Discuss fertility preservation with young breast cancer patients -Gynaecologist

Healthcare professionals have been urged to discuss fertility preservation with young women diagnosed with breast cancer before they begin treatment.

A Gynaecologist at the Korle-Bu Teaching Hospital, Dr Mary-Ann Zuolo, said some cancer treatments could damage the ovaries and cause women to lose their fertility or enter menopause earlier than expected.

She said although cancer treatment remained the priority, the possible effects of treatment on a young woman’s ability to have children in the future should not be overlooked.

Speaking at the annual general meeting of the Breast Society of Ghana (BSG) a fortnight ago, Dr Zuolo explained that women were born with a fixed number of eggs, which naturally declined with age.

However, she said some cancer treatments could accelerate the loss of ovarian follicles and lead to early menopause.

According to her, early menopause could have effects beyond fertility, including an increased risk of high blood pressure, heart disease, cholesterol-related problems and sleep difficulties.

She said the emotional impact could also be significant, particularly for young women who were still planning to have children.

Dr Zuolo introduced oncofertility, a specialised area of care that brings together cancer and fertility specialists to help protect the reproductive health of patients undergoing cancer treatment.

She said fertility preservation should be discussed as early as possible, preferably before treatment began.

Available options, she said, included embryo freezing, egg freezing, ovarian tissue preservation and ovarian transposition.

She explained that embryo freezing involved collecting eggs, fertilising them and freezing the resulting embryos for possible future use, while egg freezing involved collecting and freezing unfertilised eggs.

Dr Zuolo noted that embryo and egg freezing services were available in Ghana, but ovarian tissue cryopreservation was currently not available in the country.

She stressed that fertility preservation should not delay effective cancer treatment and called for closer collaboration among fertility specialists, oncologists and surgeons.

Dr Zuolo also urged health professionals not to assume that fertility preservation was unimportant to a patient or that she could not afford the available options.

She said a Ghanaian study involving 78 clinicians found that although many were aware of fertility preservation, only 32 per cent routinely discussed it with eligible patients.

She, therefore, called for greater awareness and timely referral of young cancer patients to fertility specialists.

“Options for fertility preservation exist in Ghana, and we need to improve access to these treatment options,” she said.

The President of the Breast Society of Ghana, Prof. Josephine Nsaful, said between 60 and 80 per cent of breast cancer cases were still diagnosed at an advanced stage.

She said advanced disease required prolonged treatment, was more expensive and had less favourable outcomes.

Prof. Nsaful said a 2020 study involving 217 patients at three cancer centres in Ghana found that the average total cost of breast cancer treatment was GH¢34,631 per patient.

She said the financial burden made it difficult for some low-income patients to comply with treatment schedules.

Prof. Nsaful said breast cancer should not be treated only as a health issue because of its impact on families, productivity and the national economy.

She said 89 per cent of the economic losses from breast cancer occurred among women aged between 20 and 59, a group that formed a significant part of the country’s productive workforce.

She called for stronger referral pathways, better treatment coordination, multi-year health budgets and improved geographical and financial access to comprehensive breast cancer care.

By Esinam Jemima

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