Every day in Italy at least 30 new cases of cancer are diagnosed in patients under the age of 40, equal to 3% of the general caseload: approximately 371 thousand new diagnoses of malignant tumors in 2019, of which 196 thousand in men and 175 thousand in women. In light of these data, and in view of World Cancer Day which is celebrated on Sunday 4 February, the Italian Society of Human Reproduction (Siru) draws attention to the importance of preserving fertility in patients of reproductive age who receive a diagnosed with cancer and who must undergo treatment.
The most common types of cancer in men – recalls Siru – are testicular cancer, melanoma, thyroid cancer, non-Hodgkin's lymphoma, colorectal cancer, while breast cancer, thyroid cancer and melanoma are more frequent in women. , colorectal and cervical cancer. These are therefore oncological pathologies with an important impact on the reproductive capacity of the patient of childbearing age.
“The preservation of fertility in cancer patients – states Francesca Parissone, coordinator of the Siru Fertility Donation and Preservation Special Interest Group – now represents a possible reality in many cases. In recent years it has gradually become more and more concrete thanks to new strategies therapeutic: on the one hand, anti-tumor treatment regimes with less toxicity on the reproductive system are adopted, on the other, consolidated cryopreservation techniques are available, i.e. freezing of gametes, oocytes and spermatozoa, and innovative techniques for cryopreservation of ovarian and testicular tissue” .
If the conservation of oocytes and spermatozoa is now a standardized and widely spread practice, certainly the field of greatest interest and future prospects – explain the experts – is represented precisely by the cryopreservation of ovarian tissue, for which more and more data and possibility of execution, and of testicular tissue, although it is still in an experimental phase. These two techniques have opened up the possibility of applying fertility preservation even in the delicate category of patients affected by childhood and adolescent tumors, an age in which the individual's development may not yet have occurred and therefore it is impossible to recover oocytes and spermatozoa with fertilization capacity. This is a cutting-edge area on which the current scientific challenges of sector experts are addressed.
“Oncofertility – comments Guglielmo Ragusa, director of Usd Pma – fertility preservation Aoui of Verona – is now a real discipline that can make use of national and international guidelines, scientific recommendations and organizational models that have the aim of making the path to the cancer patient who wishes to preserve fertility is easily accessible; moreover, these are services reimbursed by the national health system. Despite the notable progress we have witnessed in the last 15-20 years, to date, unfortunately, a portion of patients, men and women, still does not receive the necessary information on the possibility of preserving fertility. Therefore, in parallel with scientific progress, a process of awareness among the medical profession and information to patients should be encouraged.”
“Siru is active in promoting the preservation of fertility at a scientific and popular level – declares Antonino Guglielmino, founder of Siru – through the organization of dedicated webinars also in collaboration with doctor-patient associations, the drafting of scientific articles and guidelines national clinics in collaboration with other scientific societies. The commitment for the future must be aimed at increasingly guaranteeing this possibility throughout the national territory with multidisciplinary and timely organizational models”.
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