Vol 25, No 4 November 2009
ORE THAN 11.4 million cancer survivors are living in the United States, which represents
about 3.8% of the population.
Cancer survivors are living longer. Young cancer survivors,
in particular, have heightened concerns about the effects of cancer and its treatment on
While the risk of infertility in young men and women has been well-documented in the literature for
more than 20 years, the rise in strategies to reduce these risks and preserve fertility have lagged for
more than a decade. In recent years, several advocacy and professional oncology organizations have be-
gun to address the topic of fertility concerns among cancer survivors. Moreover, the reproductive and sur-
gical techniques to preserve fertility are two interventions that provide hope for cancer young survivors.
I am very pleased to present this issue of Seminars in Oncology Nursing focusing on fertility concerns
in young cancer survivors. This issue marks the ﬁrst time that the journal has devoted an entire issue to
this topic. The ﬁrst three articles focus on fertility preservation in young male and female cancer survi-
vors. First, Hobbie, Ogle, and Ginsberg examine fertility concerns of young adolescent males undergoing
cancer therapy. Using their collective clinical survivorship experiences, the authors help us to better un-
derstand the vital importance of preserving fertility. Ideally, fertility concerns must be addressed before
starting treatment. Fortunately, testicular shielding and sperm banking techniques are widely available.
Unfortunately, sperm banking has not been widely used. Time limitations and oncology and health care
attitudes are barriers to earlier intervention.
Camp-Sorrell addresses fertility preservation in young breast cancer survivors. For young female can-
cer survivors, the majority of published data relates to breast cancer survivors. Camp-Sorrell, similar to
Hobbie et al, indicate that the window of opportunity where fertility preservation techniques are best ap-
plied, are ideally done before treatment begins. She further describes updates in reproductive fertility
preservation techniques, such as embryo cryopreservation with in vitro fertilization and oocyte dona-
tion, which are increasingly used with young breast cancer survivors. While limited, these options for
improving fertility are increasing.
Schwartz focuses on fertility preservation facing young survivors of cervical cancer. Forty percent of
women with cervical cancer are of reproductive age, signaling the vital importance of conveying accurate
information to these young cancer patients. Schwartz provides excellent detail of the various surgical
methods of fertility preservation, such as trachelectomy and advanced reproductive technologies, which
have been a tremendous aid for young women with cervical cancer. However, Schwarz reminds us that
the ﬁrst intervention for young female patients with reproductive concerns begins at the ﬁrst visit. All
three articles demonstrate the vital need for information, education, and support of young cancer
The second three articles focus on the emotional, social, religious context, and future directions in in-
forming individuals about fertility and cancer. Rosen and colleagues describe the emotional distress
experienced by young cancer survivors in their quest to preserve and manage infertility. Young cancer
survivors who are not provided with timely information experience more psychological distress com-
pared with their informed counterparts. They argue for a multidisciplinary team approach with timely
referral for counseling to manage these complex issues. Earlier identiﬁcation of young survivors at risk
for psychosocial distress and earlier intervention are key strategies.
Jukkala informs us that pursuing complex fertility-sparing treatment, adoption, and other methods for
managing parenting clearly have ethical, religious, and ﬁnancial implications. Jukkala applies the ethical