Losing the ability to have children would for many be the ultimate tragedy in a young person's battle with cancer. So here's some promising news: A transplant of ovarian tissue between sisters has shown to be successful, and the eggs have even been fertilized, though complications have caused a loss of the potential the pregnancies.

The transplantation of ovarian tissue between Teresa Alvaro and her sister, Sandra, is promising though the sisters were fortunate to share the same human leukocyte antigen (HLA), meaning that they wouldn't reject tissue from the other's body. Teresa lost ovarian function due to treatment of a blood disorder when she was 20, and preferred transplantation of ovarian tissue to donation of eggs, because she felt it was more natural.

Chemotherapy is harsh, which is good when it comes to killing cancer. What's not-so-good is that it can also cause hair loss, inflict nausea, and disable the proper functioning of all sorts of organs -- including the ovaries. Chemotherapy, therefore, can affect female fertility.

In some cases, doctors have extracted immature eggs from adult women about to receive chemotherapy, matured them in a laboratory, and then implanted them when the women are ready to have children. Until now, no one had ever tried this with eggs from young girls -- girls who have not yet undergone puberty. But it's just recently happened.

Doctors have removed eggs from young female cancer patients and for the first time, have brought the eggs to maturity before freezing them.

For young women diagnosed with cancer, the disease is more than life-altering, it also sometimes dashes all hopes and dreams they might have had for the perfect marriage, the perfect career and the perfect foray into motherhood. It might seem impossible to have children after cancer, since treatment often seriously compromises a woman's chance at conceiving, but all hope's not lost. For instance, Hodgkin's survivors can get pregnant, according to a study, and women who've undergone chemo can freeze their eggs for fertilization.

And now it's being shown that a drug developed in Australia can give new hope to wannabe mothers. It works by shielding the ovaries from harmful cancer treatments by temporarily shutting them down, so to speak. The drug's been impressing doctors around the world, and honestly, I can't wait to see it hit the market and offer some salvation for young women from the horror that is cancer.

Results of two studies, sponsored by the Adjuvant Breast Cancer (ABC) Trials Collaborative Group, conclude that adding chemotherapy to the estrogen-blocking drug tamoxifen improves survival for those with early-stage breast cancer. The same studies reveal preventing the secretion of estrogen from the ovaries does not offer much benefit for most women.

Researchers studied 1991 patients, ages 28 to 81. All had received five years worth of treatment with tamoxifen therapy with or without standard chemotherapy. Some premenopausal women were also treated with ovarian removal (ablation) or suppression, a technique used to stop the glands from secreting hormones.

While early results, appearing in the Journal of the National Cancer Institute, fell short of statistical significance, chemotherapy still reduced the overall risk of death by 17 percent, mostly for women younger than 50 and especially for premenopausal women not treated with ovarian ablation or suppression.

Germ cell tumors are cancers that arise from reproductive organs but most commonly affect the ovary and testicles. Researchers report in the December 1st issue of the Journal of Clinical Oncology that cisplatin along with epirubicin appears to be effective in certain patients with advanced disease.

This combination to treat metastatic germ cell tumors was shown to help nine patients, out of 30 studied, achieve complete remission. Dr. Pablo M. Bedano, of India University School of Medicine, said that the findings "have established cisplatin-epirubicin as one more alternative in the treatment of refractory germ cell tumors".

The researchers concluded that this regimen has an acceptable level of toxicity and offers potential long term disease survival.

Some women opt to remove their ovaries to prevent breast cancer recurrence. I considered it -- and then decided I would not take such an extreme measure when I wasn't all that sure I was done having children.

Now, ovary removal may not be necessary -- because a new chemical equivalent of surgery allows women to temporarily shut down their ovaries while preserving their fertility.

The shutdown of the ovaries is called chemopause, and women who choose to go this route receive monthly injections -- considered a super-hormone treatment -- of a drug that blocks the male hormone testosterone and is often used to treat prostate cancer.

Chemopause has big advantages. It doesn't require surgery. And it's not permanent. Women who want to have children can stop the treatment in order to conceive. And women who have trouble with side effects can discontinue use of the surgery-sparing drugs.

The ovary-suppressing drugs -- triptorelin, goserelin, leuprolide, and buserelin -- can be used in place of or on top of standard chemotherapy and hormone therapy and are showing promise in their ability to decrease incidences of breast cancer recurrence.

