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Topics:
Radiation Oncology • Gastrointestinal Cancers • Rectal Cancer • Medical Oncology • Fertility Preservation • Survivorship
How do you counsel a young man receiving EBRT as part of TNT for rectal cancer about risk of infertility?
What do you quote as the chance of permanent infertility and what are the typical dose constraints used to mitigate this risk?
Answer from: Radiation Oncologist at Community Practice
I counsel male patients that, although the testes are outside the target dose volume, they will receive enough radiation that it could, at least temporarily, impair their ability to conceive. I offer to refer them for sperm banking prior to starting treatment.
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Answer from: Radiation Oncologist at Community Practice
I agree with Dr. @Myerson's answer. Another option is to consider the use of a testicular shielding device. Many studies for the treatment of testicular seminoma to the 40 Gy showed about 0.3% of the prescribed dose to the testis, which can maintain fertility (Singhal et al., PMID 24841161).