Radiation therapy and chemotherapy treatments may cause temporary or permanent infertility. These side effects are related to a number of factors including the patient's sex, age at time of treatment, the specific type and dose of radiation therapy and/or chemotherapy, the use of single therapy or many therapies, and length of time since treatment.
When cancer or its treatment may cause infertility or sexual dysfunction, every effort should be made to inform and educate the patient about this possibility. When the patient is a child, this can be difficult. The child may be too young to understand issues involving infertility or sexuality, or parents may choose to shield the child from these issues.
Radiation, chemotherapy, and biologic agents, both independently and in combination, increase the risk of cardiovascular disease in survivors of childhood cancer; in fact, cardiovascular death has been reported to account for 26% of the excess absolute risk of death by 45 or more years from diagnosis in adults who survived childhood cancers, and is the leading cause of noncancer mortality in select cancers such as Hodgkin lymphoma (HL).[1,2] During the 30 years after cancer treatment, survivors are...
For patients receiving chemotherapy, age is an important factor and recovery improves the longer the patient is off chemotherapy. Chemotherapy drugs that have been shown to affect fertility include: busulfan, melphalan, cyclophosphamide, cisplatin, chlorambucil, mustine, carmustine, lomustine, vinblastine, cytarabine, and procarbazine. In women older than 40 years, adjuvant endocrine therapy increases the risk that chemotherapy will cause permanent loss of menstrual periods.
For men and women receiving radiation therapy to the abdomen or pelvis, the amount of radiation directly to the testes or ovaries is an important factor. In women older than 40 years, infertility may occur at lower doses of radiation. Fertility may be preserved by the use of modern radiation therapy techniques and the use of lead shields to protect the testes. Women may undergo surgery to protect the ovaries by moving them out of the field of radiation.
Patients who are concerned about the effects of cancer treatment on their ability to have children should discuss this with their doctor before treatment. The doctor can recommend a counselor or fertility specialist who can discuss available options and help patients and their partners through the decision-making process. Options may include freezing sperm, eggs, or ovarian tissue before cancer treatment.
Current Clinical Trials
Check NCI's list of cancer clinical trials for U.S. supportive and palliative care trials about fertility assessment and management and cryopreservation that are now accepting participants. The list of trials can be further narrowed by location, drug, intervention, and other criteria.
General information about clinical trials is also available from the NCI Web site.
In this article
This information is produced and provided by the National
Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National
Institute via the Internet web site at http://
.gov or call 1-800-4-CANCER.
WebMD Public Information from the National Cancer Institute
September 04, 2014
This information is not intended to replace the advice of a doctor.
Healthwise disclaims any liability for the decisions you make based on this