Weighing Fertility Options Amid Cancer Treatment
- “Rescue Me” actress Natalie Distler Archer, 35, was diagnosed with leukemia, a type of blood cancer, at 24 years old. Doctors told her upon receiving chemotherapy, she may not be able to preserve her eggs. Fortunately, she managed to become pregnant and have two healthy children.
- Leukemia impacts the normal function of red blood cells, white blood cells, and platelets, which can interfere with vital oxygen being transported throughout the body to tissues. It can also disrupt the functioning of white blood cells, which are necessary to fight infections, and platelets, which help form blood clots.
- Cancer patients are also faced with the possibility of infertility because treatments, including chemotherapy and radiation, also have options, including in vitro fertilization (IVF).
- Before undergoing cancer treatment, patients must speak to their doctors about fertility preservation if they wish to have a family in the future. Egg, sperm, and embryo freezing are common approaches to fertility preservation, but other options exist.
Singer-songwriter and “Rescue Me” actress Natalie Archer, 35, and her husband were “devastated” when her doctors told her amid treatment for leukemia, a type of blood cancer, she wouldn’t be able to freeze her eggs, severely limiting her chances of becoming pregnant.
However, as luck would have it, she became pregnant, leading to the birth of their beautiful son Boden in 2019.
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Archer doesn’t take motherhood for granted. On social media, she shares countless moments with her young children, showcasing her endless love.
Natalie Archer’s rise to fame began as a teenager when she starred in “Rescue Me” under her maiden name, Natalie Distler. She portrayed Denis Leary’s daughter in the TV series.
She met Kyle Archer, whom she later married, and the two pursued a singing career together afterward. However, around 2013, she lost consciousness while shopping. She was rushed to the hospital to learn she had been diagnosed with leukemia.
“Our world just changed in an instant. I was 24 at the time, So, I mean, otherwise, just like a young, healthy person,” Archer told Fox News.
Leukemia impacts the normal function of red blood cells, white blood cells, and platelets, which can interfere with vital oxygen being transported throughout the body to tissues. It can also disrupt the functioning of white blood cells, which help fight infections, and platelets, which help the body form blood clots when bleeding occurs.
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Archer spent roughly a month at the hospital for treatment, which included chemotherapy. Amid treatment, the young couple learned Natalie’s diagnosis could potentially disrupt their plans for a family.
Helping Patients With Fertility Resources
Coping With Cancer and Fertility
“I think I’ll never forget being in the hospital and having all the doctors and…the whole team of nurses and everyone kind of, standing around us and saying, ‘We just want you to know there’s no time to do any type of freezing the eggs or do anything. There’s just no time. We have to start this now,” Archer recalled being told.
The news devastated Archer and her husband, who were hoping to have children together.
“I remember looking at Kyle and saying, ‘You know, as long as we have each other, it doesn’t matter. We can get through it, and we will have a family one day,” Archer said.
Luckily, the couple managed to get pregnant and now have two beautiful children.
“Maybe this is in God’s plan,” Archer said.
IVF as an Option for Patients Facing Infertility
Certain types of chemotherapy can destroy eggs in your ovaries. This can make it impossible or difficult to get pregnant later. Whether or not chemotherapy makes you infertile depends on the drug type and age since your egg supply decreases with age.
“The risk is greater the older you are,” reproductive endocrinologist Dr. Jaime Knopman told SurvivorNet.
“If you’re 39 and you get chemo that’s toxic to the ovaries, it’s most likely to make you menopausal. But, if you’re 29, your ovaries may recover because they have a higher baseline supply,” Dr. Knopman continued.
Radiation to the pelvis can also destroy eggs. It can damage the uterus, too. Surgery to your ovaries or uterus can hurt fertility as well.
Meanwhile, endocrine or hormone therapy may block or suppress essential fertility hormones and may prevent a woman from getting pregnant. This infertility may be temporary or permanent, depending on the type and length of treatment.
If you have a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
WATCH: Family planning after cancer
Most women preserve their fertility before cancer treatment by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor specializing in reproductive medicine can implant one or more embryos in your uterus or the uterus of a surrogate with the hope that it will result in pregnancy.
