Las Vegas-based clinic provides service to cancer patients
Caryn Goldsmith knows how the mind can play tricks on you after you’ve been diagnosed with cancer.
She was sure, for example, that she could feel the lump that couldn’t be seen with the naked eye growing in her breast.
"Everything becomes a blur," she recalled Thursday as she sat in her northwest Las Vegas home. "You don’t hear everything, realize all that is going on. You just want to get rid of the cancer."
Only 39 when she found out two years ago that she had the disease, her thoughts were on staying alive, not having children one day.
As she thinks back, she remembers her surgeon or oncologist, she isn’t sure who, brought up "for a minute" the possibility of freezing her eggs before her treatment.
Chemotherapy and radiation, treatments regularly used to fight cancer, can render a woman unable to have babies.
"At the time, I was dealing with so many things," said Goldsmith, whose cancer surgery was delayed because she had the H1N1 virus, or swine flu. "I was just focused on getting better. I thought I could deal with other things later."
Now, she said, she wishes there had been material handed out to read and more of a formal discussion about what could be done about fertility preservation, something along the lines of what the Las Vegas-based Sher Institutes for Reproductive Medicine began offering for free this month to cancer patients of childbearing age.
"It really wasn’t explained to me at all," said Goldsmith, who recently had to have a hysterectomy because of cancer-fighting drugs. "I don’t know whether I would have taken advantage of it or not, but it would have been nice to know."
In 2006, the American Society of Clinical Oncology — mindful that many more patients were surviving cancer — issued guidelines saying that any oncologist with reproductive-age patients should discuss how treatment might affect their fertility. But a 2009 study done by the Moffitt Cancer Center and Research Institute in Tampa, Fla., found that 46 percent of oncologists reported referring patients for fertility preservation.
And in 2010, the American Society of Clinical Oncology found that surveys of cancer survivors of reproductive age showed that at least half have no memory of even having a discussion of fertility with their doctors.
Dr. Heather Allen, a Las Vegas oncologist, said recently that oncologists can become so focused on preserving a patient’s life that sometimes such discussions are forgotten.
And she said that often when the topic is discussed, women become upset because of the cost of fertility preservation.
"It’ll cost $10,000, and insurance doesn’t cover it," she said. "It’s too much for many women."
That is changing, thanks to Dr. Geoffrey Sher, founder of the Sher Institutes for Reproductive Medicine, which are located in Las Vegas and seven other cities across the country. He is launching a new program called Fertility Rescue, offering a $10,000 egg freezing cycle for free.
"We’ve decided we have the means to do this and feel a moral obligation," he said recently before going into the lab at his Las Vegas office. "We feel it’s the right thing to do, now that we have the technology. People should be able to have families if they want them. We really want to remind oncologists that there is this opportunity for families."
Sher said that of the estimated 1.5 million men and women who were diagnosed as having cancer in 2010, approximately 10 percent are younger than 45 years. Youngsters are frequently overcoming such diseases as leukemia, but the cancer-fighting drugs can make them infertile.
Sperm banking, which generally costs less than $1,000 for a young man, is also done for free through the Sher Institutes.
"The reason we talk more about women than men in this program is that the cost for a woman’s fertility preservation program is so much more," said Lisa Stark, a spokeswoman for the Sher Institutes.
One woman in New York City, Vianney Pena, has signed up for the program through Sher’s New York office. She found out about it through a cancer support group.
Pena recently had a cancerous lump removed from her breast and will have about 15 eggs retrieved before chemotherapy starts in March.
"There is no way I could have afforded this if it wasn’t free," said Pena from her home in Queens. "I have a 1-year-old boy and wanted at least three kids. This is just wonderful."
Another New York woman will have her eggs frozen next month.
The expensive fertility drugs the women need to boost the number of eggs they produce in a cycle — which increase the chances of a healthy embryo at the end — are donated by pharmaceutical companies.
Stark said she expects the institute’s partnership with pharmaceutical companies to continue.
Stark said Pena’s eggs will be fertilized with her husband’s sperm. Then the Sher clinic freezes and stores her embryos, or eggs fertilized by sperm.
"After cancer treatment, she can have the frozen embryos transferred into her uterus at Sher Institute," Stark said. "If the embryo is normal, she would be pregnant. We do this also free of charge. There is no catch."
Stark expects Sher to be able to handle 150 cancer patients a year in offices from Los Angeles to Pennsylvania.
"If it gets so that there are more than we can handle, we would hope that other fertility centers around the country would step up to the plate," Stark said.
Until this month, Sher had offered 50 percent discounts on the freezing of eggs in concert with Fertile Hope/LIVESTRONG, an initiative of cycling champion and cancer survivor Lance Armstrong.
Thirty-year-old Trina Mills of San Diego took advantage of that program about three years ago. She had a rare bone marrow disorder that required chemotherapy.
"Luckily, I have proactive parents — they were the ones that brought it up, not the doctors," she said from San Diego. "They were focused on getting me well, and all I was thinking about was losing my hair and losing weight. But my mother said to them, ‘Won’t the chemotherapy make her not able to have children?’ They said that could be the case, and that’s how I started looking for a program and found the Sher Institute."
Now single, she hopes to one day marry. When she does, Sher would thaw her eggs and mix them with her partner’s sperm to create an embryo that would then be transferred into her uterus. If the embryo is normal, she would be pregnant.
Not everyone thinks it’s a good idea for cancer survivors to have children.
Bertha Hernandez of Las Vegas, whose breast cancer has spread to her brain, thinks that too often cancer returns, and then children will be left without a mother.
"From what I’ve seen, it usually comes back worse after they think they got it all," said Hernandez, who is awaiting a second operation for brain cancer. She was first diagnosed with breast cancer in 2006. "It’s not right to leave a small child behind."
She doesn’t care that two of the leading cancer institutes in the world, the National Institute of Cancer and the Mayo Clinic, both came out with papers last month urging oncologists to encourage fertility preservation. Nor does she care that cancer survival statistics, including those for breast cancer, continue to improve.
For instance, relative survival rates for women diagnosed with breast cancer are 89 percent at five years after diagnosis, 82 percent after 10 years and 75 percent after 15 years. If the disease is caught before it spreads, the five-year survival rate is 98 percent, well above the 23 percent survival rate for those who don’t catch the cancer early.
"They thought they had all of my aunt’s colon cancer, but when it came back, it spread to her brain and heart and killed her," Hernandez said. "I see that happen again and again to cancer patients.
Hernandez has two grown sons and a 10-year-old daughter.
"If I die, it’s going to be so hard on her to be a motherless child," she said. "I would have never gotten pregnant again if I had cancer. It’s an awful situation to put a child in, watching their mom die."
Oncologist Dr. Heather Allen of Comprehensive Cancer Centers of Nevada is more positive about the survival of cancer patients. She has met with officials at the Sher Institutes to see whether there is a way for Comprehensive to set up a formal educational program with Sher for cancer patients of childbearing age.
"It’s important that people know about what the Sher Institute is doing," Allen said.
That educational partnership could spread throughout the country because Comprehensive is affiliated with US Oncology, which has hundreds of cancer centers across the nation.
Stark said Sher Institutes looks forward to work with Comprehensive and any other cancer centers across the country.
Sher himself is excited at the prospect of making some people’s dreams of families come true.
"This is why we became doctors in the first place," he said. "To really help people of all means."
Contact reporter Paul Harasim at pharasim@review journal.com or 702-387-2908.
