Helping cancer patients retain their fertility

December 8, 2009 by  

laboratory2Cancer treatments sometimes come with a price – infertility and inability to have children. This is especially hard on women.

While men have the option to have their sperms frozen before starting chemo and radiation therapy or undergoing radical surgery, this doesn’t work for women for a number of reasons.

  • Cryopreservation of female eggs did not really produce successful results. Human eggs do not fare well during the freezing and thawing process.
  • Women usually produce only one mature egg at a time, once every menstrual cycle. While more eggs can be artificially induced to mature, as what is done in IVF, this process can be detrimental to the cancer patient’s health. In addition, the patient might not have the luxury to wait for the eggs to mature before treatment is initiated.

A new research funded by the National Institutes for Health (NIH) may just give female cancer patients some hope.  Researchers at Northwestern University’s Feinberg School of Medicine looked into the possibility of maturing and preserving eggs outside the body. As a first step, the researchers were already able to maintain human follicles, which are little sacs containing immature eggs, in the laboratory for 30 days. Furthermore, they were able to grown these cells to near maturity.

There are still two steps to finish before women can fully benefit from the technique. The second step is to induce the cells to undergo “meiosis”, a process wherein half of the genetic material is shed off in a cell called polar body while the other half is retained within the mature egg, ready for fertilization.

The process of meiosis has been already initiated in the lab by researchers at Stanford using stem cells, producing sperm-like cells. More work needs to be done before this technique can be applied to produce mature eggs but wheels are in motion. The Stanford study was also funded by NIH.

The third and final step is still to figure out how to cryopreserve mature eggs without causing damage. This is currently the focus of many research studies.

Currently, the most common method to help women preserve their child bearing potential is still to fertilize the eggs and cryopreserve the resulting embryos. However, this presents problems for women who do not have partners or whose partners are not willing to provide the sperms for fertilization.

Also in development is a technique which entails freezing part of or a whole ovary which can again later be implanted when the woman is ready for reproduction. However, this doesn’t work for those with ovarian cancer. There is also the danger that undetected cancer cells may be present in the ovarian tissue and that by introducing the said tissue later, new cancer cells are introduced back into the body.

According to Dr. Duane Alexander, M.D., director of NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD):

“The new technique could provide an option for women and girls who have cancer and are not yet ready to start families. An additional benefit is that it will allow researchers to more closely follow the process by which immature eggs grow and mature. In turn, these observations may lead to new advances for treating other forms of infertility.”

Photo credit: stock.xchng

The Legal Rights of Cancer Patients

June 23, 2008 by  
Filed under CANCER

Your rights as a cancer patient are covered by the laws listed below.

Consider this a jumping off point to your advocacy. If you are unable to self-advocate then utilize your personal advocate as recommended in the Battling Cancer archives article Patient Advocacy.

The Americans with Disabilities Act of 1990: Basic guidelines of the ADA include:

  • Employers may not discriminate against a person with cancer or a history of cancer.
  • Employers must provide “reasonable accommodations” in the workplace for qualified employees with a disability.
  • An individual with a disability must be able to perform the “essential functions” of the job with or without reasonable accommodation.
  • Employers may ask only job-related medical questions.
  • Employers will treat all employees the same.
  • What is reasonable accommodation? It requires employers to modify an employee with cancer’s job responsibilities and or hours while they are undergoing treatment and beyond. This may include modification of work equipment or allowing an employee to come in late and make up the hours during treatment. Employers are not required to make changes that would require an undue hardship on the business.

    Report violations of the ADA to the Equal Employment Opportunities Commission, (EEOC), within 180 days of the incident.

    Statistics from the EEOC, “In Fiscal Year 2006 EEOC resolved 15,708 disability discrimination charges and recovered $54.4 million in monetary benefits for charging parties and other aggrieved individuals (not including monetary benefits obtained through litigation).”

    The Rehabilitation Act of 1973 prohibits employers from discriminating against employees because they have cancer. This act only applies to employees of the executive branch of the federal government, as well as private and public employers who receive public funds. The Congressional Accountability Act prohibits the same discrimination practices in the legislative branch of government. Acts of discrimination in the executive branch of the federal government must be reported to the EEOC within 45 days of the incident.

    The Family Medical Leave Act of 1993: The FMLA allows an employee to take unpaid leave due to a serious health condition that makes the employee unable to perform his job or to care for a sick family member or to care for a new son or daughter (including by birth, adoption or foster care). For cancer patients, this can mean up to twelve weeks of unpaid protected leave.

    Guidelines to be covered under FMLA:

    You must be employed for 12 months or 1,250 hours prior to requesting leave and your work site employer must have at least 50 employees.

    Resources: Information and Advocacy

    The American Bar Association Breast Cancer Legal Advocacy Initiative includes information for breast cancer patients. Their ten steps to protecting the rights of breast cancer patients apply to all cancer patients when dealing with their insurance carrier. Visit their site for more details on the ten steps listed below.

    1. Read your health insurance policy carefully

    2. Determine if the treatment prescribed by your doctor is covered by your insurance policy

    3. Find out what the appeals process is for your insurance policy

    4. Consult with an expert in heath insurance law

    5. Plead your case in person

    6. Personalize your written case

    7. Obtain copies of your medical records

    8. Document everything

    9. Ask your doctor to advocate for you

    10 Be prepared to fight

    Patient Advocate Foundation: a non-profit national organization that seeks to safeguarding patients through effective mediation assuring access to care, maintenance of employment and preservation of financial stability relative to their diagnosis. Besides providing information on legal issues they also provide personal assistance.

    “Patient Advocate Foundation offers assistance to patients with specific issues they are facing with their insurer, employer and/or creditor regarding insurance, job retention and/or debt crisis matters relative to their diagnosis of life threatening or debilitating diseases.”

    National Coalition for Cancer Survivorship:

    Be your own cancer survival advocate. Download free Cancer Survival Toolbox. “The Cancer Survival Toolbox is a free, self-learning audio program that has been developed by leading cancer organizations to help people develop important skills to better meet and understand the challenges of their illness. ” It is available online or in a free CD. Especially note section 6, Standing Up For Your Rights, which is devoted to advocacy.

    American Cancer Society:

    The Patient’s Bill of Rights

    • Information and disclosure
    • Choice of providers and plans
    • Access to emergency services
    • Participation in treatment decisions
    • Respect and non discrimination
    • Confidentiality of health information
    • Right to complain and appeal

    Medicare: Your Medicare Rights and Protections. In pdf from the Center for Medicare and Medicaid Services.


    June 11, 2008 by  
    Filed under CANCER

    It is a swelling or ‘edema’ caused by a build up of fluid in the lymphatic system. Secondary lymphedema is what is seen in cancer patients after surgery to remove or dissect the lymph nodes in the arm, groin or pelvis. Normally the lymphatic system and the fluid of this system move to flight infection. Once the lymph nodes are removed fluid collects in the spaces between cell tissues. The buildup of fluid causes not only swelling but inflammation, pain and thickening of the skin in the area affected.

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    NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.