Opinión Quiral 40.1: Cáncer de mama y salud reproductiva en la mujer
2019
Breast cancer is the most common tumour in women. As they are getting pregnant later in life there are greater numbers of diagnoses of cancer in women who have never had a child. So how can we reconcile the treatment for cancer with the desire to have children? Recent advances are offering many solutions to this issue.
The Opinió Quiral debate on Breast cancer and reproductive health in women took place last 22nd November with the participation of genetics and oncology experts such as Miquel Gil (Head of Medical Oncology support services and Manager of knowledge at the Functional Unit of Oncology Support at the Catalan Institute of Oncology) and Pedro N. Barri (Director of the Department of Obstetrics, Gynaecology and Reproductive Medicine and Women’s Health at Dexeus University Hospital).
Miquel Gil focused on the advances that have been made in improving breast cancer survival rates, though in younger women one of the concerns should be to preserve fertility. It is very important for the oncology specialist to ascertain, prior to treatment commencing, whether women younger than forty years old wish to have children, or not, in the future. He also highlighted that becoming pregnant after having cancer does not increase the risk of relapse nor of damage occurring during the formation of the foetus.
Pedro N. Barri, specialist in assisted reproduction and women’s health, agreed that the current tendency to have children later in life is related to an increased risk of gynaecological cancer, particularly breast cancer, because the woman does not get the benefit of the protection that comes with pregnancy, birth and breastfeeding. He commented that it is vital to explain to the patient that there are strategies to preserve fertility and improve the chances of having children in the future. Moreover, they have a beneficial effect on the way in which the woman deals with cancer as they reinforce the idea that she will survive the illness.
As well as the two medical specialists, journalists in the field of medical communication and professionals in the fields of communication and medicine joined in the debate. It was highlighted that up to fifty percent of oncologists do not inform their younger patients of the possibilities of preserving their fertility, and therefore further research is required involving surveys of patients that are published and national statistics obtained, in addition to training on these issues for professionals in the field.
Further issues that were raised were that the evidence suggests that the risk of relapse of cancer is the same in patients who become pregnant after completing the course of treatment as in those who do not have more children, and that undergoing fertility treatment does not increase the risk of gynaecological related tumours.
A final recommendation was that the Catalan Health Service should seek to develop a transversal programme, with a network of interconnected specialist centres, with shared information and practice in order to ensure equal access for service users.
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