Objective: To describe fertility issues, only rarely discussed with patients with prostate cancer, although paternity after treatment might be an important component of quality of life for some, as exemplified by two of our patients.
Patients: During pretreatment counselling two patients with newly diagnosed prostate cancer initiated the discussion of paternity after treatment. Patient 1 then opted for radiotherapy as the treatment least likely to damage fertility, whereas patient 2 had semen cryopreservation before external beam radiotherapy combined with 6 months adjuvant hormone treatment.
Results: Patient 1 became a father to a healthy child 9 months after starting radiotherapy, with conception two days after he had received one session of brachytherapy with (192)Ir (total dose 10 Gy, testicular dose, 0.1 Gy). Patient 2 fathered a child 36 months after completing external beam radiotherapy (total dose 74 Gy, testicular dose 1.2-2.3 Gy), which was combined with medical castration of 6 months' duration.
Conclusion: Fertility issues should be considered in patients before curative treatment of prostate cancer.