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It is good news for young cancer patients, as the high cost burden has been a barrier. A system must be created for oncologists and fertility doctors to work together to provide long-term support.
The government said it will subsidize the cost of cryopreservation of patients’ eggs and sperm in case cancer treatment causes infertility starting next fiscal year. It is one of the fertility measures advocated by the Cabinet of Prime Minister Yoshihide Suga. It is estimated that 7,000 people will utilize the new program annually, and the government has earmarked ¥1.1 billion in the budget proposal for next fiscal year.
Treatment with anticancer drugs or radiation can cause infertility. Eggs and sperm are collected before treatment, and eggs are frozen either as fertilized eggs if the would-be parents are married or as they are if they are not married. In childhood cancer, ovaries and other organs are preserved.
The subsidy is supposed to be about half to two-thirds of the total cost. Many younger patients give up on cryopreservation because their incomes are low and cancer treatment costs are high. The new measure will likely ease the psychological burden of cancer patients undergoing fertility treatment.
Measures to counter infertility in cancer patients have become more common among oncologists since the Japan Society of Clinical Oncology compiled guidelines on fertility treatment for cancer patients according to the types and stages of cancer in 2017. However, the current situation cannot be said to be sufficient.
Some patients are said to have missed out on cryopreservation options because they have not been informed of them in advance. It is hoped that oncologists will provide fertility treatment information to cancer patients who are deemed in need of such treatment.
Consideration must be extended to patients in doing so. This is because the decision for cryopreservation needs to be made in a short period between the diagnosis of cancer and the start of treatment, and patients and their families are shaken by the anxiety they feel after being informed of a cancer diagnosis. Doctors should be careful to give thorough explanations.
There is also a movement to train psychologists and nurses who specialize in counseling such patients. Developing personnel for this purpose is urgent.
The central and prefectural governments plan to designate medical institutions that can collect eggs and sperm to ensure quality of treatment. It is necessary to establish facilities that can provide cryopreservation safely for a long period of time.
It will be necessary to ensure that the rules are followed, such as disposing of stored eggs and sperm when a patient becomes unable to continue fertility treatment and, if the patients are minors, confirming after they become adults whether they want to continue storage.
It is said that patients who have received subsidies will be registered for follow-up on the effects of cancer treatment and pregnancy rates. As fertility treatment for cancer patients has only a short history, it is necessary to accumulate long-term data and improve knowledge of its safety and effectiveness.
Cryopreservation is not a goal. Fertility treatment begins after cancer treatment. There are also issues involved with work and marriage. It is important for the government to pay attention not only to treatment, but also to the difficulties that cancer patients face in their lives.
— The original Japanese article appeared in The Yomiuri Shimbun on Feb. 1, 2021.
