Parenthood After Cancer: Quality of Life Issues Important

When Jay Goldberger was diagnosed with sarcoma of the nasal pharynx in 1996, his doctors at M. D. Anderson guaranteed him three things.

"One, that I would throw up a lot and be very sick. Two, that I would lose my hair. And three, that I would never be able to have kids on my own. On the first two they were right," he says, his face lit by a mischievous grin. "But on the third, they were wrong."

He was only 26 and surgery was a questionable option, the consequences of which would be serious disfigurement. Michael Burgess, M.D., professor of sarcoma medical oncology at M. D. Anderson, suggested a different plan. He had a clinical trial combining radical chemotherapy and radiation.

"He said he would take me and the cancer to the brink of death and, then, pull me back," Jay says. And that's what happened.

However, before he underwent treatment, he banked his sperm back home in Minneapolis, Minn. He and his wife, Esther, had been married for less than two years and feared the highly toxic therapies would affect fertility and their chances of having a family. And given the circumstances, they didn't want to wait. In February 1997, Esther had in vitro fertilization (IVF) and on October 17 gave birth to twin girls, Lauren and Marisa, now 6 years old.

Children and quality of life

Researchers have found that having children plays an important role in the quality of life for younger cancer survivors like Jay. Yet, highly toxic treatments can seriously affect their fertility, an issue that many oncologists fail to discuss with their patients before these therapies begin.

While sperm banking is one of the easiest ways for men with cancer to protect their chances of having children, it is an underutilized option. "Only about 25% of men eligible to bank sperm take advantage of that option. We also know that of all the men who bank sperm, only about 10% so far are using their samples to conceive," says Leslie Schover, Ph.D., professor of behavioral science at M. D. Anderson. "Some conceive naturally, but we never know in advance who that is going to be."

Jay turned out to be one of those who could, after all, conceive naturally. However, before that miracle could happen, the Goldbergers had yet another cancer to deal with. One day in early 2000, Esther called Jay at work saying she had spit up blood.

"It raised a red flag," he says. "The doctor found a tumor in her nasal passage and I insisted he remove it immediately. It was lymphoma. Then, we came to M. D. Anderson to people I knew - where I had received my chemotherapy and radiation treatments."

Despite the toxic treatments that both parents had received, Esther gave birth on February 28, 2003, to Michael Burgess Goldberger, a son who had been naturally conceived. They named him after the doctor whose clinical trial had saved Jay's life.

Positive aspects of parenthood

"As outsiders, we may tend to say that parenthood isn't important to young cancer survivors because they are going to die or they should just be glad to be alive or they're too impaired to be parents," Schover says. "None of that proves to be true."

And that is certainly the case with the Goldbergers. As Jay says, "After cancer, I had an entirely different perspective. I strive to teach my children to live life, not to sweat the small stuff. I work hard, but I try not to be too caught up in my job. I want my kids to grow up knowing their father.

"On the one side, people might say that we're unlucky. But on the other side, I would say that we're incredibly lucky. Esther and I got to understand each other early in our marriage. We appreciate each other and our family, and we can give those values to our kids."

Esther agrees as she keeps up with Lauren and Marisa and Michael Burgess and prepares for the birth of yet another little Goldberger this year.