תוצאות חיפוש עבור טיפולי-פוריות-לחולי-סרטן

דנה יקרה, קודם כל לאור הסיפור המשפחתי חשוב שתדעי האם אמא היתה נשאית של מוטציה בגנים BRCA 1 או 2. באם היא לא נבדקה חשוב שאת תגשי ליעוץ גנטי בשביל לברר באם את נשאית או אינך. גם באם אתן לא נשאיות לאור גילה הצעיר של אמך בעת אבחון המחלה את כפי שאת יודעת נמצאת בסיכון מוגבר וחשוב כי טרם טיפולי פריון תבדקי ע״י כירורג שד ושהוא יחליט לאיזו בדיקה נוספת את זקוקה (יתכן שmri שד). טיפולים הורמונליים יתכן ומעלים מעט את הסיכון - תוועצי בגינקולוג שלך לגבי התרופות שאת מקבלת ובכל מקרה תמשיכי מעקב שד צמוד בבריאות, דינה

יש הרבה מחקרים חדשים שהאונקולוגים עושים והם מורים שאין קשר בין טיפולי פוריות וסרטן. אני מסכים עימך שלא עושים מספיק הסברה להבהיר לנשים שהאונקולוגים לא מוצאים במחקרים רבים קשר ברור ומובהק בין טיפולי הפריון שכבר נעשים יותר מחמישים שנה וסרטן.

נראה שאין קשר. תוכלי לקרוא על כך בהרחבה בגיליון האחרון של "במה" העיתון של האגודה למלחמה בסרטן.

שלום רב בעקרון מאחר שאימך חלתה למיטב הבנתי בסרטן שד דו צדדי והיא כבר נפטרה יש מקום לשקול לעשות לך בירור גנטי. לשם כך את יכולה לפנות למחלקה לגנטיקה בבית החולים הקרוב אליך. אנחנו מתייחסים היום לטיפולי פוריות כגורם המעלה את הסיכון לסרטן שד. כמובן שהסיכון גבוה יותר ככל שהטיפולים יותר ממושכים וכאשר המינונים גבוהים יותר. את צריכה לעשות ניהול סיכונים בשאלה של הרצון לקבל שוב טיפוליםפ לעומת הסיכון המוגבר לסרטן שד. לדעתי הסיכון יהיה שונה במידה ואת נשאית ולכן כדאיל לחכות לאינפורמציה הזו. בברכה

