, all of which are most certainly on the to-do list.  The agency seeks to expose and attack gender inequality issues wherever they exist, whether it be on the battlefield, in the halls of congress, or within the walls of a hospital.

This is, in many ways, an ambition shared by Oncofertility Consortium and The Institute for Women’s Health Research.  These two organizations have put their full efforts behind expanding clinical trials on women’s health issues and improving women’s fertility preservation options, already to tremendous success.  Whether it’s a new international agency, a nationwide collaboration between basic science researchers and clinicians, or as an ever-growing database in the state of Illinois, the potential of this increased attention to women’s issues on all levels and in all arenas is should be exciting to women (and men) everywhere.

(via CNN)

Ariella Shikanov, PhD wins IBNAM-Baxter Early Career Award

Congratulations to Ariella Shikanov on receiving the IBNAM-Baxter Early Career Award.  She will investigate a combination of natural and synthetic hydrogels and drug delivery technology to maximize ovarian tissue transplantation.

The full story can be found here!

Oncofertility at the American Society for Bioethics and Humanities Conference

Next week, October 17, several of our Oncofertility Consortium members will be participating on a panel at the American Society for Bioethics and Humanities conference in Washington, DC. Their panel title is:  “From Lab To Bedside To Patient And Back Again: Gendered Responses To Questions About Fertility And Cancer Treatment And Their Clinical And Research Implications.” Below is an abstract for the meeting, as well as a quick summary of what each presenter will be talking about. If you happen to be attending the meeting, the panel will be held at 5:45-6:45; it promises to be interesting!!

Abstract
Because of recent breakthroughs and improved treatments, more people who are diagnosed with cancer survive. And many of these people are young, either in their childbearing years or survivors of childhood cancer. Indeed, one estimate is that by 2010 one of every 250 adults will be a survivor of childhood cancer. But while more aggressive treatments have allowed more young people to survive cancer, these treatments have also resulted in impaired fertility for some. Oncofertility has emerged as a way to address this threat to fertility for those with cancer, and through biomedical research the field is actively developing new ways to help those afflicted with cancer preserve their ability to have biological children.

Oncologists focus on treating a patient’s cancer, but cancer is more than a physical illness for the patient. Cancer, and its implications, has social, cultural, and familial repercussions for patients as well. One such implication is cancer-related infertility. As a result of improved survivorship rates, cancer-related infertility will become a greater concern for patients and their families as the growing cohort of childhood cancer survivors begins to age. Oncofertility is necessarily interdisciplinary, bridging biomedical and social sciences such as bioethics, law, and religion, in a broader effort to examine issues regarding a person’s fertility concerns, choices, and options. In this panel, we will raise the following questions: How are patients affected by infertility as a result of cancer treatment in their day-to-day lives? How is a cancer patient’s sense of self changed because of the possibility (or reality) of infertility? Are these responses different for men and women? And how do their responses affect treatment options – how do (or should) patients’ responses, desires, and beliefs affect treatment options that are part of standard therapy and/or are part of new research?

Panel members:
1) Jacqueline Jeruss, MD, PhD, Assistant Professor, Department of Surgery, Northwestern University: Dr. Jeruss, a member of the Oncofertility Consortium, will provide an overview of clinical aspects of oncofertility, describing her experience with patients at the bedside. Furthermore, she will explain the goals of the clinical side of the Oncofertility Consortium, how they respond to patient needs and demands, and what clinicians have achieved thus far.
2) Shauna Gardino, MPH, Clinical Research Coordinator, Oncofertility Consortium, Northwestern University: Ms. Gardino will discuss the Oncofertility “Quality of Life” survey she is conducting, specifically, the questions that are asked, why they are asked, and what the results are so far.
3) Sarah Rodriguez, PhD, Research Fellow, Oncofertility Consortium, Northwestern University: Dr. Rodriguez will analyze how the social implications of infertility in our culture, which places a high value on women bearing children, affects women with cancer and their fertility decisions.
4) Lisa Campo-Engelstein, PhD, Research Fellow, Oncofertility Consortium, Northwestern University: Dr. Campo-Engelstein will focus on how men’s experience with cancer and infertility differs from women’s. She will explore how social expectations of masculinity, especially sexual prowess, shape the fertility choices of male cancer patients.

Oncofertility Summer Research Internships

Oncofertility Summer Research Experience 2009

With support from the federal stimulus package Northwestern received from the National Cancer Institute, two teachers and two undergraduates gained hands-on experience in a working lab devoted to providing new fertility options for cancer patients!

IMG_0216_sThe money allowed Northwestern to bring relevant lab activities to teachers around the country and bring girls through the pipeline toward careers in science.

This video gives you an idea of what the experience was like. Check out the job summary to see if you or someone you know would be interested in doing it next summer:

http://www.osep.northwestern.edu/osep/summerfellowship/
http://www.research.northwestern.edu/

Some interesting reads..

The following articles in HemOnc Today and the UAB Reporter are good examples of the public awareness beginning to take shape around fertility preservation.  Take a moment to read the articles, and let us know what you think!

UAB Reporter Online: Fertility Hopes Don’t Have to End for Cancer Patients

HemOnc Today: Discussing oncofertility-The Oncologist’s Responsibility

Building an artificial ovary

The National Institute of Biomedical Imaging and Bioengineering (NIBIB) has just published a summary of the current oncofertility research in their e-Advances section titled “Building an Artificial Ovary – A New Tool for Understanding Reproductive Biology and Preserving Fertility”. This is a great piece to read if you just want a basic idea of the research behind the oncofertility consortium, and where the program is headed!

Our lab has found that follicles (the reproductive unit containing the egg and supporting cells) maintain their natural shape if grown within the biomaterial alginate in the form of a hydrogel. This allows scientists to study follicles in vitro, which is useful to understand how the follicle interacts with its environment. Also, beyond basic science, this follicle culture system is being optimized so that it can be translated to clinical use.

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