What Young Adults Should Know about CRC and Fertility

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Cancer treatments, including chemotherapy and radiation, can impact fertility for women and men. As more people get diagnosed with colorectal cancer at younger ages, treating cancer while preserving fertility has become a growing concern.

Not enough people understand their options for preserving fertility before treatment, says Marisa Maddox. Maddox received her diagnosis of stage III rectal cancer at just 30 years old after the birth of her son. On the advice of her radiation oncologist, Maddox underwent ovarian transposition surgery — which raises the ovaries out of the range of radiation — prior to chemotherapy and radiation. While the surgery successfully protected one ovary against radiation and prevented Maddox from going into early menopause, scar tissue complicated her efforts to conceive. 

Maddox now hopes to use her experiences to build awareness for others about fertility preservation and colorectal cancer.

"When you hear you have cancer, you think, ‘OK, let’s go’ – you’re thrown into it. You don't always take a moment to realize, ‘OK, what does this really mean, especially as a young woman?’"

–Marisa Maddox

Q: What do you want people who are newly diagnosed to know about the potential effects that colorectal cancer can have on fertility?

hear you have cancer, you think, ‘OK, let’s go’ – you’re thrown into it. You don't always take a moment to realize, ‘OK, what does this really mean, especially as a young woman?’ You don't think about what surgery or what radiation or what chemo will do to your body when it comes to the time when you want to have kids. 

Q. If someone has colorectal cancer, when should they discuss fertility options with their doctors?

A: I think that discussing fertility should be the first thing that they talk about. If you talk about it too late, you're not going to have time. 

If you're in late stage IV and the doctor tells you that you need treatment right now, then you might not have options. But if you are at an early stage, or stage III, like I was, there may be a little bit of time, and you absolutely need to think about this. You need to think, ‘Can I go in right now and get my eggs while they're still viable and healthy?’…And the same with men: If they can preserve their semen before they go through surgery, radiation, or chemo, then they should look into that as well.

Knowing your options has to do with a lot of what your doctors know as well. Some smaller hospitals might not know about these types of procedures. I went to a bigger hospital, and the first thing my radiation oncologist asked me was if I wanted to have more kids. When I answered ‘Yes,’ then I went to a specialist [for the ovarian transposition surgery].

Q: How can friends and family members of people with colorectal cancer support them through this time?

A: My mom is amazing. She helped with all of my treatment options and plans. Some people like to do their own research, but a lot of us hear our diagnosis and just completely shut down like I did. So you need those people in your corner — your parents, your friends, your family, whoever you rely on — to do the research for you when you can't, so that you can know your options and advocate for yourself. Talk to your doctor, but don’t just go with the first option that they give you. If I went with the first option that my surgeon gave me, I would have had surgery [without preserving my ovaries first], and it would have been a lot different.

Q: What advice do you have for people with colorectal cancer who are concerned about fertility?

A: When I was diagnosed, I went to work every day and didn't tell any of my colleagues that I even had cancer. I wanted to live a normal life. So, I know that everyone deals with this differently. I would just say that if you're newly diagnosed or whatever aspect of this that you're going through, reach out. You need that support system. You can't go through this alone.

Learn more about managing fertility, infertility and colorectal cancer, and fertility preservation and colorectal cancer.

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