Whether your baby, toddler or young child who is currently caught up in the fight of their lives against cancer will eventually be able to have children or not is probably the last thing on your mind, but it may be something that you should take into consideration…
Some cancer treatments do not affect a child’s growing reproductive system, but others can damage a girl’s ovaries, which contain eggs, or a boy’s testes, which contain sperm. This damage may make it impossible to have a baby for a short period after completing cancer therapy or for the rest of the person’s life.
Chemotherapy, Radiation Therapy, and other cancer treatments can be very effective at doing their job, but what makes them good at fighting cancer can also cause side effects.
One of the side-effects of cancer treatments can affect the reproductive organs and have long-term effects on a child’s reproductive health. Side effects such as reduced fertility as a result of cancer treatments are known as late effects.
Your child’s risk of having late effects depends on his or her diagnosis, the type of treatment your child is getting, and the dosages. Everyone is different so it’s best to discuss the subject with your child’s medical team.
Your child’s doctor should be able to tell you whether their cancer treatment regimen is likely to have short- or long-term effects on your child’s reproductive health or not.
How Some Cancer Treatments Can Affect Fertility
Some Chemotherapy drugs are more likely to lead to infertility than others. Cytoxan (known generically as cyclophosphamide) is part of a group of chemotherapy drugs called alkylating agents. These are more likely to affect the reproductive organs when given in higher doses.
Other chemotherapy drugs and combinations of drugs also may affect your child’s fertility. There are many different chemotherapy drugs, so it is always best to ask your child’s doctor if the drugs he or she is taking will put them at risk for fertility problems.
Some of these drugs may cause short-term effects on a girl’s menstrual cycle, but do not cause early menopause. Sometimes, medications are used to put the gonads “to rest” during chemotherapy, so that they may be less likely to be damaged during treatment.
Treatment plans for paediatric cancers often use the lowest doses of alkylating agents possible, so the risk of permanent damage to the reproductive organs is lowered. For many cancers, alkylating agents are not used at all.
Radiation Treatments also can damage sperm and eggs, whether they are aimed directly or scattered.
If radiation is focused on or near the pelvic area, abdomen, spine, or whole body, it can:
- Damage a girl’s eggs and affect the release of female hormones (ovarian insufficiency), which may initially appear as irregular or no menstruation.
- In boys, radiation can also damage sperm and affect the release of male hormones, which may result in infertility during adulthood.
Some cancer treatments involve radiation to the head as a way to kill cancer cells that may be in the central nervous system. Sometimes this can injure the parts of the brain (and the pituitary gland) that make hormones that control puberty and the menstrual cycle. If that happens, doctors can give these hormones to a patient so he or she can have normal pubertal development, sexual function, and fertility.
These changes may gradually go away after treatment is stopped, but can be permanent.
Depending on the type and target area of treatment, it may be possible to shield the testes or ovaries from damage, or even move the ovaries out of the path of radiation (this is called transposition).
For patients who need surgery for cancer, doctors may sometimes need to remove part of the reproductive organs, depending on where the cancer is situated.
While we do understand that you will have more than enough to contend with upon finding out that your child has cancer, the subsequent tests and treatments, it is important for your child’s future that you take infertility into consideration as well.
Remission is the goal when treating cancer, but your child’s future quality of life should also be part of the healing process. It is therefore important that you discuss infertility with your child’s doctor, a nurse or a social worker involved in your child’s treatment.
To read more about this, please refer to our page, Late Effects of Childhood Cancer Treatment: Infertility.