יש מאמר באתר baby4u.co.il המאמר האחרון הופיע החודש: Jensen A, Sharif H, Frederiksen K, Krüger Kjær S. Use of fertility drugs AND risk of ovarian cancer: Danish population based cohort study. BMJ 2009;338:b249 Objective To examine the effects of fertility drugs on overall risk of ovarian cancer using data from a large cohort of infertile women. Design Population based cohort study. Setting Danish hospitals AND private fertility clinics. Participants 54 362 women with infertility problems referred to all Danish fertility clinics during 1963-98. The median age at first evaluation of infertility was 30 years (range 16-55 years), AND the median age at the end of follow-up was 47 (range 18-81) years. Included in the analysis were 156 women with invasive epithelial ovarian cancer (cases) AND 1241 subcohort members identified in the cohort during follow-up in 2006. Main outcome measure Effect of four groups of fertility drugs (gonadotrophins, clomifene citrate, human chorionic gonadotrophin, AND gonadotrophin releasing hormone) on overall risk of ovarian cancer after adjustment for potential confounding factors. Results Analyses within cohort showed no overall increased risk of ovarian cancer after any use of gonadotrophins (rate ratio 0.83, 95% confidence interval 0.50 to 1.37), clomifene (1.14, 0.79 to 1.64), human chorionic gonadotrophin (0.89, 0.62 to 1.29), OR gonadotrophin releasing hormone (0.80, 0.42 to 1.51). Furthermore, no associations were found between all four groups of fertility drugs AND number of cycles of use, length of follow-up, OR parity. Conclusion No convincing association was found between use of fertility drugs AND risk of ovarian cancer. Use of fertility drugs AND risk of ovarian cancer: Danish population based cohort study) http://www.bmj.com/cgi/doi/10.1136/bmj.b249 (Editorial: Fertility drugs AND ovarian cancer) http://www.bmj.com/cgi/doi/10.1136/bmj.a3075 The use of fertility drugs does not increase a woman’s risk of developing ovarian cancer, finds a large study from Danish researchers published on bmj.com today. During the past three decades there has been considerable debate as to whether use of fertility drugs increases a woman’s risk of developing ovarian cancer. Previous studies have given conflicting results AND concerns remain, particularly for women who undergo several cycles of treatment OR who never succeed in becoming pregnant. So Allan Jensen AND colleagues at the Danish Cancer Society examined the effects of fertility drugs on ovarian cancer risk by using data from the largest cohort of infertile women to date. The study involved 54,362 women with infertility problems referred to all Danish fertility clinics between 1963 AND 1998. 156 of these women had ovarian cancer. After adjusting for several risk factors, the researchers assessed the effects of four groups of fertility drugs over an average period of 16 years. They found no overall increased risk for ovarian cancer after use of any fertility drug. They also found no increased risk among women who had undergone 10 OR more cycles of treatment OR among those who did not become pregnant. Although the authors did observe a statistically significant increase in risk of the most common serious type of ovarian cancer among women who had used the drug clomiphene, they stress that this was probably a chance association. Our results show no convincing association between the overall risk for ovarian cancer AND use of fertility drugs, AND are generally reassuring, say the authors. However, they do point out that, as many of the study participants have not yet reached the peak age for ovarian cancer, they will continue to monitor the risk. In a society where there is more AND more female infertility AND later age at birth of the first child, the unfavourable effects of fertility drugs should be balanced against the physical AND psychological benefits of a pregnancy made possible only by the use of these drugs, they conclude. These data are reassuring AND provide further evidence that use of fertility drugs does not increase a woman’s risk of ovarian cancer to any great extent although, small increases in risk cannot be ruled out, warns Penelope Webb of the Queensland Institute of Medical Research, in an accompanying editorial. Some women who take fertility drugs will inevitably develop ovarian cancer by chance alone, she writes, but the current evidence suggests that women who use these drugs are not increasing their risk of developing this highly fatal cancer. Published 5 February 2009, doi:10.1136/bmj.a3075 Cite this as: BMJ 2009;338:a3075 Editorials Fertility drugs AND ovarian cancer Current evidence shows no increased risk During the past two decades, considerable debate has centred around whether the use of fertility drugs increases a woman’s risk of developing ovarian cancer. Most ovarian cancers are assumed to arise from the layer of epithelial cells surrounding the ovary, AND it has been suggested that the repeated cycle of damage AND repair that occurs with ovulation may lead to DNA damage AND potentially cancer—the so called "incessant ovulation" hypothesis.1 By stimulating hyperovulation, fertility drugs might therefore increase the risk of cancer. A second hypothesis posits that increasing exposure to gonadotrophins increases the risk of ovarian cancer,2 AND because gonadotrophins are used to treat infertility, such treatment might, theoretically, put patients at risk. In the linked study (doi:10.1136/bmj.b249), Jensen AND colleagues use data from a large cohort study of infertile women to assess the effects of fertility drugs on the risk of ovarian cancer.3 Anxiety was initially fuelled by two studies suggesting that women who had taken fertility drugs had an increased risk of developing ovarian cancer.4 5 However, these studies included only 20 AND 11 women with ovarian cancer who had used fertility drugs. Subsequent studies have generally reported no association,6 but concerns remain, particularly for women who