Show notes
As colorectal cancer rates rise among younger adults, surgeons are increasingly caring for patients with rectal cancer who are pregnant or hoping to preserve future fertility. With more individuals delaying childbearing, balancing effective cancer treatment with fertility preservation and maternal–fetal safety has become an important clinical challenge. This timely topic was recently highlighted by Dr. Sharon Suwanabol during a presentation at the American Society of Colon and Rectal Surgeons annual meeting 2026. In this episode, we explore the intersection of rectal cancer, fertility, and pregnancy through a multidisciplinary, case-based discussion. We review how surgery, chemotherapy, and pelvic radiation can affect fertility and sexual function in both men and women, and why early counseling and referral to reproductive endocrinology specialists are essential. The discussion also emphasizes that evaluation and treatment during pregnancy can often be performed safely, with care individualized based on tumor stage, gestational age, and the patient’s goals and values. Hosts and discussants · Dr. Betelhem Yohannes, General surgery resident at the University of Washington · Dr. Griffen Allen, General surgery resident at the University of Washington · Dr. Raga Siddharthan, Assistant Professor of Surgery in the Section of Colorectal Surgery at the University of Washington · Dr. Stacey Cohen, Professor in the Division of Hematology and Oncology at the University of Washington and a gastrointestinal medical oncologist at Fred Hutch Cancer Center, specializing in colorectal and other GI cancers. Learning objectives · Describe the impact of rectal cancer surgery on fertility, sexual function, and future childbearing potential. · Review the effects of chemotherapy and pelvic radiation on reproductive health and fertility preservation. · Discuss available fertility preservation strategies and the importance of early pre-treatment counseling and referral. · Recognize the diagnostic challenges of rectal cancer during pregnancy, including overlapping gastrointestinal symptoms. · Review appropriate staging and workup considerations for suspected rectal cancer in pregnant patients. · Discuss multidisciplinary management strategies for rectal cancer during pregnancy, including individualized treatment sequencing. · Examine ethical and patient-centered considerations when balancing maternal cancer treatment and fetal outcomes. References
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Stal J, YI SY, Cohen-Cutler S, et al. Fertility Preservation Discussions Between Young Adult Rectal Cancer Survivors and Their Providers: Sex-Specific Prevalence and Correlates. Oncologist. 2022;27(7):579-586. doi:10.1093/oncolo/oyac052 [https://pubmed.ncbi.nlm.nih.gov/35708892/]
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