Medical professionals agree there is value in ovarian suppression. Studies show women whose periods do not return after chemotherapy -- which often causes early menopause -- have lower relapse rates than women whose periods resume. So shutting down the ovaries and stopping menstruation may not be such a bad idea -- and not such an extreme measure either.

I'm coming up on my last year on tamoxifen. I often wonder if it would be beneficial to me to begin taking an aromatase inhibitor following my five years of tamoxifen. According to an article published in the journal Cancer, premenopausal women with breast cancer that has spread to at least four lymph nodes received the most benefit from aromatase inhibitors following treatment with tamoxifen. Postmenopausal women with cancer that has spread to three or less nodes only seem to get a 1-2 percent benefit from the addition of an aromatase inhibitor following tamoxifen.

I don't seem to fit in either category since I had premenopausal breast cancer with less than four lymph nodes positive. I also thought that if you are premenopausal that aromatase inhibitors were not beneficial at all and only postmenopausal women were able to take these drugs.

Aromatase inhibitors work by reducing the amount of estrogen your body makes. Your adrenal glands produce a substance called androstenedione, which gets converted into estrogen in tissues such as fat and muscle. The conversion requires the enzyme called aromatase. Aromatase inhibitors stop the conversion of androstenedione to estrogen. However, if your ovaries are still functioning then the body still will have estrogen that can help cancer to grow and the aromatase inhibitors will not stop the estrogen production of the ovaries.

The study that was done concluded - it appears that women who are premenopausal and those whose cancer has spread to four or more lymph nodes would derive greater benefit from the addition of aromatase agents following tamoxifen.

I am assuming that they mean if these premenopausal women are then put into a postmenopausal state, either happening by chemotherapy or shutting down the ovaries by injection or oophorectomy.

This is a confusing article that doesn't seem to make sense. Any insights?

This is surprising -- and not good news -- for women. For women who carry one of two specific gene mutations, BRCA1 or BRCA2, linked to an increase in breast and ovarian cancer risk, even if the ovaries and fallopian tubes are surgically removed, they are still at risk for developing a form of ovarian cancer called peritoneal cancer.

According to Dr. Steven Narod, a leading researcher in the field of inherited breast and ovarian cancers, women with the gene mutations still have a cancer risk nine times higher than women without the inherited BRCA1 or BRCA2 gene mutation.

"Is it bad news? Well, one would like to think you have your organs removed and the disease is not going to come," said Dr. Narod. The average Canadian woman has about a 1.4 percent lifetime risk of developing ovarian cancer. The risks for women with the BRCA1 gene mutation is 60 percent and with the BRCA2 gene mutation is 25 percent.

Researchers call the surgical removal of ovaries and fallopian tubes a method of risk-reduction but that it will not completely prevent ovarian cancer. The Hereditary Ovarian Cancer Clinical Study Group have reported the study results in the Journal of the American Medical Association.

Chemotherapy sometimes creates a problem with infertility. I stopped having monthly periods at the age of 41 when going into early menopause after chemotherapy. Women want to be aggressive in treating their cancer but worry about how to protect themselves from becoming sterile. Especially those women who have not yet had children and are planning a family.

One option for women who are getting ready to undergo chemotherapy is to harvest some of their eggs involving freezing and storing them for later use. Lots of campaign issues against egg harvesting are actively being discussed but for women undergoing chemotherapy and still wanting to have children, this has been the number one option they have faced. Now research is being done on using a new drug to temporarily shut down the ovaries. Then when chemotherapy is completed, doctors work on restoring your periods.

Mercy medical oncologist Dr. David Riseberg of the Institute for Cancer Care at Mercy Medical Center said the idea is that putting a woman into temporary menopause will protect the ovaries from chemo. Studies about that are going on right now. "There are still questions about whether -- with these injections -- whether there is still impairment in the ability of women to have children, but we think getting the periods to return is an important first step," Dr. Riseberg said.

There is no major test or screening tool or exam that reveals the definite presence of cancer in the body. There are mammograms that can detect suspicious masses in the breast and there is a blood test that might raise concerns about the health of ovaries and there are various x-rays and scans that allow doctors to peek into the intricacies of the human body -- and some tests, like the mammogram clearly do save lives -- but some tests that seem harmless can damage the psyche while accomplishing little else.

