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2012年9月22日 星期六

Lymphoma Cancer Symptoms in Women - Be Aware - Stay Alive


Lymphoma symptoms and especially lymphoma cancer symptoms in women are easy to be missed. It is so, because they can be taken for standard discomfort, to which we women are so familiar with by the default of being female.

Lymphoma is a form of cancer of the lymphocytes, a type of white blood cell.

Because our knowledge about this disease is so limited, it comes to be even more dangerous.

Let me share with you what my friend told me about her condition. "At first, I started losing weight. I was so glad to see it happen; we all know how hard it is to lose weight in our age (after 50). The next - somewhat unusual for me condition - was heavy sweating, especially at night. I didn't think twice about this though, it was winter time, I was probably too hot in general from the combination of keeping the house warm and using a heavy comforter, so I thought. You know, we always find an answer if and when we want to. Another day I noticed, my skin was itching; I had an explanation here as well; it must have been something wrong with the soap. Another incident of lymphoma symptoms I did not recognize, another unpremeditated excuse minimizing the seriousness of the situation. It was not until I noticed blood while coughing, when I decided to see my doctor".

Why this story? To help you recognize the limited knowledge about the lymphoma symptoms leading to a very late diagnosis, diagnosis at a very advanced stage of cancer. Should the lymphoma cancer symptoms have been diagnosed early, the condition could be put in regression, if not totally cured. It is not the ignorance though. The difficulty in recognizing lymphoma cancer symptoms is coming from the fact that the same symptoms are very "common" to other, not necessarily serious conditions.

Let's concentrate on lymphoma symptoms in women. What are they?

First and most common of all are the swollen lymph nodes, caused by the lymphoma cancer cells. This can be noticed mainly in the armpits, neck and groin. The nodes are quickly noticeable because of their location near to the skin surface and not so due to pain.

The next symptom is a rapid and unintentional loss of weight. Fever and night sweats, fatigue as well as problems with breathing continue the list. Since these symptoms very closely resemble infection symptoms, a lot of patients are being incorrectly treated for such instead of the true cause - lymphoma.

Mentioned here are only the few lymphoma symptoms in women. There are at least fifteen of them, which women can easily neglect, because we are so used to different kinds of discomforts being women. The list continues with abdominal pain, headaches, weakness and swelling of arms and legs, bowel obstruction, shortness of breath, coughing.

In conclusion, our strong recommendation is to see an oncologist if such symptoms stay unchanged (hopefully not getting any worse) for two - three weeks. It is in the patient's best interest to check it out. With a series of tests the presence or absence of lymphoma can be easily diagnosed; the sooner the diagnosis, the better chances of survival. And - if there is nothing wrong, the peace of mind gained after such visit is just priceless.




Be am amazed with the value of experience that comes from a simple heart to heart conversation. Yes, when the words are missing, hearts talk.
Breathe in the magnificence of life and breathe out the passion for love so others can be poisoned with it.
http://lifelonghomebiz.com





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

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2012年9月19日 星期三

Symptoms of Lymphoma in Women


Symptoms of lymphoma in women are generally the same as for men.

Lymphoma often develops quietly and with few symptoms so it may take a while before you may realize that there is something very much the matter.

Following is a list of the typical symptoms of lymphoma in women and symptoms of lymphoma in men alike.

One thing to keep in mind is that these lymphoma symptoms can be symptoms of any of a large number of conditions that are generally harmless.

For this reason, it's wise to consult with your doctor if you experience any of them.

1. Enlargement of the Lymph Nodes

This is the most characteristic lymphoma symptom and can be the only symptom that one experiences.

It's very important to note that a lot of different things can cause an enlargement of the lymph nodes and it does NOT necessarily mean you have lymphoma!

Typically, the lymph nodes of the groin, armpit and neck will swell but cause no pain.

Humans have 500+ lymph nodes in the body which are basically "forts" of immunity.

When they swell, it is often indicative of the body initiating an immune response against some type of microscopic invader.

You may notice these lumps in the course of your daily routine, such as when showering or applying creams, etc.

The symptoms outlined most often only indicate a possible lymphoma if they are discovered in addition to swollen lymph nodes.

2. Losing Weight

Typically, sudden weight loss will occur over a period of several months with no good reason.

