Fertility preservation advice advocated for cancer patients.(News)

New guidelines issued by the American Society of Clinical Oncology advise discussion of fertility preservation options with cancer patients as early as possible in treatment planning.

Sperm banking and embryo cryopreservation are proven methods of saving fertility in survivors, but they are rarely discussed when physicians and patients are dealing with a cancer diagnosis, Dr. Stephanie J. Lee, cochair of the committee that wrote the document, said in an interview.

It's not surprising that the topic gets short shrift in the flurry of activity at this time, she said. "A diagnosis of cancer is overwhelming, and there are many things to talk about and many decisions to make. Often, neither patients nor oncologists are thinking about future fertility. But it is important to many patients, even if they don't bring up the issue themselves."

Addressing the issue quickly is crucial, said Dr. Lee, an associate member of the Fred Hutchinson Cancer Research Center, Seattle, Wash. "Time is of the essence," Dr. Lee said in an interview. "Some fertility preservation options, especially for women, are time consuming and can delay the start of cancer therapy." To minimize this possible delay, patients who desire fertility preservation should be referred to a fertility specialist as quickly as possible, she stressed.

Fertility counseling isn't only appropriate for adults, the guidelines note. Parents may be interested in learning about the options available for their pubertal children; there are very limited data on techniques for prepubertal children.

The guidelines, based on a review of 267 studies published from 1987 to 2005, conclude that fertility preservation can be a psychological benefit to cancer patients. Although infertility is low on the list of stressors during the initial phase of a cancer diagnosis, it is one of the highest stressors among survivors of reproductive age, the document says. One study concluded that sperm banking improves cancer coping in men, regardless of whether they ever use the samples. And cancer survivors often report heightened appreciation of family closeness and improved coping skills--attributes important to being good parents, the document says.