Megan Rogers’ work as a navigator oncology nurse at Sanford Health in Fargo, North Dakota, represents a new role in medicine that can help cancer patients make informed decisions about having children.
“Oncofertility” is a term that not many people are familiar with. Rogers explains it this way:
“The best way to describe tumors is that they are a collaborative bridge between oncology (the study and treatment of cancer) and reproductive medicine,” Rogers said. “We are working to address fertility problems that can arise due to cancer treatments.”
Cancer and cancer treatments can affect the ability to have children, depending on the type of cancer, the age of the patient, and the type of treatment required.
navigator nurse interview
For patients diagnosed with cancer usually, the first questions are about the cancer itself. Beyond that, however, those who want to have children or may want to have children someday will have questions about fertility:
What is the risk that this cancer and treatment will affect the ability to have children in the future? What options are available before or during treatment that may preserve fertility?
These are questions that the people on your patient’s cancer team can answer. If the patient desires to have children, navigators work to get the patient to see reproductive medicine providers soon after.
“At that date they will give them more details about their options,” Rogers said. “If they choose to go ahead with egg/embryo or sperm freezing, they get it on schedule as soon as possible. This is the point where we are working closely with the oncology team to determine how long they can safely wait to start cancer treatment. It is Really collaborative approach to come up with the best plan for the patient.”
At that reproductive medicine appointment, patients can also see a financial counselor if desired. Finances can often be a huge part of fertility preservation.
“The way I think about it, knowing you have cancer is already hard enough,” Rogers said. “It can really turn people’s worlds upside down. And then you add to those treatments that can determine whether someone can be a mother or a father as they’ve always imagined. It can be really heartbreaking. That’s why fertility tumors are so important.”
Fertility Preservation Options
For men, the most common fertility preservation option is sperm freezing prior to cancer treatment. For women, the options are more complex but often involve freezing eggs or embryos. Other options are available, depending on the type of cancer treatment in some cases.
“It’s an evolving field,” Rogers said. “The options available 10 years ago are very different from what they are now. The options will likely be greater than they are today in another five or 10 years.”
The hope is that fertility will become a resource from the start for those diagnosed with cancer who are of childbearing age.
“We have patients who have told us that trying to navigate the world of oncology and the world of reproductive medicine is very difficult,” Rogers said. “Both can be challenging in their own right, and then when you add them together there is a lot that needs to be done. That’s why we created this role as a way to support patients going through it so they don’t have to do it all themselves.”
Sanford Health now has fertility navigation resources in Sioux Falls, Fargo, Bemidji and Bismarck.
“To be on the cutting edge of something like this is absolutely amazing,” Rogers said. “We want our patients to be able to look back on their cancer journey as a very small part of a long, satisfying life. If part of that life includes being a parent, we want to be able to help them do that.”