Weight loss can range from a few pounds to up to 20 or so.

3. Running a Fever

A random fever that keeps occurring for no good reason (i.e., is not connected with a flu, cold, etc.) is usually an indication to go see your physician.

Symptoms of lymphoma can be confused with symptoms of other illnesses and, in fact, a lymphoma that causes fever accompanied by lymph node swelling is frequently mistaken for a flu or something similar.

Additionally, in those afflicted by a Hodgkins type lymphoma, a quintessential type of fever termed Pel-Ebstein fever can develop.

4. Night Sweats

Excess sweating at night may find you waking up soaked in your own sweat.

5. Pruritis (Itchiness)

Lymphoma cells can secrete certain substance which cause the entire body to be itchy, a condition known as pruritis.

6. Lack of Appetite

Individuals with lymphoma can experience a drop in their usual appetite which can also cause weight loss, one of the other symptoms of lymphoma listed above.

7. Fatigue and Listlessness

Cancer cells hijack the body's energy resource that would otherwise be utilized by healthy cells, causing a drop in energy levels.

8. Swelling

Depending upon where a lymphoma grows (and it can occur in any organ of the body), it may compress and block off veins, effectively limiting blood supply and causing swelling.

Site-specific lymphomas produce rather widely varying symptoms.

A lymphoma of the brain may cause pains in one's legs while a lymphoma in the stomach can cause stomach pains.

General Symptoms of Lymphoma in Women and General Symptoms of Lymphoma in Men

The first and most obvious sign of lymphoma is adenopathy, aka lymphadenopathy, which is a painless swelling of the lymph nodes.

Swollen lymph nodes by themselves, however, are NOT necessarily an indication of lymphoma.

It requires medical testing to confirm or negate the diagnosis.

Symptoms of lymphoma can come in many varieties, dependent upon the location of the lymphoma, the stage of growth, size of tumor, etc.

Symptoms linked with bone marrow issues such as becoming anemic (having a low red blood cell count) are uncommon in the beginning stages of a lymphoma but often are seen later in the game and often as a result of treatment.

MALT (Mucosa-associated lymphoid tissue) lymphomas affect any mucosal site, the stomach being the most common one. Alterations in bowel movement and stomach pains can be indications.

As far as the stomach lymphoma goes, if it is a result of infection with the H. Pylori bacterium, antibiotic treatment can cause the lymphoma to regress in 70%+ of cases.

How To Report Your Symptoms To A Doctor Effectively:

Describe the intensity of your symptom on a scale such as "This hurts about a 7 out of 10″.

For visually observable symptoms, show them to the doctor and also explain how they started off and looked like initially.

Explain when you first experienced your symptoms

How long have you been experiencing this symptom?

Is the symptom constant or does it come and go?

Describe any medications or dietary supplements you take/did take starting from the time symptoms manifested.

Do the symptoms change depending upon body positioning, time of day, etc.?

Do certain foods trigger the symptoms?

Be as descriptive as possible. The more accurate and specific the information you give, the more your doctor will be able to pinpoint the nature of your problem (if you have any!) and the better he/she will be able to treat you and advise you.

As you can see the Symptoms of Lymphoma in Women are generally the same as they are for men. It's important to pay attention to your body and note any symptoms you may have so that you can discuss them with your doctor in detail and he will be in a better position to help you.




John-Michael David is a well-informed patient who writes about the Symptoms of Lymphoma in Women and the Causes of Lymphoma among other important topics.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

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2012年9月14日 星期五

Fertility Preservation in Women and Men With Hodgkin Lymphoma


Lymphoma is cancer of lymphocytes, the cells that are part of human immune system. The disease was first described in 1832 and can start anywhere lymphocytes are found (lymph nodes, spleen, bone marrow, or digestive tracts). Two types are recognized; Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The American Cancer society estimates that approximately 3800 women and 4600 men will be diagnosed with HL in 2010. The majority of those diagnosed with HL are children and young adults (age 15 to 40 years). Modern treatment carries high survival rates. (>80%). HD, however, by virtue of the disease itself or its treatment poses considerable risk to fertility in women and men, especially if it recurs after treatment.

