Oncology Nursing Stories: Pregnancy After Lymphoma Chemoradiation

In this episode of The Vitals, Ellen Miller, MSN, FNP-BC, a nurse practitioner with Vanderbilt University’s Radiation Oncology Survivorship Clinic, shares her experience with a 26-year-old woman who wanted to get pregnant after undergoing chemoradiation for stage II extranodal natural killer T-cell lymphoma of the nasal cavity as a teenager. Miller underscores why some patients may not choose or be able to pursue fertility preservation when they receive a cancer diagnosis, and what follow-up conversations might be necessary for survivors who have family building goals following cancer treatment. 
References and resources are provided below. 

Episode Highlights
“When I talked with her, I asked her, specifically, ‘Were you offered fertility preservation?’ And she said, ‘Absolutely.’ [But] she declined, she said, ‘I was 19, I didn’t think I wanted kids.’ But she had [since] met her husband, a wonderful man, and decided that she wanted to have kids.” Time Stamp (TS) 05:29
“The out-of-pocket [cost] for fertility preservation is $10,000 to $15,000, on average. That’s hard for [anyone], not to mention a young [woman].” TS 06:26
“Not only can chemotherapy damage existing eggs, but it can also lead patients to have early or premature menopause.” TS 09:16
“If patients were to have left-sided chest radiation, [for] a lymphoma or maybe even a breast cancer, we would do some cardiac monitoring, since both the chemotherapy and the radiation can be damaging to the heart, and pregnancy can cause the heart to work harder.” TS 12:16
“[The] trajectory for her experience was pretty standard, and we were thankful for that. But there are some reasons why some women would need further monitoring.” TS 15:41

Episode Notes

 The Vitals Podcast:
Improving Onco-Fertility Conversations With Adolescents and Young Adult Patients With Cancer Oncology Nursing News® Online Articles
Fertility and Family Planning: Supportive Patient Conversations Quality Oncology Care: Discussing Fertility Preservation for Patients With Breast Cancer Fertility Preservation Guidelines Urge for Early Discussions With Young Patients with Cancer Video Interviews

Jennifer Levine on Fertility Challenges in Survivors of Childhood Cancer  Gwendolyn Quinn Discusses Fertility Concerns in Childhood Cancer Survivors Oncology Nursing News® Publication Features

 Let's Talk About Sex, Fertility, and Intimacy After Cancer Adolescen