Cancer's Impact on Fertility and How to Possibly Overcome It
“Basketball Wives” star Brandi Maxiell, 40, embraces motherhood years after struggling with fertility following ovarian cancer treatment.
Doctors usually determine the stage of ovarian cancer during surgery, where they can see the tumor, see where it’s growing, and check for distant or tiny metastases (spreading of cancer) by removing tissue and examining it under the microscope.
Various cancer treatments can affect both men’s and women’s fertility. 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.
Ovarian cancer is often harder to catch in its early stages because of its subtle symptoms such as bloating, weight gain, and abdominal pain that can mimic regular menstrual cycle fluctuations.
“Basketball Wives” star Brandi Maxiell, 40, is embracing motherhood for her adorable 11-year-old son. Being able to have and raise children is something that is cherished by many women, however for Maxiell that blessing was nearly stolen from her after a bout with ovarian cancer threatened her fertility.
Coping with a cancer diagnosis is a stressful and emotional experience for patients and their loved ones. When faced with fertility concerns due to cancer, couples, fortunately, have options offering them much-needed hope.
“My baby is getting too big. He’s almost taller than me. Thank you, God, for blessing me with this blessing,” Maxiell wrote in an Instagram caption as she wished her son a great first day of school.
Most of Maxiell’s social media posts are dedicated to her beloved son Jason II. She’s shared video clips of him after undergoing open heart surgery as well as more delightful everyday experiences including fun dances around their home.
Maxiell had her son with retired NBA Detroit Pistons player Jason Maxiell. Her marriage to the famous basketball star helped propel her into superstardom as a cast member of the “Basketball Wives” reality show franchise.
This joyous time in Maxiell’s life was hard to fathom roughly 14 years ago after she reached remission from ovarian cancer. At the time, she worried that cancer treatment impacted her ability to have children.
STAND UP TO CANCER – ARRIVALS – In this handout image provided by ABC, An extraordinary lineup of actors, musicians, athletes, and journalists are banding together for “Stand Up To Cancer” (SU2C), the groundbreaking initiative aimed at raising funds to accelerate innovative cancer research bringing new therapies to patients quickly that will save lives now. “Stand Up To Cancer” (www.standup2cancer.org) will return to primetime TV on SEPTEMBER 10 (8:00-9:00 p.m., ET/PT). The one-hour fundraising event will be simulcast live and commercial-free on ABC, CBS, FOX, NBC, Bio, current TV, Discovery Health, E!, G4, HBO, HBO Latino, MLB Network, mun2, Showtime, Smithsonian Channel, The Style Network, TV One and VH1. All rights reserved. NO ARCHIVE. NO RESALE. (Photo by Rick Rowell/ABC via Getty Images) JASON MAXIELL, BRANDI MAXIELL
“It left me struggling with fertility issues,” Maxiell shared with Essence.
Maxiell’s cancer journey began in her early twenties.
“I had all the classic symptoms of ovarian cancer – back pain, bloating, weight gain, abdominal pain, feeling full quickly after eating a couple of bites of food as well as the need to urinate urgently or often,” Maxiell described.
She said she associated her symptoms with her regular menstrual cycle. For this reason, ovarian cancer is considered the “cancer that whispers” because symptoms usually don’t fully present themselves until the cancer has advanced into later stages.
“It creeps into your body with symptoms so subtle that it can mimic other, unrelated conditions,” Maxiell said.
She went to see her doctor after experiencing unusual symptoms but unfortunately, her symptoms were seemingly dismissed.
“On my first trip to the doctor’s office, I was misdiagnosed. I was given medicine for back pain and sent home,” she said.
Luckily, Maxiell followed her gut and sought a second opinion. This is something SurvivorNet experts encourage everyone to do when they feel their symptoms are not fully taken into account.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Dr. Steven Rosenberg told us SurvivorNet. “Because finding a doctor who is up to the latest information is important.”
WATCH: The value of second opinions.
More reason to seek multiple opinions is to avoid doctor biases. Some surgeons may prefer certain treatment options for one reason or another.
Other reasons to get a second opinion include:
To see a doctor who has more experience treating your type of cancer
You have a rare type of cancer
There are several ways to treat your cancer
You feel like your doctor isn’t listening to you, or isn’t giving you good advice
You have trouble understanding your doctor
You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
Your insurance company wants you to get another medical opinion
Your cancer isn’t improving on your current treatment
After getting a second opinion, Maxiell finally got affirmative answers.
“Thankfully, the second doctor diagnosed the problem in 2007 and sent me straight to an oncologist. My oncologist didn’t mince words. ‘You have cancer,’” Maxiell said.