When HD is suspected usually because of enlarged lymph nodes or other symptoms such as a fever, weight loss or night sweating, a biopsy of lymph nodes is required for the diagnosis. Biopsy require special stains (CD15, CD 30) for proteins on the surface of the characteristic cell. Once confirmed certain imaging studies (especially PET scan) to detect the extent of the disease.

Chemotherapy for Hodgkin Lymphoma; combination chemotherapy is used either ABVD, BEACOPP or MOPP-ABV. Each of the letters represent one medication. The combination of drugs is used for several cycles usually 3 to 6. This is the principle treatment for HL.

Radiation therapy using external beam is sometimes combined with chemotherapy. Radiation is usually localized to the area of the body that harbors enlarged lymph nodes.

Hematopoietic stem cell transplantation (HSCT). This treatment is used for resistant HL or HL that recurred after successful treatment in the past (relapse). This treatment requires 1. very high dose of chemotherapy and possibly total body radiation then 2. transplantation of the mother cells of the bone marrow that produce our blood cells. The sources of these cells could be the person himself (autologous) a donor person (allogenic).

Effects of Hodgkin Lymphoma and treatment on future fertility. It has been shawn that men and women attempting conception after treatment for HL had lower chances of becoming pregnant than general population (Aisner 1993).

Men: There is evidence to suggest that HL itself can affect sperm production in 50 to 70% of boys and men, probably due to disturbance of the immune cells. Chemotherapy also can be harmful to sperm production. Alkylating agents especially cyclophosphamide can cause prolonged or permanent azospermia (no sperm production). The other agents may have a reversible effect with some prospect to recovery after months to years. The final effect of chemotherapy is difficult to predict and is related to the type of regimen and doses used. For example the old MOPP regimen for 6 or more cycles result in very high rate of azospermia while the newer ABVD regimen usually causes reversible azospermia.

HSCT entails the use of high dose of alkylating agents and sometimes radiation. It commonly result in prolonged azospermia. HL or its treatment may also affect sperm quality (sperm shape and motility) in addition to concentration. Suppression of sperm production in the testes using a group of medication called gonadotropin releasing hormone agonists (GnRHa) has been suggested but there is no proof that they protect the gonads from the effects of treatment in men and women. The testes should be sheilded from the radiation feild whenever possible.

Women: Chemotherapy for HL can result in reduction of ovarian reserve and may reduce future fertility depending on the medication used, dose, frequency, intensity, age and associated radiation treatment. Multiple studies suggested that the risk of loss of fertility is related to 1. Age > 30 years (or > 25years with hifg dose therapy) 2. Type of chemotherapy. MOPP was associated with loss of fertility than ABVD and BEACOPP. 3. Dose and frequency of chemotherapy. Dose escalation BEACOPP used in more advanced HL was associated more with ovarian failure. 4. Exposure of the ovaries to radiation. In a large study about 20% of women experienced menopause. In another study about 40% of women were able to conceive after treatment. In general published literature is not accurate in reporting fertility potential becaus they used menses as as their end point. Resumption of menses after chemotherapy does not accurately reflect fertility potential. The high dose of chemotherapy used prior to HSCT is associated with ovarian failure in the vast majority of women and girls.

Options for preservation of fertility in men. 1. Sperm cryopreservation: This is a widely available and safe option in adults. One or multiple sperm samples are obtained and frozen for later use. After remission the sample is thawed and used for intrauterine insemination or in vitro fertilization. If IVF is used a single sperm is injected directly into a partner oocyte (ICSI) and the rest of the sperm is refrozen. ICSI is a very powerful tool that can compensate for lower quality sperm encountered in men with HL. In prepubertal boys, sperm may be found in the ejaculate as early as 12 years. Asking prepubertal boys to produce a sperm sample may carry some ethical consideration. The majority of cancer patients are interested in knowing their option about preservation of genetic parenthood in the future. In spite of that, only about one quarter freeze their sperm, mainly because of lack of information about sperm freezing (Schover at al 2002). A survey of over 700 oncologists indicated that less than half offer this option to their patients diagnosed with cancer. 2. Surgical sperm retieval (TESE). Testicular sperm extraction is a surgical procedure where a small amount of tissue is harvested directly from the testes to obtain sperm. Its used in men with azospermia before starting treatment. The specimen is frozen for future use with IVF-ICSI. This is a common procedure in adults and has been reported in prepubertal boys. 3. Testicular stem cell freezing; either within testicular biopsy or separated cells. This is an experimental method with no reported human pregnancy. It is considered for prepubertal boys. The cells or tissue is later transplanted back for sperm production.

