Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, August 13, 2015

The Way Forward....

"It seemed very new and pretty amazing that we can do something like this and help her in a bigger way."
"It definitely brought some peace [raising hope for two-year-old's future]."
Maria Pisano, Griffith, Indiana

"We try to be thoughtful about the fact that their main focus and ours is on the survival of the child. That often is the one piece of information that gives them [parents of children with cancer] a glimmer of hope -- that we believe that their children will live long enough to grow into adulthood and have their own family."
Dr. Erin Rowell, surgeon, Lurie Children's Hospital, Chicago, Illinois

"[Offering children experimental fertility-preserving procedures has no ethical draw-back] as long as there's informed consent and a desire to do it."
"Kids themselves when they grow up would likely appreciate having that [fertility] option."
Dr. John Lantos, bioethics chief, Children's Mercy Hospital, Kansas City, Kansas
AP Photo/Christian K. Lee
AP Photo/Christian K. Lee    To battle infertility sometimes caused by cancer treatment, some children’s hospitals are trying a futuristic approach: removing and freezing immature ovary and testes tissue, with hopes of being able to put it back when patients reach adulthood and want to start families.

When children have cancer, the focus is on saving their lives. Chemotherapy is one of the tools used to battle cancer cells. It works by killing those rapidly dividing cells that characterize cancer. While chemotherapy kills the malignant cells it also kills hair follicles, digestive tract cells, along with sperm and eggs. As well, radiation is capable of damaging these cells.

Removing and freezing ovary and testes tissues in adults undergoing cancer treatment has become fairly routine. People undergoing chemotherapy in their fertile years often choose to freeze eggs and tissues to give themselves the opportunity in the future to have children of their own. Now, the procedure is being offered to parents of young children undergoing cancer treatment.

Inherent in the offer itself is the assumption that the child will survive the cancer and go on to live a normal, healthy life. A life, granted, where their natural ability to conceive will have been impaired by chemotherapy and/or radiation treatment. Parents, thinking ahead to their children's future and their own wish to some day become grandparents would see the offer as a double blessing.

On the one hand, an implied guarantee that their child suffering from cancer will become cancer-free and resume their growing phases as they are normally expected to do, once treatment is completed and its effect considered a success. And on the other hand, the nightmare they are currently living will one day become a dim, distant past, and their healthy child, become adult, will have children of their own.

Children's hospitals are moving toward a futuristic approach to the problem of infertility resulting from cancer treatments. They are removing and freezing those critical tissues in the hope that placing them back where they came from once patients reach adulthood and look toward beginning a family they will be able to, thanks to this new experimental initiative.

It is a stab in the dark, as yet, removing such tissues from children who haven't yet reached puberty. Only time will tell whether the procedure will be successful. Fertility researchers plan on refining the science during the time when children whose tissue has been frozen, awaiting that time when they will be of use, are implanted at maturity.

AP Photo/Christian K. Lee
AP Photo/Christian K. Lee   In this June 13, 2015 photo, Talia Pisano, second from right in blue dress, celebrates her second birthday with family and friends in Wheaton, Ill.

Two-year-old Talia Pisano is one of the first infants to undergo that procedure. Treated for kidney cancer a year ago, the cancer spread, and new treatment, including brain radiation, was brought into play. The surgery to remove tissue is performed while the child is being sedated for some other reason; the opportunity taken to double-down on procedures and minimize surgical exposure.

In Belgium, a baby boy was born to a woman who had ovarian tissue removed before undergoing treatment for sickle cell anemia, at age 13. Doctors were of the impression that there were signs of puberty at the time the tissue was frozen. And ten years on, the tissue was thawed and parts of it were grafted to her remaining ovary. She experienced a normal pregnancy, giving birth last November.

The medical community will have to wait until the current crop of very young children being treated for cancer reach adulthood, before they will know that this experimental treatment will work, enabling adults treated as children for cancer to have children of their own.

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