Cancer Survivors Delivered Good News

Childhood cancer survivors can have healthy pregnancies despite increased infertility risks

(RxWiki News) Women who had cancer as children can feel better. According to a new study, most of these women can become mothers. Getting pregnant might just take a little longer than it does for women who’ve never had cancer.

Cancer treatments during childhood increase a woman’s risks of infertility, or not being able to conceive after actively trying for a year.

Despite these odds, a new study found that two-thirds of infertile childhood cancer survivors were able to eventually get pregnant.

"Talk to your oncologist about fertility issues relating to cancer treatment."

Lisa Diller, MD, chief medical officer of Dana-Farber/Boston Children's and medical director of the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber Cancer Institute, was the study’s senior author.

"Most women think that if they had cancer as a child, then they'll never have children. It turns out that many of them can get pregnant. It just might be a little harder," Dr. Diller said in a statement.

This study involved 3,531 female childhood cancer survivors between the ages of 18 and 39, along with a group of 1,366 women with no cancer history who were sisters of the survivors.

The researchers relied on data from the Childhood Cancer Survivor Study, a study of five-year survivors who had been diagnosed with cancer before the age of 21 between 1970 and 1986. 

The study found women who had received a type of chemotherapy and/or high-dose radiation to the abdomen or pelvis as youngsters were at greatest risk of infertility.

Alkylating agents (sold under such names as Mustargen, Ifex, Cytoxan and Leukeran) are in a class of anti-cancer medications linked to infertility in childhood cancer survivors. 

Among women who had been treated for cancer as children, 15.9 percent were infertile, with 12.9 percent having been unsuccessful in conceiving after a year of trying.

The remaining women in the infertile group may not have tried to get pregnant, in part because their ovaries didn’t function properly.

Of the women who were trying to become moms, 64 percent of them became pregnant within 18 months. It took other infertile women a total of about 17 months to get pregnant.

This study also discovered that fewer cancer survivors were offered fertility assistance than women who did not have childhood cancer. Physicians prescribed medication to 42 percent of cancer survivors and 75 percent of women in the comparison group.

Dr. Diller said, "Women who have a history of childhood cancer treatment should consider themselves likely to be fertile. However, it might be important to see an expert sooner rather than later if a desired pregnancy doesn't happen within the first six months."

According to the study authors, "A more comprehensive understanding of infertility after cancer is crucial for counseling and decision making about future conception attempts and fertility preservation."

This study was published in the July 13 issue of Lancet Oncology.

Funding for this study came from the National Cancer Institute, American Lebanese Syrian Associated Charities and Swim Across America. No conflicts of interest were reported.

Review Date: 
July 12, 2013