Options for preservation of fertility in women.

1. Embryo freezing. This technology is widely available and suitable for women with a partner (or accepting donor sperm) and treatment can be delayed for 3 weeks. It require stimulation of the ovaries and egg retrieval (an outpatient procedure under sedation). Embryos can be frozen for a long time and transferred after remission when fertility is desired.

2. Egg freezing. Used in women with no partner and declining the use of donor sperm. It also require ovarian stimulation and a treatment delay for 3 weeks. Its generally less successful than embryo freezing, although the use of vitrification method can yield comparable results to embryo freezing.

3. Ovarian tissue freezing. This method is experimental. Its used in prepubertal girls or in women that need to start treatment urgently and do not have the time to undergo ovarian stimulation. Its also considered in women or girls before undergoing HSCT since it is associated with very high rate of ovarian failure. One ovary is harvested usually using minimally access surgery (laparoscopy). Patient is diacharged the same day and can start treatment immediately. The ovary is processed so that the outer part (2mm thin) is isolated and frozen. The inner part of the ovary (does not bear eggs) is submitted for pathological examination. After remission the ovary is transplanted back in the abdomen or under the skin.

Women and men diagnosed with Hodgkin Lymphoma experience high chance for cure. Counseling about fertility issues before treatment can enable them to preserve their sperm, eggs or embryos for future use after treatment.




Amr Azim is a board certified reproductive endocrinologist and fertility specialist in New York City IVF and author of many scientific publication in the area of fertility treatment and fertility preservation. I specialize in helping women and men with fertility counseling, testing and infertility treatment including IUI and IVF.
I am very passionate about helping women, men and children diagnosed with cancer and other diseases understand the impact of disease and its treatment on future fertility.
I write regularly at http://nycivf.org and http://preservationoffertility.org





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

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2012年8月14日 星期二

Lymphoma Cancer Symptoms in Women - Be Aware - Stay Alive


Lymphoma symptoms and especially lymphoma cancer symptoms in women are easy to be missed. It is so, because they can be taken for standard discomfort, to which we women are so familiar with by the default of being female.

Lymphoma is a form of cancer of the lymphocytes, a type of white blood cell.

Because our knowledge about this disease is so limited, it comes to be even more dangerous.

Let me share with you what my friend told me about her condition. "At first, I started losing weight. I was so glad to see it happen; we all know how hard it is to lose weight in our age (after 50). The next - somewhat unusual for me condition - was heavy sweating, especially at night. I didn't think twice about this though, it was winter time, I was probably too hot in general from the combination of keeping the house warm and using a heavy comforter, so I thought. You know, we always find an answer if and when we want to. Another day I noticed, my skin was itching; I had an explanation here as well; it must have been something wrong with the soap. Another incident of lymphoma symptoms I did not recognize, another unpremeditated excuse minimizing the seriousness of the situation. It was not until I noticed blood while coughing, when I decided to see my doctor".

Why this story? To help you recognize the limited knowledge about the lymphoma symptoms leading to a very late diagnosis, diagnosis at a very advanced stage of cancer. Should the lymphoma cancer symptoms have been diagnosed early, the condition could be put in regression, if not totally cured. It is not the ignorance though. The difficulty in recognizing lymphoma cancer symptoms is coming from the fact that the same symptoms are very "common" to other, not necessarily serious conditions.

Let's concentrate on lymphoma symptoms in women. What are they?

First and most common of all are the swollen lymph nodes, caused by the lymphoma cancer cells. This can be noticed mainly in the armpits, neck and groin. The nodes are quickly noticeable because of their location near to the skin surface and not so due to pain.

The next symptom is a rapid and unintentional loss of weight. Fever and night sweats, fatigue as well as problems with breathing continue the list. Since these symptoms very closely resemble infection symptoms, a lot of patients are being incorrectly treated for such instead of the true cause - lymphoma.

