Sperm banking is of key importance in patients with prostate cancer

Capsule:
One out of five patients with prostate cancer considered preoperative sperm banking to be very important, and most wanted a dedicated service for preoperative sperm cryopreservation.

Authors:
Andrea Salonia, M.D., Paolo Capogrosso, M.D., Fabio Castiglione, M.D., Andrea Russo, M.D., Andrea Gallina, M.D., Matteo Ferrari, M.D., Maria Chiara Clementi, M.D., Giulia Castagna, M.D., Alberto Briganti, M.D., Francesco Cantiello, M.D., Rocco Damiano, M.D., Prof., Francesco Montorsi, M.D., Prof.

Volume 100, Issue 2, Pages 367-372.e1, August 2013

Abstract:

Objective:
To assess the need for sperm banking among patients with prostate cancer (PCa) who are candidates for radical prostatectomy (RP).

Design:
Cross-sectional study.

Setting:
Urologic department.

Patient(s):
Cohort of 510 Caucasian-European candidates for RP.

Intervention(s):
A 10-item self-administered questionnaire to assess opinions on sperm banking before RP, to which descriptive statistics and logistic regression models were applied.

Main Outcome Measure(s):
PCa patients’ wishes for preoperative sperm banking.

Result(s):
Data collection was completed for 495 patients (97.1%). Ninety-nine (20%) expressed a wish for preoperative sperm banking. Men who wanted to bank sperm were younger (mean 62.2 vs. 65.1 years), were more frequently childless (21.2% vs. 8.8%), and more frequently had a more intense desire for fatherhood (64.7% vs. 9.3%) than the patients not interested in banking sperm. Willingness to bank sperm was not affected by the patient’s educational or relationship status. Moreover, the interest for sperm banking was maintained regardless of cost issues. Overall, 84% of the patients considered it necessary to have a dedicated service of preoperative sperm cryopreservation.

Conclusion(s):
One out of five PCa patients would bank sperm before RP. Most patients considered it necessary to establish a dedicated service for preoperative sperm cryopreservation, regardless of their own motivation to bank sperm.

  • Michael Eisenberg

    The average age at prostate cancer diagnosis is conventionally thought to be older than when men wish to have children. However, as the oldest father in the world was 96 when his last son was born, it is difficult to assume that a man is no longer interested in fertility. This is also demonstrated by increasing age of paternity in the US among other countries. Cryopreserving ejaculated sperm will give him options moving forward. This study nicely demonstrates that a large proportion of patients with prostate cancer agree.

  • In most institutions, oncologic sperm preservation is not discussed due to time constraints, lack of education (physician and patient), or lack of resources. Even in an older population as studied in this article, >80% of patients, regardless of whether they desired sperm preservation or not, would consider information pre-operatively as being important.

    Another problem area occurs when cancer patients receive chemotherapy or radiation therapy with or without surgery. These toxic anti-tumor therapies may have irreversible effects on spermatogenesis.

    Oncofertility education among clinicians is of utmost importance. There are resources in the United States that can help alleviate some of the associated costs (i.e. Fertile Hope, etc.). Education will help clinicians widen their horizons from just focusing at the cancer at hand and treat the patient and their future progeny with the same intensity as their underlying problem.

Translate »