undergo 12 OR more cycles of treatment OR who never succeed in becoming pregnant. For example, a Cochrane review on the use of clomifene citrate for unexplained subfertility mentions that use for more than 12 cycles has been associated with increased risk of ovarian cancer.7 Cochrane reviews are, rightly, highly respected AND widely accessible to clinicians AND patients, yet the body of the review suggests the statement about ovarian cancer risk is based solely on the results of the early studies.4 5 So should women seeking treatment for infertility be worried that fertility drugs might increase their risk of ovarian cancer? More than 10 cohort studies AND a similar number of case-control studies have attempted to answer this question. Most have been limited by small sample sizes—only three studies have included more than 25 women with ovarian cancer who have used fertility drugs.8 9 10 Furthermore, infertility itself is a risk factor for ovarian cancer,9 but many studies have been unable to separate the potential effects of the use of fertility drugs on the risk of ovarian cancer from the effects of the underlying infertility; others could not control for potentially important confounding factors such as parity AND use of oral contraceptives. Jensen AND colleagues’ study included 54 362 women with infertility problems referred to Danish fertility clinics from 1963 to 1998.3 It found that use of four groups of fertility drugs (gonadotrophins, clomifenes, human chorionic gonadotrophin, AND gonadotrophin releasing hormone) was not associated with an overall increase in the risk of ovarian cancer. They also found no suggestion that risk was increased in women who had undergone 10 OR more cycles of treatment OR in those who remained nulliparous. Although the authors did see a significantly increased risk of the most common serous subtype of ovarian cancer in women who had used clomifene, this was just one of 20 separate comparisons in their subgroup analyses AND was probably a chance association. This study is important because it included 156 women with ovarian cancer, more than three times as many as any previous cohort study, AND it compared infertile women who had used fertility drugs with infertile women who had not used fertility drugs. Although information on parity AND use of oral contraceptives was unavailable for many women, analyses in the subgroup of women with this information suggested that adjusting for these variables would have had little effect on the results. However, although the study was much larger than previous investigations, it still could not exclude the possibility of a small increase in the risk of ovarian cancer in users of fertility drugs—the rate ratio for use of any fertility drug was 1.03, but the upper bound of the 95% confidence interval was 1.47.3 Larger numbers of women will need to be studied to answer this question, AND these will come with further follow-up of the cohort as they enter the age range where ovarian cancer is most common. These data are reassuring AND provide further evidence that fertility drugs do not increase a woman’s risk of ovarian cancer to any great extent, although small increases in risk cannot be ruled out. Given the increasing numbers of women seeking fertility treatment,11 this is important information for clinicians AND their patients, AND in a world where women increasingly turn to the internet for health information, clinicians should take time to discuss this matter so that women are properly informed. Some women who take fertility drugs will inevitably develop ovarian cancer by chance alone, but current evidence suggests that women who use these drugs do not have an increased risk of developing ovarian cancer. Cite this as: BMJ 2009;338:a3075 Penelope M Webb, senior research fellow 1 Queensland Institute of Medical Research, Royal Brisbane Hospital, Brisbane, QLD 4029, Australia [email protected] Research, doi:10.1136/bmj.b249 ________________________________________ Competing interests: None declared. Provenance AND peer review: Commissioned; not externally peer reviewed. References 1. Fathalla MF. Incessant ovulation—a factor in ovarian neoplasia? Lancet 1971;2:163.[CrossRef][ISI][Medline] 2. Cramer DW, Welch WR. Determinants of ovarian cancer risk II: inferences regarding pathogenesis. J Natl Cancer Inst 1983;71:717-21.[ISI][Medline] 3. Jensen A, Sharif H, Frederiksen K, Kjaer SK. Use of fertility drugs AND subsequent risk for ovarian cancer: Danish population based cohort study. BMJ 2009;338:b249.[Abstract/Free Full Text] 4. Whittemore AS, Harris R, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Am J Epidemiol 1992;136:1184-203.[Abstract/Free Full Text] 5. Rossing MA, Daling JR, Weiss NS, Moore DE, Self SG. Ovarian tumors in a cohort of infertile women. N Engl J Med 1994;331:771-6.[Abstract/Free Full Text] 6. Brinton LA, Moghissi KS, Scoccia B, Westhoff CL, Lamb EJ. Ovulation induction AND cancer risk. Fertil Steril 2005;83:261-74.[CrossRef][ISI][Medline] 7. Hughes E, Brown J, Collins J, Vanderkerckhove P. Clomiphene citrate for unexplained subfertility in women. Cochrane Database Syst Rev 2000;(1):CD000057. 8. Brinton LA, Lamb EJ, Moghissi KS, Scoccia B, Althuis MD, Mabie JE, et al. Ovarian cancer risk after the use of ovulation-stimulating drugs. Obstet Gynecol 2004;103:1194-203.[CrossRef][ISI][Medline] 9. Mosgaard BJ, Lidegaard O, Kjaer SK, Schou G, Andersen AN. Infertility, fertility drugs, AND invasive ovarian cancer: a case-control study. Fertil Steril 1997;67:1005-12.[CrossRef][ISI][Medline] 10. Ness RB, Cramer DW, Goodman MT, Kjaer SK, Mallin K, Mosgaard BJ, et al. Infertility, fertility drugs, AND ovarian cancer: a pooled analysis of case-control studies. Am J Epidemiol 2002;155:217-24.[Abstract/Free Full Text] 11. Human Fertilisation AND Embryology Authority. Facts AND figures 2006—fertility problems AND treatment 2008., www.hfea.gov.uk/docs/2008-10-08_Facts_and_Figures_2006_-_fertility_problems_and_treatment.pdf.