Mentioned here are only the few lymphoma symptoms in women. There are at least fifteen of them, which women can easily neglect, because we are so used to different kinds of discomforts being women. The list continues with abdominal pain, headaches, weakness and swelling of arms and legs, bowel obstruction, shortness of breath, coughing.

In conclusion, our strong recommendation is to see an oncologist if such symptoms stay unchanged (hopefully not getting any worse) for two - three weeks. It is in the patient's best interest to check it out. With a series of tests the presence or absence of lymphoma can be easily diagnosed; the sooner the diagnosis, the better chances of survival. And - if there is nothing wrong, the peace of mind gained after such visit is just priceless.




Be am amazed with the value of experience that comes from a simple heart to heart conversation. Yes, when the words are missing, hearts talk.
Breathe in the magnificence of life and breathe out the passion for love so others can be poisoned with it.
http://lifelonghomebiz.com





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

張貼者： 於 沒有留言:
標籤： , , , , ,

2012年8月10日 星期五

Symptoms of Lymphoma in Women


Symptoms of lymphoma in women are generally the same as for men.

Lymphoma often develops quietly and with few symptoms so it may take a while before you may realize that there is something very much the matter.

Following is a list of the typical symptoms of lymphoma in women and symptoms of lymphoma in men alike.

One thing to keep in mind is that these lymphoma symptoms can be symptoms of any of a large number of conditions that are generally harmless.

For this reason, it's wise to consult with your doctor if you experience any of them.

1. Enlargement of the Lymph Nodes

This is the most characteristic lymphoma symptom and can be the only symptom that one experiences.

It's very important to note that a lot of different things can cause an enlargement of the lymph nodes and it does NOT necessarily mean you have lymphoma!

Typically, the lymph nodes of the groin, armpit and neck will swell but cause no pain.

Humans have 500+ lymph nodes in the body which are basically "forts" of immunity.

When they swell, it is often indicative of the body initiating an immune response against some type of microscopic invader.

You may notice these lumps in the course of your daily routine, such as when showering or applying creams, etc.

The symptoms outlined most often only indicate a possible lymphoma if they are discovered in addition to swollen lymph nodes.

2. Losing Weight

Typically, sudden weight loss will occur over a period of several months with no good reason.

Weight loss can range from a few pounds to up to 20 or so.

3. Running a Fever

A random fever that keeps occurring for no good reason (i.e., is not connected with a flu, cold, etc.) is usually an indication to go see your physician.

Symptoms of lymphoma can be confused with symptoms of other illnesses and, in fact, a lymphoma that causes fever accompanied by lymph node swelling is frequently mistaken for a flu or something similar.

Additionally, in those afflicted by a Hodgkins type lymphoma, a quintessential type of fever termed Pel-Ebstein fever can develop.

4. Night Sweats

Excess sweating at night may find you waking up soaked in your own sweat.

5. Pruritis (Itchiness)

Lymphoma cells can secrete certain substance which cause the entire body to be itchy, a condition known as pruritis.

6. Lack of Appetite

Individuals with lymphoma can experience a drop in their usual appetite which can also cause weight loss, one of the other symptoms of lymphoma listed above.

7. Fatigue and Listlessness

Cancer cells hijack the body's energy resource that would otherwise be utilized by healthy cells, causing a drop in energy levels.

8. Swelling

Depending upon where a lymphoma grows (and it can occur in any organ of the body), it may compress and block off veins, effectively limiting blood supply and causing swelling.

Site-specific lymphomas produce rather widely varying symptoms.

A lymphoma of the brain may cause pains in one's legs while a lymphoma in the stomach can cause stomach pains.

General Symptoms of Lymphoma in Women and General Symptoms of Lymphoma in Men

The first and most obvious sign of lymphoma is adenopathy, aka lymphadenopathy, which is a painless swelling of the lymph nodes.

Swollen lymph nodes by themselves, however, are NOT necessarily an indication of lymphoma.

It requires medical testing to confirm or negate the diagnosis.

Symptoms of lymphoma can come in many varieties, dependent upon the location of the lymphoma, the stage of growth, size of tumor, etc.

Symptoms linked with bone marrow issues such as becoming anemic (having a low red blood cell count) are uncommon in the beginning stages of a lymphoma but often are seen later in the game and often as a result of treatment.

