Safeguarding the future of cancer patients

Article from 2019/2020 Impact of Giving Annual Report

Every year in Australia, 1,000 young people are diagnosed with cancer and 87 per cent are aged 14 or under. For children and families, this brings immediate worries about treatment options, hospital stays, and missing out on school, friends and family. Often, the last thing on their mind is the impact of treatment on the child’s fertility. This is where the fertility preservation service steps in, playing a life changing role in the holistic care of patients at the RCH.

The Fertility Preservation Service was established with philanthropic support in response to the increasing awareness of the long term impacts of cancer treatment on children and their reproductive systems. The team currently consists of two onco-fertility coordinators Rafael Serrano Real and Paula Spain, onco-fertility program manager Dr Lei Shong Lau, research officer Catherine Allingham and clinical lead in fertility Dr Yasmin Jayasinghe. The service is overseen by an expert steering committee of specialists and technicians. Together, they are committed to improving the lives of children and adolescents whose fertility care may be adversely impacted due to cancer treatment or other medical conditions.

“Although it was already an international standard of care to discuss the impact that cancer treatment can have on a patient’s fertility, it traditionally wasn’t considered within the scope of practice, and there was limited guidance to help clinicians, resulting in disparities in care,” said clinical lead in fertility, Dr Yasmin Jayasinghe.

“With significant advances in paediatric medicine, quality of life beyond treatment is now a focus of care, and we have developed a framework for clinicians to have discussions on fertility to provide accurate information to both the patient and their families. The clinician support provided through the onco-fertility coordinators has been invaluable.”

Thanks to the establishment of the Fertility Preservation Service, when a patient is diagnosed with cancer at the RCH, discussions around their treatment options factor in their future. Chemotherapy, radiation and surgery can have long term implications on a child’s ability to have children of their own later in life, as well as more immediate effects on their puberty and development. After discussions with their oncologists, an onco-fertility coordinator now meets with the patient and their family to talk about fertility and possible fertility preservation options.

“We are now leading an Australian and New Zealand Paediatric, Adolescent and Young Adult Fertility Preservation Coalition to support the implementation of quality fertility care at other Australian and New Zealand Children Haematology and Oncology Group centres. This will give all young cancer patients in Australia and New Zealand equal access to quality fertility care. This work would not have been possible without the ongoing support of the RCH Foundation,” said program manager Dr Lei Shong Lau.

For 22 year old Amelia Di Virgilio, having fertility options after her bone cancer diagnosis was a significant part of her care at the RCH.

“I know for me at the age of 13 I didn’t think it would be something I was discussing or thinking about having children, but it’s something I had to do at the time and I’m so thankful that I got the opportunity to. I think discussing fertility at any time during the diagnosis is so important,” said Amelia.

“The Fertility Preservation Service aims to speak to all cancer patients, however not everyone will receive fertility preservation procedures. This can depend on the type of treatment they are receiving, their age, and ultimately the wishes and beliefs of the young person and their family,” said Catherine Allingham, research officer at the Fertility Preservation Service.

“Currently at the RCH, patients have the option to freeze sperm, ovarian or testicular tissue or take medication used to suppress the production of sex hormones during chemotherapy.”

As Australia’s leading fertility preservation service for young people with cancer, the team’s practices are guided by data and the latest research to inform the care of patients. Thanks to the generous support of donors to the RCH Foundation, the onco-fertility coordinators within the Fertility Preservation Service are ensuring that cancer patients are receiving coordinated best-practice care, enabling sick children and their families to make informed decisions about their fertility and long term options.