In Australia, 1-in-9 new bowel cancer cases (1,716) occur in people under the age of 50 each year. Bowel cancer is the second most common cancer in women after breast cancer.
Bowel cancer treatment can come with fertility risks and understanding the options for preservation of fertility is an important consideration for many patients.
Just as all other side effects are discussed, possible impacts on reproductive function and fertility should be part of any discussion with your treating specialist before starting treatment for bowel cancer.
Women who receive a bowel cancer diagnosis before starting or completing their families will often have many questions about how cancer treatment might affect their ability to have children in the future.
Surgery that involves removal of the uterus and/or both ovaries in women will cause infertility. Even if the reproductive organs are able to be partially or totally preserved, there may be scarring that can make it difficult to conceive or carry a pregnancy.
Radiation treatment to the pelvic area can damage the ovaries, which are very sensitive to even low doses of radiation. The amount of damage depends on the size of the radiation field, the dose of radiation given and the number of treatments. If the uterus is included in the radiation field, it can be damaged, making it difficult to conceive and carry a pregnancy.
Chemotherapy can cause temporary or permanent infertility, depending on the drugs and doses used. Your periods may become irregular or stop during treatment.
Precision medicines may also affect your fertility, depending on which drug you are taking.
Some treatments for bowel cancer also carry a risk of infertility for men.
Coping with a bowel cancer diagnosis as well as possible infertility can be hard. Even if you are not ready to have a child now, you might want the option to start or grow your family in the future. You might feel that things are moving very quickly with little time to make important decisions.
If you are considering trying for a family or growing your family, there can be a lot of fear around falling pregnant, miscarrying or not being there while your child/children grow up. If you have had treatment that has left you unable to carry a child, you may experience intense feelings of disappointment, loss, or grief.
"I was diagnosed with bowel cancer at 33 when my son was just 15 months old.(...) Facing a cancer diagnosis at such a young age and having just become a mother was traumatic enough but I also experienced a lot of grief, anxiety and fear over whether I would be able to have more children." ~ Jessica
Fertility preservation options include ovary transposition and egg or embryo freezing before treatment.
In some cases, bowel cancer is diagnosed during pregnancy. Although rare, this often leads to bowel cancer being detected in its later stages.
Common presenting symptoms of bowel cancer – fatigue, anaemia, abdominal discomfort or pain, bowel changes including constipation, nausea, vomiting and rectal bleeding – might be attributed to pregnancy itself and are often overlooked.
Treating (or not treating) bowel cancer during pregnancy can impact mother and baby, with effects continuing in the postpartum period.
Our new Pregnancy and Fertility Resource provides information on symptoms, diagnosis, fertility and the impact on pregnancy and the postpartum period.
If you have received a bowel cancer diagnosis and are planning or trying to conceive, pregnant, or still growing your family, it is vital that you speak to your GP or specialist about your fertility or pregnancy. They can refer you to a counsellor or fertility specialist, who can provide invaluable support in addition to your medical team.
Our dedicated team of Bowel Care Nurses, Nutritionists and Oncology Social Workers can provide additional support and ensure you are aware of any resources at your disposal.
Contact us via our Support for You webpage or call our free Helpline on 1800 727 336 during business hours.