MALT (Mucosa-associated lymphoid tissue) lymphomas affect any mucosal site, the stomach being the most common one. Alterations in bowel movement and stomach pains can be indications.

As far as the stomach lymphoma goes, if it is a result of infection with the H. Pylori bacterium, antibiotic treatment can cause the lymphoma to regress in 70%+ of cases.

How To Report Your Symptoms To A Doctor Effectively:

Describe the intensity of your symptom on a scale such as "This hurts about a 7 out of 10″.

For visually observable symptoms, show them to the doctor and also explain how they started off and looked like initially.

Explain when you first experienced your symptoms

How long have you been experiencing this symptom?

Is the symptom constant or does it come and go?

Describe any medications or dietary supplements you take/did take starting from the time symptoms manifested.

Do the symptoms change depending upon body positioning, time of day, etc.?

Do certain foods trigger the symptoms?

Be as descriptive as possible. The more accurate and specific the information you give, the more your doctor will be able to pinpoint the nature of your problem (if you have any!) and the better he/she will be able to treat you and advise you.

As you can see the Symptoms of Lymphoma in Women are generally the same as they are for men. It's important to pay attention to your body and note any symptoms you may have so that you can discuss them with your doctor in detail and he will be in a better position to help you.




John-Michael David is a well-informed patient who writes about the Symptoms of Lymphoma in Women and the Causes of Lymphoma among other important topics.





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

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標籤： , ,

2012年7月31日 星期二

Fertility Preservation in Women and Men With Hodgkin Lymphoma


Lymphoma is cancer of lymphocytes, the cells that are part of human immune system. The disease was first described in 1832 and can start anywhere lymphocytes are found (lymph nodes, spleen, bone marrow, or digestive tracts). Two types are recognized; Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The American Cancer society estimates that approximately 3800 women and 4600 men will be diagnosed with HL in 2010. The majority of those diagnosed with HL are children and young adults (age 15 to 40 years). Modern treatment carries high survival rates. (>80%). HD, however, by virtue of the disease itself or its treatment poses considerable risk to fertility in women and men, especially if it recurs after treatment.

When HD is suspected usually because of enlarged lymph nodes or other symptoms such as a fever, weight loss or night sweating, a biopsy of lymph nodes is required for the diagnosis. Biopsy require special stains (CD15, CD 30) for proteins on the surface of the characteristic cell. Once confirmed certain imaging studies (especially PET scan) to detect the extent of the disease.

Chemotherapy for Hodgkin Lymphoma; combination chemotherapy is used either ABVD, BEACOPP or MOPP-ABV. Each of the letters represent one medication. The combination of drugs is used for several cycles usually 3 to 6. This is the principle treatment for HL.

Radiation therapy using external beam is sometimes combined with chemotherapy. Radiation is usually localized to the area of the body that harbors enlarged lymph nodes.

Hematopoietic stem cell transplantation (HSCT). This treatment is used for resistant HL or HL that recurred after successful treatment in the past (relapse). This treatment requires 1. very high dose of chemotherapy and possibly total body radiation then 2. transplantation of the mother cells of the bone marrow that produce our blood cells. The sources of these cells could be the person himself (autologous) a donor person (allogenic).

Effects of Hodgkin Lymphoma and treatment on future fertility. It has been shawn that men and women attempting conception after treatment for HL had lower chances of becoming pregnant than general population (Aisner 1993).

Men: There is evidence to suggest that HL itself can affect sperm production in 50 to 70% of boys and men, probably due to disturbance of the immune cells. Chemotherapy also can be harmful to sperm production. Alkylating agents especially cyclophosphamide can cause prolonged or permanent azospermia (no sperm production). The other agents may have a reversible effect with some prospect to recovery after months to years. The final effect of chemotherapy is difficult to predict and is related to the type of regimen and doses used. For example the old MOPP regimen for 6 or more cycles result in very high rate of azospermia while the newer ABVD regimen usually causes reversible azospermia.

HSCT entails the use of high dose of alkylating agents and sometimes radiation. It commonly result in prolonged azospermia. HL or its treatment may also affect sperm quality (sperm shape and motility) in addition to concentration. Suppression of sperm production in the testes using a group of medication called gonadotropin releasing hormone agonists (GnRHa) has been suggested but there is no proof that they protect the gonads from the effects of treatment in men and women. The testes should be sheilded from the radiation feild whenever possible.

