The complexity of reproductive decisions for patients with advanced cancer: Ethical and communicative dimensions

Paul R. Helft, Melissa K. Cavaghan

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

"Should We Have Children?" Case 1: A 34-year-old married man with two children recently was diagnosed with stage IV colon cancer. At his wife's obstetrical appointment for her second pregnancy, the patient and his wife remarked how tired and pale he seemed; the obstetrician offered to check his complete blood cell count. The man was found to have a hemoglobin level of 7.3 g/dL and was referred to his primary care physician. A workup revealed right-sided colon cancer and an isolated metastasis in the right lobe of the liver. He underwent staged resections of his primary colon cancer and his liver metastasis. While completing a course of chemotherapy, he and his wife asked his oncologist whether they should plan on having more children given his situation. Case 2: After presenting with abdominal pain, a 26-year-old married woman was diagnosed with a large, multifocal fibrolamellar hepatocellular carcinoma. She underwent primary liver resection involving an extended right hepatectomy. Within 6 months of surgery, however, surveillance imaging revealed an isolated mass in the lung and several retroperitoneal and mesenteric lymph nodes suspicious for metastases. She underwent video-assisted thoracoscopic wedge resection of the pulmonary lesion, which demonstrated a fibrolamellar variant hepatocellular carcinoma. Serial imaging of her abdomen showed enlarging abdominal lymphadenopathy consistent with metastatic disease. At the time of her diagnosis, she had been married for 3 years and had always desired children. During the course of her care, she and her husband asked her oncologist on several occasions whether they should have children and, if so, when.

Original languageEnglish (US)
Pages (from-to)45-48
Number of pages4
JournalJournal of Supportive Oncology
Volume8
Issue number1
StatePublished - Jan 1 2010

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ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)

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