Modern chemotherapeutic protocols are highly effective at destroying malignant cells, but also damage ovaries and testicles in the process, leading to infertility in a sizable percentage of patients. This is a challenging survivorship issue faced by fertility specialists and cancer specialists alike. Most young cancer survivors desire future pregnancy, and the psychological impact of infertility can be greater than the effects of the cancer itself, with overt PTSD seen in some cases.[1] Fertility preservation treatments can increase the likelihood of future pregnancy.
Infertility is defined as the failure to achieve a pregnancy after 12 months of unprotected intercourse. It is a prevalent condition that affects about 15% of couples[1] and is commonly encountered by family physicians in the community. The majority of couples conceive within the first 3 months of trying, after which time the chances of pregnancy decline substantially.[1] After 1 year, 85% of couples will have achieved a pregnancy, while after another year only an additional 5% to 8% of couples will become pregnant.[2]
If you have ever ordered a pneumoencephalogram, administered an aminophylline drip, cross-eyed stereo-viewed a cerebral angiogram, or used Tensilon to convert paroxysmal atrial tachycardia, then you are likely retired or in the retirement-contemplative stage. So it is with me. After 40 years in medicine it’s time to retire and also step down from my 10-year membership on the BCMJ Editorial Board, which of all the committees I’ve served on has been my favorite.
I’m overdue for a good rant. Synonyms for the word rant include shout, wild, impassioned, fulminate, vociferate, diatribe,sound off, spout, pontificate, bluster, tirade, yell, and bellow. Who wouldn’t feel better after all of that is said and done?
Even though breast cancer is a major killer of women, especially women age 35 to 64, mortality rates have declined steadily since 1986.[1] This improvement has been attributed to two main factors:
• Increased screening, which has allowed for earlier and thus more effective intervention.
• Improved treatment with adjuvant therapies.