Women: Chemotherapy for HL can result in reduction of ovarian reserve and may reduce future fertility depending on the medication used, dose, frequency, intensity, age and associated radiation treatment. Multiple studies suggested that the risk of loss of fertility is related to 1. Age > 30 years (or > 25years with hifg dose therapy) 2. Type of chemotherapy. MOPP was associated with loss of fertility than ABVD and BEACOPP. 3. Dose and frequency of chemotherapy. Dose escalation BEACOPP used in more advanced HL was associated more with ovarian failure. 4. Exposure of the ovaries to radiation. In a large study about 20% of women experienced menopause. In another study about 40% of women were able to conceive after treatment. In general published literature is not accurate in reporting fertility potential becaus they used menses as as their end point. Resumption of menses after chemotherapy does not accurately reflect fertility potential. The high dose of chemotherapy used prior to HSCT is associated with ovarian failure in the vast majority of women and girls.

Options for preservation of fertility in men. 1. Sperm cryopreservation: This is a widely available and safe option in adults. One or multiple sperm samples are obtained and frozen for later use. After remission the sample is thawed and used for intrauterine insemination or in vitro fertilization. If IVF is used a single sperm is injected directly into a partner oocyte (ICSI) and the rest of the sperm is refrozen. ICSI is a very powerful tool that can compensate for lower quality sperm encountered in men with HL. In prepubertal boys, sperm may be found in the ejaculate as early as 12 years. Asking prepubertal boys to produce a sperm sample may carry some ethical consideration. The majority of cancer patients are interested in knowing their option about preservation of genetic parenthood in the future. In spite of that, only about one quarter freeze their sperm, mainly because of lack of information about sperm freezing (Schover at al 2002). A survey of over 700 oncologists indicated that less than half offer this option to their patients diagnosed with cancer. 2. Surgical sperm retieval (TESE). Testicular sperm extraction is a surgical procedure where a small amount of tissue is harvested directly from the testes to obtain sperm. Its used in men with azospermia before starting treatment. The specimen is frozen for future use with IVF-ICSI. This is a common procedure in adults and has been reported in prepubertal boys. 3. Testicular stem cell freezing; either within testicular biopsy or separated cells. This is an experimental method with no reported human pregnancy. It is considered for prepubertal boys. The cells or tissue is later transplanted back for sperm production.

Options for preservation of fertility in women.

1. Embryo freezing. This technology is widely available and suitable for women with a partner (or accepting donor sperm) and treatment can be delayed for 3 weeks. It require stimulation of the ovaries and egg retrieval (an outpatient procedure under sedation). Embryos can be frozen for a long time and transferred after remission when fertility is desired.

2. Egg freezing. Used in women with no partner and declining the use of donor sperm. It also require ovarian stimulation and a treatment delay for 3 weeks. Its generally less successful than embryo freezing, although the use of vitrification method can yield comparable results to embryo freezing.

3. Ovarian tissue freezing. This method is experimental. Its used in prepubertal girls or in women that need to start treatment urgently and do not have the time to undergo ovarian stimulation. Its also considered in women or girls before undergoing HSCT since it is associated with very high rate of ovarian failure. One ovary is harvested usually using minimally access surgery (laparoscopy). Patient is diacharged the same day and can start treatment immediately. The ovary is processed so that the outer part (2mm thin) is isolated and frozen. The inner part of the ovary (does not bear eggs) is submitted for pathological examination. After remission the ovary is transplanted back in the abdomen or under the skin.

Women and men diagnosed with Hodgkin Lymphoma experience high chance for cure. Counseling about fertility issues before treatment can enable them to preserve their sperm, eggs or embryos for future use after treatment.




Amr Azim is a board certified reproductive endocrinologist and fertility specialist in New York City IVF and author of many scientific publication in the area of fertility treatment and fertility preservation. I specialize in helping women and men with fertility counseling, testing and infertility treatment including IUI and IVF.
I am very passionate about helping women, men and children diagnosed with cancer and other diseases understand the impact of disease and its treatment on future fertility.
I write regularly at http://nycivf.org and http://preservationoffertility.org





This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

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