When you can’t have children because of cancer

My blog today is about the emotional impact of not being able to have a baby, because of cancer and its treatments. It’s an emotive and sensitive subject, and possibly not discussed as often as it should. Being infertile, because of cancer treatments designed to save your life, can sometimes feel bittersweet. For some people, there is the additional stress and upset of trying and failing with fertility treatment, post cancer.

Introduction

When diagnosed with cancer, there are many things to think about. Fertility issues may not be something you feel is relevant to you when you’re diagnosed. Ideally, you and your specialist cancer team will have addressed the possible impact on fertility of cancer and its treatments. If there’s time to plan, steps to preserve your fertility will have been taken. Even if you are not at a stage in life where you’ve thought about future children, your fertility options should be discussed.

Fertility preservation techniques are improving and more and more people, post cancer, can go on to have a biological child of their own. You may hear about freezing eggs, sperm, embryos or reproductive tissue – which can happen before your cancer treatment to help you have a child at a later date.

However, there remain a number of people, post cancer, who cannot have a baby of their own. Some cancer treatments such as high dose chemotherapy and radiotherapy, or surgery may cause infertility. Cancer can also develop mid-life. Its treatments may tip women into an early menopause, so that child bearing is no longer possible. Men may have had treatment which stops or reduces sperm production. For those with advanced cancer – having a child may no longer seem a practical option (even if remains an emotional one).

The reality of infertility

Coming to terms with the possibility that you may never have a family of your own, can be emotional and difficult. Some people adjust to the news fairly early on – accepting that saving life and health has been the priority of all concerned. However, living with the possibility of never having a family of your own can be distressing. It’s a lot to deal with, on top of cancer itself. Others report coping initially, but then struggle later on. If you have a partner, then discussions about the future may have to acknowledge that having a family is not going to happen.

Infertility doesn’t just affect women, although it may be more acknowledged. Men, traditionally, are seen as coping with infertility, in a different way to women. It may be that men don’t feel able to share the emotions they feel. Society tends to view fathering a child as a symbol of ‘virility’, and this can lead to a misplaced sense of failure, and loss of manhood.

How you may feel?

Each person facing infertility is unique. It’s your life, your hopes, your expectations that count and colour how you feel. Added to the mix, will be the feelings of those around you too – particularly partners, and family. You may also feel pressure from friends and family who are having children. Research shows that cancer related Infertility can cause feelings of grief and loss, and a challenge to identity of ‘self’ as a man or woman. (Western Sydney University). Emotions you may experience include:-

Grief – We tend to think of grief being associated with a death, but in reality, infertility can be classed as a major loss for many. Losses include the potential future you may have planned, the family you may have had – as well as the practical inability to have a child. This can lead to sadness, tears, anger, and heartache. Men and women may react differently – women are more likely to seek support over the issue, but men still grieve too.
Anger - It can seem unfair that the future you may have planned is now changed. Future and present relationships can be affected – as not being able to have children can change how relationships are planned or can work. Some people feel angry because, in some cases, fertility issues were not discussed before their cancer treatment.
Yearning – Sometimes, you may find yourself yearning for what might have been, and certain things can trigger these emotions. For example, friends, siblings and peers announcing a pregnancy, invitations to baby showers, or not feeling part of the children-led conversations in society. Added to yearning, you may experience feelings of regret, and envy.
Guilt – guilt is an emotion that creeps in, uninvited. You may feel guilty that you resent those around you without cancer in their lives, and those who have had children. Sometimes you may experience guilt, even if you can’t always identify the cause.
Uncertainty – life during and after cancer can feel uncertain. Add into the mix, for some, the fertility attempts that may fail, and worries that the cancer may come back – a cocktail of emotions that can be hard to process.

What can I do?

Many people with infertility tell me that it can be the insensitivity of others that can undo the ability to cope. You may have had your cancer treatment some years ago, and look well. Infertility is invisible. Society can make people who have not had a family feel less valued, or ‘selfish’. This can be hurtful when you would dearly wish to have a child.

Open communication can help. Think about you might handle well intentioned, but insensitive comments. For those people probing about your family plans and hopes, it can feel intrusive. It can help to explain that treatment you had for cancer, makes having a baby difficult. However, not everyone feels ready to talk about their infertility.

Friends, family and work colleagues can be over enthusiastic about their own baby plans, and it can be hard being shown baby scans/invitations to baby showers etc. In the initial days of living with infertility, you may find it hard to cope with such occasions. Most friends will understand if you say that whilst you can’t attend, you’ll be thinking of them – a gift and a card instead, will be gratefully received.

If you can, talk about how you feel. Particularly with your partner, as there may be times when you’re both affected by the future without your own biological child. If you haven’t a partner currently, then you may feel tentative about new relationships. However, if you’re open with whoever you fall in love with, early on – then infertility doesn’t become ‘the elephant in the room’.

Seeking support and counselling for the feelings you experience, can help move through the grief, and help you realise that what you’re feeling is both normal and understandable. Online organisations such as Fertility Network UK, The Dovecote: Childless Support Organisation, and Gateway Women offer mutual support and encouragement. You could ask your GP, or hospital team for a referral for counselling or psychologist support.

Maggie’s Centres, including here online, offer support and the opportunity to talk through your feelings. This is for women – and men. There are also practical ways Maggie’s can help – teaching you coping skills through relaxation, Tai Chi, Yoga and meditation. Learning to acknowledge your feelings and helping you move forward, and plan for a different future. Writing your emotions down, through journaling, can also help process what is going on for you.

The future

It can be intensely painful and emotional to realise that for you, having your own biological child, is not going to happen. However, gradually, it is possible over time to adjust to life without children. You can still be happy and fulfilled, but in a different way. The American website, Very Well Family, sums it up – ‘You’re going to have to hurt before you can heal. The healing is non-linear. There will be good and bad days. Infertility is not something you get over. You come to terms with it. Reminders of what might have been will remain, but the pain will, in time, subside’.

In the meantime, if you feel able to, I’d value your comments. How are things for you – whether you’re the person experiencing childlessness, a partner, family or friend?

Warm wishes

Sue

Links updated April 2020

Useful links

Coping with infertility Cancer Research UK

Having a baby after cancer Cancer.Net

Emotional challenges when facing cancer and infertility Livestrong

Treatment induced infertility Healthtalk.org

How cancer treatments can affect fertility in women American Cancer Society

Fertility and men with cancer American Cancer Society

Coping with the loss of fertility after cancer CancerCare

The impact of infertility on cancer patients MedicalXpress