אין מחקרים המוכיחים את הקשר בין טיפולי פוריות וסרטן. יש להוכיח לפני הטיפול מצב בריאותי תקין כולל ממוגרפיה ובדיקת שד.

למיכאלה כל המחקרים שנערכו בארץ ובעולם לא מצאו קשר בין טיפולי פוריות לבין עלייה בסיכון להופעת סרטן השד. מקובל לבצע ממוגרפיה פעם בשנתיים אצל אישה בגיל 40 ומעלה. במידה ויש סיכון מוגבר לסרטן השד מומלץ לבצע ממוגרפיה פעם בשנה. אין סיבה לכן לא לבצע טיפולי פיריון.

לצערנו יש לזכור שהסיכוי לידל משיטות אלו נמוך ביותר והדרך הנכונה היא למנוע סרטן אני מאמין שפריצת דרך אמיתית תהיה מניעת גידול כגון פפ שנתי

החשש לא מוצדק. מאות מחקרים הראו שטיפולי פוריות לא מגבירים משמעותית את הסיכון לסרטן.

איני מכיר אתר ספציפי המרכז חומר בנושא אך ניתן לחפש ברשת או להיכנס לאתרים אונקולוגים שאליהם יש רשימת קישורים באתרי החברה הישראלית לאונקולוגיה (www.iscort.org.co.il). וגניקו-אונקולוגיה (gynonc.org.co.il)

יש ויכוח על הנושא - בכל מיקרה הסיכון אם קיים כניראה קטן מאד ולא מצדיק להימנע מלהביא ילד לעולם בהצלחה ושנה טובה דר חיים קריסי

המחקרים שנעשו עד כה הראו ברובם הגדול שאין כל קשר בין טיפולי פריון וסרטן.

לא נמצא עד כה קשר בין סרטן השחלות לטיפול עם זריקות להשראת ביוץ, למרות שנעשו בישראל ובעולם מחקרים רבים בנושא. מאחר וקבלת טיפולי פריון אינה ממש נדירה, ולצערי כך גם הסיכוי ללקות בסרטן, מן הסתם הצרוף קיים לעתים, אך מקובל כיום שהצרוף מקרי. ברור שהכי בטוח והכי מומלץ להימנע מטיפול רפואי מסוג זה ואת צריכה להחליט עד כמה חשוב לך להרות והאם הטיפול נחוץ.

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