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Women Can Now Preserve Fertility During Cancer Treatments

Katlyn Joy | 1, December 2014


Until recently, a young woman who received a cancer diagnosis followed by chemotherapy had another unfortunate likelihood -- infertility. That's because the drugs used in chemotherapy don't just kill off bad cells in the body, they also attack good cells. The ovaries are among the tissues of the body that are quite sensitive to chemo damage.

Now a new study shows hope for these women. Researchers from the Cleveland Clinic looked at the impact a new drug can have on breast cancer patients who want to preserve their reproductive options.

Dr. Halle Moore, medical oncologist and staff physician in the Taussig Cancer Center at Cleveland Clinic headed the research team. They looked at 200 women, and studied the rate of ovarian failure in women in two groups; the first had first stage breast cancer and received standard chemo treatment while the second group received both chemotherapy and the drug, Goserelin.

Goserelin, also known as Zoladex, is a hormone medication used in both breast and prostate cancer, as well as endometriosis. Technically, this drug is classified as a LHRH agonist, or luteinizing hormone releasing hormone. Basically, Goserelin tells the pituitary gland to stop manufacturing the luteinizing hormone so that estrogen production is halted, and so therefore are cancer cells that depend on estrogen.

What happens when a woman takes this drug, is her body is put in a kind of temporary menopause. This includes some side effects, such as hot flashes.

However, it gives hope for women wanting to have children after cancer. In the study of 200 women, 22 percent of the women who received standard chemo treatment had ovarian failure compared to the 8 percent who received both chemo and goserelin. Also, women who took the drug also had were more likely to become pregnant in the five years following treatment.

An unexpected finding was that of the women who received the drug in the study, their cancer outcomes were also more likely to be positive. This will be the topic of future research.

The only options previously for those wanting to preserve fertility following chemo were shielding the reproductive organs during radiation, freezing sperm or eggs, moving the ovaries out of the way of the treatment site, and removal of the cervix in early stage cervical cancer.

Dr. Moore stated, "For a young woman with a new diagnosis of breast cancer it can really be quite devastating to learn not only that she has cancer, but that the treatments, even if successful may result in significant long-term side effects, such as not being able to have a child in the future."

Moore explained how the drug was used, "Goserelin is one of a class of medications called GNRH agonists and it's basically a synthetic version of a hormone that we normally have that regulates the estrogen levels and other hormone levels. When we give it in the manner we did in the clinical trial it will suppress the ovaries from cycling."

The drug was administered as an injection and the cycle of treatment began a week before the chemo began, then given monthly for the duration of the chemotherapy treatment. This would normally be 3 to 6 months in all.

More possible good news is that the drug may be helpful for more than just breast cancer patients.

"This treatment probably could be used in other types of cancer that are treated with similar chemotherapy to what we used in this study. In our study we only included women receiving cyclophosphamide-based standard chemotherapy for breast cancer," said Moore.

Another area for future research is why it seemed to improve cancer outcomes for patients, including those without identification of hormone sensitive cancers. Previously the drug had only been used in patients diagnosed with hormone sensitive breast cancer.

"I think further research needs to be done on whether this class of medication is going to somehow contribute to the anti-cancer treatment of women with hormone receptor negative breast cancer. In addition we would like to do further research to try to see which other patient groups, including those with other cancer types or event non-malignant conditions treated with chemotherapy, can benefit from this intervention," stated Moore.

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