Take Your Kids to Work Day: Fertility Preservation for the Mini-Me’s!

Yesterday, April 26th, was Take Your Kids to Work Day and as always, the Woodruff Lab opened its doors to the future generation of white coats!  Woodruff Lab members brought their children in to take part in a day of activities to help them learn more about the research we do at the Oncofertility Consortium (and have a ton of fun while doing it)!  The kids ranged in age from 2 to 7, and we even had a 3 month old nearby refusing to nap as she could not keep her little eyes off of the fun experiments taking place around her.

Our morning activities included:

What is Alginate?

Mini-scientists learned what alginate is, where you find it in your every day life, and how we use it in the lab.  They made alginate beads, wrote a recipe for what they did, and drew their results in their notebooks.

Fun with dry ice and liquid nitrogen

Mini-scientists watched as a researcher used liquid nitrogen to freeze grapes and oranges. They got to feel and see the fruit before and after the freezing process and discussed how the process changed the fruits texture.

What Do you See Under the Microscope?

Mini-scientists looked at slides of oocytes under the microscope and drew what they saw in their notebooks.

What Does a Lab Mouse Do?

Mini-scientists got to meet and learn about how lab mice contribute to science. This was hands down, their favorite activity! 

After a long morning of scientific activities, our little lab members were treated to a nutritious lunch and a PBS broadcast of Sid the Science Kid, before heading home.  It was a great day and we love getting the opportunity to show children and young adults all the dynamic things we are working on in the lab to help cancer patients. Hopefully this will plant the seed in their young minds that they too can make a difference through science and innovative thinking.

 

Collaborative Care for Young Women with Post-Surgical Menopause

We talk a lot about the importance of collaborative care at the Oncofertility Consortium. Often cancer patients have a variety needs that require multiple specialists, thus the need to consult and collaborate to ensure the patient is receiving comprehensive care is pertinent. In a new article in the journal Familial Cancer entitled, “The Consequences of Risk Reducing Salpingo-Oophorectomy: The Case for a Coordinated Approach to Long-Term Follow Up Post Surgical Menopause,” the authors Carmel Pezaro, MD, Paul James, MD, Joanne McKinley, Mary Shanahan, Mary-Anne Young and Gillian Mitchell, MD argue that young women who have had risk reducing salpingo-oophorectomy (RRSO) need improved support services from their healthcare team in the long-term aftermath of this surgery.

First of all, let’s start by going over what salpingo-oophorectomy is for those of you who don’t know. Salpingo-oophorectomy is the removal of the ovary(ies) together with the fallopian tube(s).  For young women with mutations in BRCA1 and BRCA2 genes, an RRSO is often recommended as a preventative measure against the increased risk for breast and ovarian cancer prior to natural menopause.  Up to this point, no long-term studies have been done on pre-menopausal women who have undergone RRSO  focusing on the wider physical consequences of the surgery (aside from sexual dysfunction) such as the severity of menopause symptoms and risk factors like osteoporosis.

The significance of menopause systems in RRSO patients is important to investigate due to research suggesting  that surgical menopause “may result in a more rapid decrease in bone density when compared to natural menopause, it’s association with cognitive impairment or dementia, and an increased risk of cardiovascular mortality.”  Often health care providers emphasize the importance of RRSO in preventative cancer care, but it is unclear whether or not the long-term consequences of this surgery and the management of those symptoms are addressed. Furthermore, symptom severity was markedly higher in women who were less than 50 years old prior to surgery regardless of their menopause status.  The authors hypothesize that one reason for this may be that younger women are more affected by the sexual consequences of menopause because they are engaged in a greater amount of sexual activity.

The results of this study demonstrate that women are not receiving appropriate structured support for their symptoms post surgery. The authors suggest that because their follow-up care crosses many disciplines, it falls between the cracks as providers assume someone else is taking care of it, therefore the medical team providing the long-term genetic follow-up should also be reasonable for coordinating the long-term post RRSO management in conjunction with general practitioners. Read the article, “The Consequences of Risk Reducing Salpingo-Oophorectomy: The Case for a Coordinated Approach to Long-Term Follow Up Post Surgical Menopause.”

April 22nd-28th: National Infertility Awareness Week

April 22-28, 2012 is National Infertility Awareness Week (NIAW), a nationwide campaign intended to educate the public about infertility and the concerns of the infertility community.  This year’s theme is “Don’t Ignore Infertility,” with an emphasis on speaking out about the realities of infertility, and acknowledging that infertility is a medical condition with far-reaching social and emotional implications, thereby breaking the silence surrounding this life-altering condition.

