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32 - Late reproductive sequelae of treatment for childhood cancer

from Part III - Management of specific disorders

Published online by Cambridge University Press:  04 May 2010

By
Angela B. Thomson ,
Hilary O.D. Critchley ,
Christopher J. H. Kelnar  and
W. Hamish B. Wallace
Edited by
Adam H. Balen ,
Sarah M. Creighton ,
Melanie C. Davies ,
Jane MacDougall  and
Richard Stanhope
Angela B. Thomson
Affiliation:
Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, UK
Hilary O.D. Critchley
Affiliation:
Department of Developmental and Reproductive Sciences, University of Edinburgh, Edinburgh, UK
Christopher J. H. Kelnar
Affiliation:
Department of Developmental and Reproductive Sciences, University of Edinburgh, Edinburgh, UK
W. Hamish B. Wallace
Affiliation:
Department of Haematology/Oncology, Royal Hospital for Sick Children, Edinburgh, UK
Adam H. Balen
Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton
Affiliation:
University College London Hospitals
Melanie C. Davies
Affiliation:
University College London
Jane MacDougall
Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope
Affiliation:
Great Ormond Street Hospital
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Summary

Introduction

Tremendous therapeutic advances in the management of childhood malignancies mean that the majority of children can realistically hope for long-term survival. Cancer in childhood is rare, with about 1400 new cases per year in the UK and a cumulative risk of 1 in 650 by the age of 15 years (Stiller, 1997; Wallace, 1997). With survival rates in excess of 70%, it is estimated that by the year 2010, 1 in 250 of the young adult population will be a long-term survivor of childhood cancer (Fig. 32.1) (Bleyer, 1990). However, the successful treatment of cancer in childhood with chemotherapy and or radiotherapy is associated with a number of unwanted side effects in later life (Wallace et al., 2001). Therefore, the major challenge faced by paediatric oncologists today is to sustain the excellent survival rates while striving to improve the quality of life of the survivors.

One of the most important issues for the survivors of childhood cancer is the impact of their disease and its treatment on reproductive function and the implications for the health of their offspring. In the female, chemotherapy and radiotherapy may damage the ovary and hasten oocyte depletion, resulting in loss of hormone production, truncated fecundity and a premature menopause (Meirow, 2000; Thomson et al., 2002). Infertility is one of the most commonly encountered and psychologically traumatic late complications of treatment for childhood cancer, and consequently, strategies to preserve fertile potential are being pursued.

Type
Chapter
Information
Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
 , pp. 397 - 415
Publisher: Cambridge University Press
Print publication year: 2004

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