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Cancer Patients Find Hope for Fertility at Stanford

By Mignon Fogarty

Barry Behr, PhD, and Lynn Westphal, MD
Barry Behr, PhD, and Lynn Westphal, MD. Photo: Mark Hundley

 

Lindsay Beck was just 22 when she learned she had a rare form of tongue cancer; and just 24 when the cancer came back. She learned that not only was her life at stake, but that the treatment that could save her might also rob her of her fertility. “It was too much to take. I couldn't say it, or even imagine that one more terrible thing was going to happen,” she says.

Searching for Solutions

At the time, back in 2000, information about cancer and infertility was limited. Yet, Beck attacked the search for a solution with determination. “I did all the things that most patients do, like scour the Internet, talk to friends and family, ask physicians, and I was really coming up empty handed,” she says.

Beck even went so far as to call medical centers over and over, trying to get a new person on the phone who could give her different information, and eventually this method paid off. “I finally got someone who knew that Stanford had an excellent program for cancer patients,” says Beck. “I literally went in the next day for a consultation with Dr. Lynn Westphal, and two weeks later my eggs were frozen.”

Westphal is a reproductive endocrinologist at Stanford who has been a pioneer in egg freezing, and is the primary fertility physician treating cancer patients in the clinic.

The Stanford Advantage

“A lot of fertility centers have a long waiting list and tight schedules, which I know Dr. Westphal had. But they understood what it meant to have cancer, and what it meant that infertility was on the horizon - that I didn't have time, and that I couldn't wait,” says Beck.

It was only later that Beck realized how lucky she really was. The Fertility and Cancer program at Stanford – although the largest in the country -- was the first of its kind, and only two years old. When she talked to young cancer survivors, she'd hear the same story time and time again: None of them had been informed by their oncologists that cancer treatment could put them at risk of infertility.

Founding Fertile Hope

Six months later, with a new lease on life, and a feeling that she had information to share, Beck launched a foundation called Fertile Hope that at first focused on educating cancer patients about the risks to their fertility. “I knew there were risks and I knew there were options, and I wanted to get that information out there,” she says.

The foundation has a portfolio of educational materials that they make widely available, and also coordinates a speakers bureau to get physicians like Dr. Westphal out speaking and making oncologists aware of their patients' fertility needs.

Although it was common in 2000 for oncologists to neglect to inform their patients, Westphal says that as groups like Fertile Hope raise awareness, attitudes are changing. “More and more oncologists are realizing that this is an important thing to discuss with patients, so I see more and more support,” she says.

The Center of Excellence Award

Noting that Stanford is a leader in addressing fertility in cancer patients, Fertile Hope awarded its first Center of Excellence award to Stanford. The criteria for the award include committing to provide information to all cancer patients about risks to their fertility, providing educational materials to health care professionals as well as patients and survivors, and providing referrals when the patient wants one.

“A final, optional criteria, is to help advance research on this subject, which obviously Stanford is doing with a lot of Dr. Westphal's studies,” adds Beck. In addition to her studies on egg freezing, Dr. Westphal has also participated in studies of medical therapy that could protect a woman's eggs during chemotherapy, and studies that evaluate quality of life issues for cancer patients. For example, Westphal explores how women with breast cancer felt about the information they received from their doctors, what they wished they had received that they didn't, and if they wished that they had taken advantage of some of the fertility preservation techniques that are available.

Hope is Powerful Medicine

At a time when young men and women are fighting for their lives, the act of planning for their future can be a powerful and optimistic experience. “Stanford really did a number of things well,” says Beck. “At that time, to have people doing whatever they could to make this happen for me, it really made me feel like they thought I would survive. They were actively helping me plan for my future. It was just such a tangible piece of hope.”

Westphal notes that this is a common reaction among her patients. “It is important for them to be able to look past their cancer, so it gives them something else to focus on,” she says.

Fertile Hope Grows

When Beck received her treatment at Stanford, Dr. Westphal discounted her normal rate, and worked to get fertility medications donated by pharmaceutical companies. After Fertile Hope achieved its basic goal of educating physicians and patients about fertility risks and options, the organization found that many patients ended up needing financial assistance just as Beck had. “The patients don't have a lot of time, two to four weeks between diagnosis and starting treatment. And in that time you have to move forward with your fertility preservation treatments, and pay for them up front,” explains Beck.

To meet this need, Fertile Hope developed a program that reduces the cost of fertility preservation for cancer patients in much the same way that Westphal was able to help Beck. “The medications are donated to approved patients, which is about a $3,000 to $5,000 savings. We've partnered with centers all around the country, including Stanford, that significantly reduce the cost of treatment for cancer patients who are approved through our program. So instead of paying $15,000 to freeze your eggs, which is the average across the country, a patient pays closer to $2,500 or $5,000.”  In the last year the program has approved over 100 patients.

A Happy Ending

Recently, Beck's story has taken another hopeful turn. Right now, she is seven months pregnant with her first child. Ironically, she retained her fertility after chemotherapy and didn't have to use her frozen eggs. Nevertheless, Beck and her husband know that she is still at risk of entering menopause early, and they’re glad that those frozen eggs are banked away for the day when they might want baby number two or three. 

Posted: 03/13/06

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