I think this year’s theme particularly resonates with the young cancer community who often find themselves advocating for their own fertility in the face of cancer.  The Oncofertility Consortium and the AYA cancer community work tirelessly to ensure that fertility counseling and preservation options are incorporated into cancer treatment plans for newly diagnosed cancer patients with reproductive potential so that they have fertility options as they transition to survivorship.

Together, in support of this very important health awareness week, we can educate millions of people about a condition that is often overlooked or misunderstood by healthcare professionals, insurance companies, and even family members. RESOLVE, the National Infertility Association, has put together a number of ways that you can show your support for NIAW, which we decided to tweak a bit for the cancer community. Take a look!

  • Don’t ignore opportunities to talk about infertility.   Take advantage of opportunities to share information about or bring attention to the cause of infertility, particularly if you are a young cancer survivor who has experience with fertility issues.
  • Don’t ignore legislation affecting infertility patients.  Several pending and existing laws encroach upon the rights of the infertile to freely build their families. Help change policy and protect your rights. Advocate for infertility insurance coverage in your state.
  • Don’t ignore infertility support available.  Infertility is a lonely road, but no one has to travel it alone. Find support networks such as “Starting a Family After Cancer,” with Gilda’s Club Chicago.
  • Don’t ignore people struggling with infertility.  Reach out to friends or family members struggling with infertility. Ask how you can best support them in their journey.
  • Don’t ignore family building alternatives.  You can build your family through many paths (adoption, surrogacy, donor eggs, etc…). During this week, open your mind to options that you had not previously considered.
  • Don’t ignore your own strength. Be your own best advocate. If you are faced with a cancer diagnosis, don’t wait for your healthcare provider to talk to you about your fertility options, be the first to ask them.

In celebration of NIAW, take control of your reproductive health and recognize the importance of ensuring that we incorporate fertility options into comprehensive care plans for all newly diagnosed pediatric, adolescent and young adult cancer patients.

Fertility Preservation Options, Procedures and Protocols

Fertility preservation services are expanding as advances in cancer treatment are made, allowing people to live longer and fuller lives. As a result, quality-of-life issues including fertility preservation, are a concern for more and more cancer patients within their reproductive years.  In a new article in Reproductive Biomedicine Online by oncofertility researchers Nicole Noyes, MD, Jaime M. Knopman, MD, Katherine Meizer, MD, M. Elizabeth Fino, MD, Brooke Friedman, MD and Lynn M. Westphal, MD, entitled, “Oocyte Cryopreservation as a Fertility Preservation Measure for Cancer Patients,” the authors discuss the various fertility preservation procedures, options, and stimulation protocols available to female cancer patients.

One particular cancer, cervical cancer, is commonly diagnosed during the reproductive years. Historically, the treatment for cervical cancer was a radical hysterectomy, meaning the surgical removal of the uterus, ovaries, oviducts, cervix and related lymph nodes making it impossible for a female to conceive or carry a child.  The radical hysterectomy is often followed by pelvic radiation and chemotherapy depending on what stage the disease is in at diagnosis. As a result of the average age and reproductive potential of women diagnosed with cervical cancer, an alternative treatment for early stage cervical cancer was implemented: the radical trachelectomy.

A radical trachelectomy is the surgical removal of the uterine cervix. As the uterus is preserved, this type of surgery is a fertility preserving surgical alternative and is applicable in selected younger women with early cervical cancer.  According to the authors, “it is estimated that up to half the patients diagnosed in their child-bearing years are eligible for this procedure,” and data suggests that survival is similar to that of a radical hysterectomy. As you may remember from a previous blog, Michelle Whitlock opted for this procedure when she was first diagnosed with cervical cancer in an attempt to preserve her fertility.

Undergoing a radical trachelectomy does not ensure that conception and birth can be achieved. The authors discuss complications that can arise from radical trachelectomy such as cervical-factor infertility, premature delivery, and late-term miscarriage. They also suggest that patients who pursue IVF, opt for a single embryo transfer to lessen their chance of twins and/or miscarriage. To learn more about this procedure as well as other fertility sparing procedures, options, and protocols for women, please click here to read, “Oocyte Cryopreservation as a fertility Preservation Measure for Cancer Patients.”

2012 Oncofertility Conference Launch!!

The Oncofertility Consortium is pleased to announce the launch of the 2012 Oncofertility Conference webpage!  For anyone who doesn’t know yet, the 6th annual Oncofertility Conference  (#oncofert12 for you Twitter folks!) is being held in Chicago this fall, September 26th-28th.  This year will prove to be one of our most exciting and dynamic conferences yet.  If you’ve been waiting to register, peruse our presenter line-up or submit an abstract, now’s your chance.  This year we are also offering some very exciting preconference courses for researchers and clinicians on starting your own fertility preservation program and in vitro follicle growth.