If you freeze eggs only before treatment, a fertility specialist can use sperm and eggs to create embryos in vitro and transfer them to your uterus.
Coping With a Leukemia Diagnosis
While it remains unclear the exact type of leukemia Archer was diagnosed with, there are various types.
Acute and chronic leukemia and myeloid or lymphocytic leukemia are common forms of the disease.
Acute myeloid leukemia (AML) is a fast-growing blood cancer that begins in the bone marrow, the factory that makes white and red blood cells and platelets.
Stem cells within the bone marrow eventually develop into white blood cells (WBCs), red blood cells (RBCs), and platelets, which help blood clot.
Stem cells can copy themselves to make progenitor cells or precursor cells. Myeloid progenitor cells turn into red blood cells, granulocytes (a type of white blood cell), and platelets. AML affects the myeloid progenitor cells during a stage of development when they are called myeloblasts.
With AML, myeloblasts fail to turn into fully developed blood cells, leaving them to build up in the bone marrow and blood.
WATCH: After An AML Diagnosis, What are the Next Steps?
AML is diagnosed by extracting samples of liquid bone marrow and a chip of bone from the back of the hip. The samples are then tested to determine whether blood cells in the bone marrow are abnormal.
Dr. Gail Roboz, an AML expert and medical oncologist at Weill Cornell Medicine, says, “The majority of patients have this sporadically out of the clear blue sky.”
Symptoms for acute myeloid leukemia can include:
- Flu-like symptoms
- Fatigue
- Fever
- Loss of appetite
AML causes certain symptoms, but having these symptoms doesn’t necessarily mean you have AML. Your doctor will do diagnostic tests to confirm whether you have AML before recommending a treatment.
WATCH: Diagnosing CML
Chronic Myeloid Leukemia (CML), also known as chronic myelogenous leukemia, is a type of cancer of the white blood cells. As the disease progresses, CML cells crowd out healthy cells and eventually build up and spill over into the blood. Although CML usually grows slowly, it can also turn into a faster-growing acute leukemia, which is more challenging to treat.
Symptoms for CML are often vague, as many other ailments can cause them. However, common symptoms include:
- Weakness
- Fatigue
- Night sweats
- Weight loss
- Fever
- Bone pain
- An enlarged spleen (which may be felt as a mass under the left side of the ribcage)
- Pain or a sense of fullness in the stomach
- Feeling full after a small amount of food
Chronic lymphocytic leukemia is a slow-growing chronic cancer. Many people diagnosed with this disease won’t need treatment at diagnosis. Instead, patients are monitored, and their blood count is tracked to determine if treatment is necessary.
“Chronic lymphocytic leukemia is a cancer of a white blood cell called a B lymphocyte,” explains Dr. Matthew Davids, director of the Center For Chronic Lymphocytic Leukemia at the Dana Farber Cancer.
WATCH: When should you begin treatment for CLL
“These are cells that are normally there to help you fight off infections, and for reasons that we don’t often understand, these cells can gradually accumulate over time and become a tumor that we call CLL,” Dr. Davids said.
Tyrosine kinase inhibitors (TKIs) Are Effective Treatments for Chronic Myeloid Leukemia
Targeted cancer drugs can change how cells work and help the body control cancer growth. The main type of CML is tyrosine kinase inhibitors (TKIs), which are oral medications. They are the initial treatment of choice for most people with CML.
More than two-thirds of patients with chronic phase CML achieve long-term control of the disease with TKIs. Although TKIs have not been proven to cure CML, people who have an excellent response to TKI therapy have expectations for survival that are similar to age-matched individuals without CML. The progression rates have reduced significantly from over 20% in the pre-TKI era to less than 5%.
Asciminib (brand name Scemblix) is an example of an approved TKI drug used to treat CML.
Scemblix (generic name asciminib) and Iclusig (generic name Ponatinib) are newer TKIs generally reserved for people who have not responded to other TKIs.
These TKIs are usually used for the treatment of CML in the following scenarios:
- Patients with Philadelphia chromosome-positive CML (Ph+CML) in the chronic phase were previously treated with more than two tyrosine kinase inhibitors (TKIs)
- Chronic phase Ph+CML patients with the T315I mutation.
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