As if the trauma and pain of childhood cancer aren’t enough, a recent study found that up to one in five former childhood cancer patients struggles with infertility as adults.
However hildren and young people about to undergo cancer treatments face a postcode lottery to get the services they need to preserve their future fertility.
The good news is that childhood cancer treatments have greatly improved over the past five decades – more than 80% of children will survive for decades after their diagnosis and treatment
The fact is that one in five will experience fertility issues directly resulting from their treatment when they try to conceive in adulthood. International consensus dictates that children and young people who have cancer be given help to preserve their fertility, which can be harmed during treatment or by the disease itself. Clinical best practice states that ovarian tissue or eggs and testicular tissue or sperm be frozen for children who may lose or impair their fertility.
However, new data from the Archives of Disease in Childhoodshows that UK funding varies wildly across the country. After studying 20 paediatric cancer units, they found that many children and young people are being treated for cancer with no attempt made to preserve their fertility.
While all of the centres had referred at least some patients for fertility preservations, none of the centres in the east or Midlands referred patients for mature egg storage. Less than half referred patients for testicular tissue storage. In many cases, the funding had to be provided by charities.
The researchers involved are calling for centralised NHS funding so that everyone has equal access to fertility preservation. Lead author Prof Adam Glaser states, “urgent action is required to ensure that NHS funding is available for all to provide the appropriate security and hope for these individuals while permitting delivery of accepted and NHS mandated standards of care.”
Glaser, a specialist in adolescent and paediatric oncology at Leeds teaching hospitals continues, “it is essential that all young people with cancer have access to optimal and internationally recognised best practice.”
The report concludes with strong guidance. “Inequality exists in the provision of fertility preservation for children with cancer across the UK. There is a lack of formalised government funding to support international guidelines, with resultant geographical variation in care.”
“There is heavy reliance on charitable funding, particularly in England, compared with the other countries of the UK. Centralised NHS funding should be made available to ensure equitable provision of fertility preservation services and delivery of internationally acknowledged quality standards to all young people with cancer across the UK.”
It is clear that more NHS funding needs to be dedicated specifically to preserve childhood cancer patient fertility, and the guidance must be streamlined across the country. It remains to be seen if NHS will act on this new study.
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