Since June is Men's Health Month, this issue will focus on cancers that can affect male fertility due to the cancer itself or due to its treatment.

The most common cancer diagnosed in males is prostate cancer, followed by lung, and then colorectal cancers.  A small percentage of men diagnosed with prostate cancer are under age 45, however, testicular cancer is the most common cancer diagnosed in males aged 20-34.  Both prostate and testicular cancers are most often 100% treatable, but treatments can compromise fertility.

Cancers that interfere with the production of sperm, spermatogenesis, will affect fertility.  Cancer treatments such as surgery, radiation and chemotherapy, can also affect fertility.  The following information is taken from the National Cancer Institute's (NCI) website, www.cancer.gov.

• Testicular Cancer - Most commonly diagnosed in males aged 20-34.  Nearly all are either seminoma or non-seminoma, other types are rare.  A common treatment for testicular cancer is removing one or both testicles (orchiectomy).  Fertility depends on the functioning of a remaining testicle.  For more information, please visit the National Cancer Institute's (NCI) Testicular Cancer FactSheet.
• Prostate Cancer - Most common cancer diagnosed in men, usually aged 45 and up.  For men with localized prostate cancer, treatments such as radiation and surgery that removes the prostate and seminal vesicles (radical prostatectomy) may be performed.   Men whose prostate cancer has metastasized may have both testicles removed (bilateral orchiectomy) in addition to the prostate.  Both procedures will cause infertility.  For more information, please visit NCI's Early Prostate Cancer FactSheet.
• Non-Hodgkin's Lymphoma and Hodgkin's Lymphoma - While Non-Hodgkin's is most commonly diagnosed in men and women over age 60, Hodgkin's Lymphoma is most commonly diagnosed in ages 15-35 and 55 and up (men and women combined).  Because these cancers affect the lymphatic system, they can start almost anywhere in the body.  Treatments for both types include chemotherapy and radiation, which can both affect fertility.  For more information, please visit NCI's Lymphoma & Hodgkin's Booklets.
• Leukemia - Of the four common types of leukemia, two mainly affect adults, and two affect both adults and children.  Leukemia is a blood cancer, and treatments include radiation and chemotherapy, which can affect fertility.  For more information, please visit NCI's Leukemia Booklet.
• Childhood Cancers - Among the 12 major types of childhood cancers, leukemias and cancers of the brain and central nervous system account for more than half of the new cases. About one-third of childhood cancers are leukemias.  As with all cancer treatments, surgery, radiation and chemotherapy can affect fertility.  For more information, please visit NCI's Childhood Cancers FactSheet.

For detailed information on the following Fertility Preservation options, including costs, please view our previous Fertility Preservation 101 issues.

• Sperm Banking/Cryopreservation - proven to be the most effective (and convenient) method of male Fertility Preservation.
• Testicular Epididymal Sperm Extraction (TESE) - method of sperm retrieval involving needle biopsy to obtain individual sperm from the testes and/or epididymis or a micro-dissection of the testicular tissue itself.
• Electroejaculation (EEJ) - uses a probe attached to an electric current to induce ejaculation to produce semen.
• Testicular Tissue Freezing - the best option for pre-pubescent males, although considered experimental.
• Testicular Shielding - a shield is used to reduce the dose of radiation delivered to the testes.