Not forgetting the advocates and all that they do for cancer and fertility, we will be hosting a cocktail hour for the many supporters we’ve joined forces with along the way, including the infamous AYA group, Stupid Cancer.   You know that if Stupid Cancer’s there, you’re bound to have a great time AND be inspired!

Some highlights of this year’s conference include:

We look forward to seeing you in September!

 

The Role of Radiation Oncologists in Fertility Preservation Consultations & Referrals

As we’ve discussed in previous blogs, certain health care providers have a unique role in communicating fertility preservation information to newly diagnosed cancer patients. For example, often a gynecologist is the primary health care provider for many young women, therefore, based on “regular and consistent” interactions with patients, they play a pivotal role in discussing fertility preservation options should the circumstances arise. In a new article by Oncofertility Consortium researchers, Clement K. Gwede PhD, MPH, RN, Susan T. Vadaparampil PhD, MPH, Sarah Hoffe MD and Gwendolyn P. Quinn PhD, entitled, “The role of radiation oncologists and discussion of fertility preservation in young cancer patients,” published in the journal, Practical Radiation Oncology, the authors examined potential differences in practice behaviors, specifically referral and discussion of fertility preservation, among oncologists (ie, surgical oncologists, medical oncologists, and radiation oncologists).

The authors hypothesized that radiation and medical oncologists would be the most likely likely to initiate discussions about fertility preservation and subsequently refer patients to a reproductive specialist. They argued that “due to the inherent scope of radiation and chemotherapy treatment practices that include both verbal and written enumeration of potential short- and long-term treatment toxicities that can arise from the intended course of therapy.” In addition to that, they argued that because radiation treatment takes place over several weeks, patients have daily interactions with staff and weekly treatment exams with the radiation oncologist and nurse putting them in a unique role to discuss fertility preservation with their patients.

The results of their study are very interesting – they found that 82% of radiation oncologists say that they “always/often” discussed the impact cancer treatment may have on fertility compared to only 51% of surgical oncologists, however they found no substantial difference in referral rates with only 24-31% of subspecialty oncologists “rarely/never” referring patients to a reproductive specialist. Their findings suggest that there is still an opportunity to ensure that subspecialty oncologists are provided with appropriate fertility preservation information and resources so that patients receive comprehensive cancer care, including fertility preservation consultations and referrals. This in turn may improve the quality of life of cancer survivors within their reproductive years. To read, “The role of radiation oncologists and discussion of fertility preservation in young cancer patients,” please click here.

National Minority Cancer Awareness Week: April 15th-21st

Fifteen years ago, the U.S. House of Representatives designated the third week in April as National Minority Cancer Awareness Week in an effort to draw attention to the disparities in cancer incident and death rates, stating  “While cancer affects men and women of every age, race, ethnic background, and economic class, the disease has a disproportionately severe impact on minorities and the economically disadvantaged.” Next week, April 15th-21st, is this year’s National Minority Cancer Awareness Week and the Oncofertility Consortium plans to continue to raise awareness about this divisive health discrepancy.

National Minority Cancer Awareness Week promotes increased awareness of prevention and treatment among segments of the population that are at greater risk of developing cancer. The week’s emphasis gives us an opportunity to focus on high-risk populations and to develop innovative approaches to battling cancer incidence unique to these communities.
As reported by the Centers for Disease Control and Prevention (CDC), cancer death rates for women are highest among African American women and new research suggests they are less likely to receive fertility preservation information after cancer diagnosis than Caucasian women. Although cancer deaths have declined for both Caucasians and African Americans living in the US, African Americans continue to suffer the greatest burden for each of the most common types of cancer. For all cancers combined, the death rate is 25 percent higher for African Americans than for Caucasians.

To better understand the disparities among the overall incident and death rates among racial/ethnic groups, please take a look at the tables below provided by the National Cancer Institute (NCI):

Table 1. Female Breast Cancer Incidence and Death Rates

Breast
Racial/Ethnic Group Incidence Death
All 127.8 25.5
African American/Black 118.3 33.8
Asian/Pacific Islander   89.0 12.6
Hispanic/Latino   89.3 16.1
American Indian/Alaska Native   69.8 16.1
White 132.5 25.0

Table 2. Cervical Cancer Incidence and Death Rates

Cervix
Racial/Ethnic Group Incidence Death
All   8.7 2.6
African American/Black 11.4 4.9
Asian/Pacific Islander   8.0 2.4
Hispanic/Latino 13.8 3.3
American Indian/Alaska Native   6.6 4.0
White   8.5 2.3

Although much progress has been made in addressing disparities in cancer treatment and support, there is still much to be done!  Please use National Minority Cancer Awareness Week as an opportunity to continue to push for progress among minority communities in the fight against cancer.

