I can share a bit of my experience on the fertility side. I was diagnosed with stage 4 rectal cancer at 36 years old. Before I started treatment I froze some sperm, and then had chemotherapy, pelvic radiation, and several surgeries.
After I finished treatment earlier this year, I did a semen analysis and my sperm count was zero. This was apparently most likely due to the radiation as it’s way tougher on that area than chemo, but the chemo may have also contributed. I was told however there is a chance that sperm production an recover in 6-12 months, especially if only chemo was done.
My wife and I have been considering IVF, and had my previous stored sperm tested. The count was very good (300 million), but the quality fairly poor - the ‘morphology’ (shape) of the sperm is normally >15% normal, and mine was only 1%. The fertility doc speculated this may have been because I had cancer and was under a lot of stress at the time. So on this basis she doesn’t recommend we try insemination, but IVF is fine as they only need a few good speed, and even at 1% that means my sample still has 3 million decent ones.
So I would definitely suggest freezing sperm before treatment, but it’s only chemo then I think there’s still a decent chance of recovering some fertility.
10/2018 Dx RC, 12cm high
Mod diff, EMVI+ LVI+. 4 liver mets
pT3N1aM1a Stage IVa. MSS NRAS G13R
CEA: Oct-18= 12; Nov-18= 14, Mar-19= 2.4, Aug-19 <2.0, Mar-20=2.2, May-20=1.9, Jun-20=2.1, Sep-20: 2.1
11/18 FOLFOX x6
3/19 Liver resect
5/19 25x pelvic radiation; complete met. response
07/19 ULAR w ileo, 1/27 LN+
08/19 Found liver spot
08/19 FOLFOX x1, FOLFOXIRI x1, FOLFIRI x5
12/19 Liver resect
02/20 Ileo reversed
03/20 NED (PET+MRI)
06/20 NED (CT+MRI)
07/20 Clear scope
09/20 NED (PET)