Testicles
Childhood cancer survivors may have late effects that affect the testicles.
Testicular late effects may cause infertility or a low sperm count. Low sperm counts may be temporary or permanent depending on the radiation dose and schedule, the area of the body treated, and the age when treated.
Certain factors increase the risk that testicular late effects will occur.
The risk of testicular late effects may be increased in childhood cancer survivors who received either of the following:
- Chemotherapy with alkylating agents, such as cyclophosphamide, procarbazine, and ifosfamide.
- Radiation therapy to the abdomen.
Testicular late effects may be caused by treatment for certain childhood cancers.
Treatment for these and other childhood cancers may cause testicular late effects:
- Acute lymphoblastic leukemia (ALL).
- Osteosarcoma.
- Hodgkin lymphoma.
- Sarcoma.
Ovaries
Childhood cancer survivors may have late effects that affect the ovaries.
Ovarian late effects may include the following:
- Infertility.
- Irregular menstrual periods.
- Ovarian failure.
- Early menopause.
Certain factors increase the risk that ovarian late effects will occur.
The risk of ovarian late effects may be increased in childhood cancer survivors who received any of the following:
- Chemotherapy with alkylating agents, such as cyclophosphamide, mechlorethamine, procarbazine, and ifosfamide.
- Radiation therapy together with alkylating agents.
- Treatment at an older age.
Uterus
Childhood cancer survivors may have late effects that affect the uterus.
The uterus may become less elastic and grow to a size that is smaller than normal. This can cause an increased risk of miscarriage and premature birth. Growth of the fetus within the uterus may also be affected.
The risk of uterine late effects may be increased in women who received radiation therapy to the abdomen.
Ovarian and uterine late effects may be caused by treatment for childhood osteosarcoma and other childhood cancers.
Reproduction
Childhood cancer survivors may have late effects that affect pregnancies.
Late effects on pregnancies include increased risk of the following:
- Miscarriage.
- Ending the pregnancy for medical reasons.
- Low birth-weight babies.
- Early labor.
- Premature delivery.
- Abnormal position of the fetus.
- Birth defects.
For male survivors of childhood cancer, there is an increased risk that their children may be stillborn.
Certain stem cell and bone marrow transplants increase the risk of infertility.
Stem cell and bone marrow transplants that include total-body irradiation (TBI), cyclophosphamide, or busulfan may damage the ovaries. Problems with the ovaries, fertility, and the ability to carry a baby to term may occur.
There are methods that may be used to help childhood cancer survivors have children.
The following methods may be used so that childhood cancer survivors can have children:
- Freezing the eggs or sperm before cancer treatment in patients who have reached puberty.
- In vitro fertilization (IVF).
There is a risk that there may be cancer cells in the saved eggs, sperm, or embryo. This risk is highest in patients who had cancer of the blood, testicles, or ovaries.
Children of childhood cancer survivors are usually not affected by a parent’s prior cancer treatment.
Survivors of childhood cancer may wonder if their children will have birth defects, inherited diseases, or cancer. There is a small increase in the risk of birth defects in the children of females who received radiation therapy to the lower back, but most children of childhood cancer survivors are born healthy.
There may be an increased risk of birth defects in children whose embryos were created in the laboratory and an increased risk of cancer in the children of cancer survivors who had second cancers.
The Web site of the National Cancer Institute (http://www.cancer.gov)
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