She was 24 years old when she was diagnosed with ovarian cancer. Her treatment involved surgery followed by several rounds of chemotherapy.
“After two weeks of chemo, I noticed my hair shedding while attending a basketball game,” Maxiell said.
Hair loss is tough for women and men alike, but it can be especially challenging for cancer patients. Losing your hair or seeing it thinning is often a side effect of some cancer treatments.
WATCH: Hair loss during chemo.
Chemotherapy can cause hair loss. It usually begins about three to four weeks after beginning chemotherapy and continues throughout treatment.
It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells, but also hair cells.
While coping with hair loss, Maxiell said her husband supported her by shaving his head.
After undergoing treatment, Maxiell said she reached remission but by that time she worried if chemo negatively impacted her ability to have children at all.
“In August 2009, I got married and was excited to start a family. However, the cancer had taken a toll on my body. It left me struggling with fertility issues. I went through various IVF fertility treatments that failed,” she said.
Some 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 type of drug and your 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.
Most women who preserve their fertility before cancer treatment do so by freezing their eggs or embryos.
After you finish your cancer treatment, a doctor who specializes 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.
Fortunately for Maxiell, she was able to have a child of her own in 2011.
Why Your Stage of Ovarian Cancer Matters
Cancer is subcategorized into stages because it helps understand how advanced the cancer has become. The maturity of the cancer also impacts potential treatment options.
Doctors usually determine a tumor’s stage during surgery, where they can see the tumor, see where it’s growing, and check for distant or tiny metastases by removing tissue and examining it under the microscope.
“The staging of cancers is really to help us with a dialogue, and the honesty of our outcome.” If you detect any symptoms of ovarian cancer, and a visit to your doctor confirms the diagnosis, then the next step would be discussing the stage of your illness.
Stage 1 – Confined to the ovary
Stage 2 – Spread to pelvic structures
Stage 3 – Spread to abdominal structures
Stage 4 – Spread outside the abdomen or inside the liver or spleen
Staging’s Influence on Treatment
Surgery is usually the first treatment recommended, with chemotherapy for use after treatment. For all four stages of ovarian cancer, two specific chemotherapy drugs are usually suggested. A platinum compound (carboplatin), which kills ovarian cancer cells, and a taxane like paclitaxel (a chemical compound originally derived from plants, which interferes with the growth of cancer cells) are the therapies used. These two drugs are usually given as an IV into the vein, every three to four weeks.
Dr. Beth Karlan, Director of the Women’s Cancer Program at Cedars-Sinai Medical Center explains that even during this treatment, most women should be able to go about most of their daily routines, whether it is working or running a carpool, with the caveat that they will most likely feel more fatigue than normal.
Cancer Treatment’s Impact on Fertility
Many cancer treatments can do wonders in fighting off cancer, but their side effects can be difficult to manage as some can be long-lasting. If you are having a treatment that includes infertility as a possible side effect, your doctor won’t be able to tell you for sure whether you will have this side effect. That’s why you should discuss your options for fertility preservation before starting treatment.
Research shows that women who have fertility preserved before breast cancer treatment are more than twice as likely to give birth after treatment than those who don’t take fertility-preserving measures.
If you freeze eggs only before treatment, a fertility specialist can use sperm and your eggs to create embryos in vitro and transfer them to your uterus.
When freezing eggs or embryos is not an option, doctors may try these approaches:
Ovarian tissue freezing is an experimental approach for girls who haven’t yet reached puberty and don’t have mature eggs or for women who must begin treatment right away and don’t have time to harvest eggs.
Ovarian suppression prevents the eggs from maturing so that they cannot be damaged during treatment.
Ovarian transposition, for women getting radiation to the pelvis, moves the ovaries out of the line of treatment.
WATCH: Family planning after cancer.
In addition to preserving eggs or embryos, positive research has shown that women with early-stage hormone-receptor (HR) positive breast cancer were able to safely pause endocrine therapy (ET) to try to get pregnant and they did not have worse short-term recurrence rates than people who did not stop endocrine therapy.
Questions for Your Doctor
If you’re wondering how your cancer treatment may affect your fertility and what options are available to you, consider asking your doctor these questions, according to the National Cancer Institute:
Could my treatment lead to infertility?
Are there other recommended cancer treatments that might not cause fertility problems?
Which fertility preservation options would you advise for me?
What fertility preservation options are available at this hospital? At a fertility clinic?
Would you recommend a fertility specialist (such as a reproductive endocrinologist) that I could talk with to learn more?
What are the chances that my fertility will return after treatment?
