Fertility preservation is now within reach for nearly all post-pubertal, premenopausal female cancer patients. In 2013, the American Society for Reproductive Medicine published a clear opinion, stating “Clinicians should inform patients…about options for fertility preservation and future reproduction prior to the initiation of [gonadotoxic therapies].”¹ Oocyte and embryo cryopreservation are considered non-experimental procedures, thanks to significant technological advances achieved in the past ten years. With this, insurance payer coverage for the procedures is available in many states. In others, like Pennsylvania, private charitable organizations are stepping forward. According to Stephanie Estes, M.D., of Penn State Hershey Obstetrics and Gynecology, “At Penn State Hershey Medical Center, Four Diamonds covers fertility costs for Penn State Hershey pediatric cancer patients younger than 22 years-old who qualify to benefit from Four Diamonds. This coverage includes harvesting of eggs or semen for future fertility use and the annual storage fees for cryopreserved eggs or semen until the childhood cancer patient reaches five years off treatment.” Continue reading
Tag Archives: ovarian cancer
Laparoscopic Cytoreduction for Primary Advanced Ovarian Cancer: A Strategy to Limit Morbidity and Maintain Patient Quality-of-Life
Ovarian cancer, occurring in approximately 25,000 women each year in the United States, frequently presents as advanced disease, with most cases at stages 3/4 at initial detection. Improvements in chemotherapy regimens and cytoreductive surgery have boosted five-year survival rate to about 40 percent. “On average, most of these patients will require two or three additional cytoreductive surgeries over five years, and right now most are managed with conventional open laparotomies,” explained James Fanning, D.O. of Penn State Hershey Gynecologic Oncology.
Minimally invasive laparoscopic surgery is one strategy Fanning and his colleagues are actively employing to reduce the complications and morbidity associated with repeated cytoreduction in their patients with advanced ovarian cancer. “Because a minimally invasive laparoscopic approach is well-proven to lead to less blood loss, postoperative pain, gastrointestinal complications, and adhesions, this type of procedure was evaluated for cytoreduction in patients with ovarian cancer.” In one report of outcomes among twenty-five patients with advanced stage 3/4 ovarian cancer, all of whom had evidence of omental metastasis and ascites, and in whom Fanning performed laparoscopic cytoreduction, disease outcomes were similar to those typically seen with open laparotomy.1 Continue reading