Cancer survival rates continue to improve, but many patients face long-term reproductive health challenges after treatment. Dr. Leslie Appiah, provider at CU Medicine Gynecology – Cherry Creek and Medical Director of the Fertility Preservation and Reproductive Late Effects Program at the University of Colorado, explains what patients should know about protecting their reproductive health during and after cancer treatment.
What Are Reproductive Late Effects?
"Reproductive late effects refer to the negative gynecologic and urologic effects that occur after cancer treatments," explains Dr. Appiah. These effects can vary significantly depending on the type of treatment received.
How Different Cancer Treatments Affect Reproductive Health
Cancer treatments can impact reproductive health in various ways. Pelvic radiation may cause vaginal scarring and affect a woman's ability to have intercourse. It can also damage the uterus, potentially leading to pregnancy complications such as miscarriages and low birthweight infants.
Chemotherapy, particularly a category called alkylating agents, can significantly affect reproductive function. "These agents, like cyclophosphamide, are extremely effective in curing cancers but can be harmful to normal tissues including hair, skin, ovaries and testes," Dr. Appiah notes.
Some patients may experience early menopause, bringing challenges such as night sweats, early osteoporosis, hot flashes, joint pain, and mood disorders.
Different types of radiation therapy can damage reproductive organs and disrupt hormone production essential for fertility. The following radiation treatments can cause infertility:
- Total body radiation used during stem cell or bone marrow transplants that can damage reproductive organs
- Pelvic radiation that directly harms the uterus, ovaries or testes
- Brain radiation that disrupts hormone production needed for egg or sperm development
Specialized Care Makes a Difference
As a reproductive health specialist, Dr. Appiah works with her team to predict which patients might experience these effects and develops preventive strategies. "My role is to screen for these late effects and start therapies very early to help prevent them from progressing into something more permanent," she explains.
Taking Action Early
Dr. Appiah emphasizes the importance of early intervention: "Any patient who has a cancer diagnosis or where there's a concern for cancer should ask their oncologist to refer them for consultation with a fertility preservation specialist."
While not every institution has a fertility specialist, there is a growing network of specialists seeing patients from surrounding cities and states like the one at the University of Colorado. The goal is to ensure patients understand their options for fertility, gynecologic, urologic, and sexual health before beginning cancer treatment.
Working Together for Better Outcomes
Patients can partner with their primary care physician or a reproductive health specialist to improve their health outcomes. Through early screening, preventive treatments and ongoing education, many reproductive late effects can be managed effectively.
For general questions and to make an appointment please call the Fertility Preservation Program Coordinator and Navigator: Mikayla Ecker, BSN, RN, CPN
Fertility Preservation Specialty Coordinator
Telephone: (303) 724-2960
Email: FertilityPreservation@CUAnschutz.edu
To schedule an appointment with Leslie Appiah, MD at CU Medicine Gynecology – Cherry Creek, please call (720) 516-9410 or visit the website here.
