Women who survive childhood cancer after receiving chemotherapy stand a good chance of having children, but the same doesn’t appear to be as true for men, a new study finds.
More than 80 percent of children with cancer survive into adulthood, so their ability to have children is a major concern, the researchers noted.
Their findings were published March 22 in The Lancet Oncology journal.
“We think these results will be encouraging for most women who were treated with chemotherapy in childhood. However, I think we, as pediatric oncologists, still need to do a better job discussing fertility and fertility preservation options with patients and families upfront before starting cancer treatment,” said Dr. Eric Chow, of the Fred Hutchinson Cancer Research Center, in Seattle.
“In particular, all boys diagnosed post-puberty should be encouraged to bank their sperm to maximize their reproductive options in the future,” he said in a journal news release.
The new study included nearly 11,000 men and women in the United States and Canada who had been diagnosed with the most common types of childhood cancer and had survived at least five years. They were compared with more than 3,900 siblings who had not been diagnosed with cancer.
The childhood cancer survivors were treated with various doses of the 14 most widely used chemotherapy drugs, and they did not receive any radiation to the pelvis or brain.
By age 45, 70 percent of female cancer survivors had become pregnant, compared with more than 80 percent of female siblings. By that age, 50 percent of male cancer survivors had fathered a child, compared with 80 percent of male siblings, the study found.
Men were significantly less likely to have fathered children if they received high doses of commonly used alkylating drugs (which prevent proper DNA replication) and the chemotherapy drug cisplatin (Platinol), which treats many types of solid tumors.
Previous research has suggested that these drugs affect men’s fertility, the study authors noted.
Among female cancer survivors, only the leukemia drug busulfan (Busulfex) and high doses of lomustine (Ceenu), which treats Hodgkin’s and brain tumors, were directly linked with a reduced chance of pregnancy, according to Chow and his colleagues.
Richard Anderson, a professor from the University of Edinburgh, Scotland, and Dr. Hamish Wallace, from the Royal Hospital for Sick Children in Edinburgh, wrote an editorial accompanying the study. In it, they said the findings should help doctors provide more accurate information to patients about their individual risks.
The U.S. National Cancer Institute has more on childhood cancers.