Virtual Grand Rounds Tomorrow: Preserving Sexual Function After Cancer

Quality-of-life issues are important for the many young cancer survivors who will spend decades in post-treatment survivorship. Of the many considerations for survivors, most of the time the Oncofertility Consortium focuses on the reproductive future of young people. However, related issues of sexuality after cancer can have equally significant impacts on later quality of life. Stacy Lindau, MD, MAPP will be sharing her insights on sexual health for survivors at the next Oncofertility Virtual Grand Rounds, tomorrow, April 11th, at 10 AM central time.

Dr. Lindau is an Associate Professor at the Pritzker School of Medicine in the Departments of Obstetrics and Gynecology, Medicine-Geriatrics, and University of Chicago Comprehensive Cancer Center. She is also the director of the University of Chicago’s Program in Integrative Sexual Medicine (PRISM), which uses a multi-disciplinary and multi-institutional approach to solving the sexual health problems of cancer patients. At tomorrow’s rounds, Dr. Lindau will present a “Call to Action to Preserve Sexual Function in Women and Girls with Cancer.”

To join the Oncofertility Virtual Grand Rounds, login to participate beginning at 9:50AM Central Time by visiting http://nwuniversity.na3.acrobat.com/oncofertility. Login as a guest (you will not be given a login), When asked for your name, please try to include your institution (for example: YourName@Northwestern) so we can identify you if you ask a question! For technical assistance, please contact: Zoran Ilic at z-ilic@northwestern.edu

NOTE: test the computer you plan to use the day of the conference for compatibility by visiting:http://nwuniversity.na3.acrobat.com/common/help/en/support/meeting_test.htm

 

Oncofertility joins the AAMC Steering Committee on Women in Medicine and Science

Congratulations are in order for Kate Waimey Timmerman, PhD, who was just named by the American Association of Medical Colleges (AAMC) to the Women in Medicine and Science Steering Committee (GWIMS).  This appointment is an important step for Dr. Timmerman as well as the Oncofertility Consortium as it provides her with the opportunity to advocate for sex and gender equity in health and medicine nationally.

In 2009, the AAMC’s Board of Directors approved the creation of the GWIMS. This committee serves as a national forum for the advancement of women’s success in medicine and science by addressing gender equity, career advancement, awards and recognition, and recruitment and retention. The committee does this through advocacy, collaboration, fact-finding, and the development of initiatives, programs, and networking opportunities. GWIMS also supports women faculty in their development and implementation of institutional policies and professional development activities.

The GWIMS steering committee meets twice a year and provides additional networking opportunities at the AAMC Annual Meeting and the Early and Mid-Career Women Faculty Professional Development Seminars. According to Elizabeth Coakley, Director of GWIMS, “In order to address the growing number of gender-related issues in academic medicine, academic medical centers need visionary representatives who understand the complex responsibilities for women leaders.”

Dr. Timmerman is thrilled with her new appointment adding this new post to her repository of work promoting women in medicine and science. She states, “I am a great believer in collaborative approaches to problem solving and enjoy building relationships with like-minded individuals and groups for similar causes such as women’s education in science and medicine.” Congratulations Dr. Timmerman, we are very excited to see where this road takes you!

National Young Adult Cancer Awareness Week

This week is the 10th Annual National Young Adult Cancer Awareness Week, beginning April 2nd and ending on April 8th. In April 2003, National Young Adult Cancer Awareness Week was launched, and organizations and clinical institutions throughout North America began partnering to raise awareness about the unique needs of this age group. The young adult cancer population is defined as anyone who has been diagnosed with cancer between the ages of 15 to 39, and according to the National Cancer Institute (NCI), more than 70,000 young adults are diagnosed with cancer each year.

Young adults with cancer face unique concerns such as fertility, body image, cognitive function, long-term effects, education, insurance and employment. They also deal with distinct issues based on their age group, still reaching for their goals and dreams, which many older cancer patients have already achieved. For many young cancer patients, they envision themselves with a biological family at some point in their lives so fertility is a top concern for the young adult population.

In 2003, when National Young Adult Cancer Awareness Week was founded, there were few groups or organizations advocating for young adults with cancer. Today though, there is a large movement on behalf of this age group providing a number of services, programs, and networking opportunities including the Oncofertility Consortium, Stupid Cancer, and Imerman Angels among so many others.  There is something for everyone!

For more information on community resources for young adults with cancer, please visit the Patients page of our website. You will find support groups and organizations that cater to the specific needs of young adults diagnosed with cancer. In the meantime, help us bring awareness to the young adult cancer community by spreading the word about National Young Adult Cancer Awareness Week!

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