I asked my oncologist how he would know if my breast cancer returns. He said I will receive regular mammograms and ultrasounds of my breasts. And he will perform in-office exams every few months. He will complete a breast exam and will feel my neck for enlarged lymph nodes. He will listen to my lungs and feel my stomach. But largely, he will rely on me to report symptoms and signs and complaints -- because these are the true indicators that something is amiss.

I imagined myself getting a whole host of tests on my whole body to rule out that cancer is invading every part of me. But this won't happen without reason -- because some tools, like imaging tests, may detect noncancerous abnormalities and false positives that lead to unnecessary psychological stress and tests -- and sometimes even surgery. So if I develop a persistent cough that can't be controlled, perhaps my oncologist will order a chest x-ray. If headaches begin to plague me and relief is not in sight, then perhaps a scan of my head will be in order. But as long as I feel well, the assumption is that I am well. It's better for my soul this way -- to live life without the constant worry that cancer will return. And it's a whole lot more cost effective too.

On May 24, 2006, The Vegetarian and Vegan Foundation will be launching White Lies, a campaign to raise awareness of the health risks of consuming dairy products. Why You Don't Need Dairy, an event to mark the beginning of the campaign, will feature Heather Mills McCartney as a speaker who will call for milk to be dropped from the nation's diet. At the same time, the Physicians Committee for Responsible Medicine, PCRM, a nonprofit health organization comprised of physicians and nutritionists, will be asking consumers to eliminate dairy from their diet for three weeks to see if they notice an improvement in health.

In three short weeks, PCRM is confident those who take the dairy-free challenge will notice immediate benefit in better digestion, easier breathing, better sleep, a lessening of headaches and for sufferers of acne or dermatitis -- clear skin. Health benefits that are not immediately noticeable but of significant value is a reduction in the risk of prostate and ovarian cancer. Research had proven the link between dairy and these two cancers. Because dairy products such as cheese, ice cream, milk, butter, and yogurt all contain high levels of fat, it is reasonable to assume there might be a dairy link to other cancers as well.

The Nutrition Resource Centre of the Ontario Public Health Association, has published Non-Dairy Sources of Calcium, available as a PDF document online, with food suggestions that offer plenty of calcium.

Several days ago, the American Society of Clinical Oncology issued new guidelines concerning the preservation of fertility during cancer treatments. Many treatments for cancer will lead to infertility if precautionary measures are not taken before treatment begins. The two methods of fertility preservation with the highest likelihood of success for cancer patients are embryo cryopreservation for women and sperm cryopreservation for men. Today, I came across a news story describing another option called ovarian transposition. In the article about dreams surviving cancer, surgeons made tiny incisions in Carrie Lintner's abdomen and gently pulled her ovaries behind her uterus, where they were held in place with a few stitches. The uterus shielded her ovaries from the damaging radiation beams from the treatment she received for her recurrent Hodgkin's lymphoma. The ovarian transposition procedure took 30 minutes and saved her ability to give birth. Ms. Lintner, who is now cancer-free, is the mother of a baby girl, Maia.

Yesterday, the television news was on in the background as I sat at my computer working. I heard a male newscaster say, "Hooray for HRT!" I stopped to listen to what he meant by the lead-in announcement to the story, because frankly, I thought perhaps he had lost all sense of objectivity. But indeed, he was reporting on the results of a new study, which is part of the NIH-funded Women's Health Initiative, that suggests postmenopausal women who take estrogen as a hormone replacement therapy do not have an increased risk of developing breast cancer.

HRT is most often prescribed to relieve menopausal symptoms, and to protect the heart and bones from damage resulting from the natural loss of estrogen women experience during and after menopause. Menopausal symptoms can be major, and for many women, limiting when it comes to quality of life. But for women at risk, or diagnosed with, estrogen-positive breast cancer, HRT would seem, by all rational consideration, not a smart choice.

We have been told that hormone replacement therapy for postmenopausal women can lead to increased risks for breast cancer. We have been told that hormone replacement therapy for postmenopausal women does not lead to increased risks for breast cancer. So, is it safe? Or is it dangerous? I don't know, but as a woman with estrogen-positive breast cancer, I am not going to the take a chance by introducing any more estrogen into my body, and frankly, I cannot imagine a doctor who would prescribe it as a therapy for me. To find more in depth information, go here.