At 42, can my aunt with breast cancer choose IVF?

Question

Hello doctor,

My aunt is currently battling metastatic breast cancer. She is only 42 years old, and this diagnosis has hit our family hard. Her cancer has spread to the bones and liver, and she's undergoing targeted therapy and hormonal treatment. One thing that has been really concerning her lately is her missed periods and the hormonal side effects.

We are unsure whether it is menopause due to cancer treatment or something else. She has also been feeling very fatigued, has hot flashes, and is emotionally overwhelmed. She had been trying for a child before her diagnosis and is devastated by the thought that it might no longer be possible.

Could you please clarify if it is possible to preserve fertility in such advanced cancer cases?
Can hormonal therapy permanently stop her periods or induce early menopause?
Is IVF or surrogacy ever an option for patients like her?
Can hormonal fluctuations worsen her cancer?
How should we manage her mood swings and sexual health during this time?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Menopause and fertility are important concerns in this situation. Targeted therapies and hormonal treatments often temporarily stop periods or induce early menopause. This can sometimes be reversible if treatment is stopped, but with metastatic cancer, pausing treatment is usually not considered safe. Unfortunately, preserving fertility through options such as egg or embryo freezing is rarely possible once treatment has started, especially at this stage. In-vitri fertilization (IVF) or surrogacy would generally require pausing therapy, which may carry significant risks at present.

Hormonal fluctuations can potentially affect her hormone-sensitive breast cancer, which is one reason why treatments are often designed to suppress hormone activity. Her medical team has likely chosen a treatment plan that carefully balances cancer control with these hormonal considerations.

There are several ways to support her quality of life during treatment. For mood-related symptoms, it may be helpful to ask her oncologist about antidepressants that are compatible with her cancer therapy. Some of these medications may also help reduce hot flashes. Counseling or therapy can also help her process grief and emotional stress.

Sexual health concerns are also common. Vaginal dryness can occur during treatment, and non-hormonal moisturizers such as vaginal moisturizer or hyaluronic acid gels may provide safe relief.

For fatigue and hot flashes, she can do the following things;

Light exercise.
Comfortable cool clothing.
Paced periods of rest may help improve day-to-day comfort.

Please consider connecting with a palliative care specialist. Palliative care focuses on quality of life, symptom management, and emotional well-being during serious illness. They can provide valuable support for both physical and emotional challenges and work alongside her oncology team.

Your aunt is much more than her diagnosis. It is important to acknowledge her grief and concerns while also reminding her that she is deeply loved and supported. Continue discussing these questions with her medical team, as they can provide guidance tailored to her specific situation.

I hope this information helps you.

Feel free to ask further queries.

Thank you.