Each survivor’s risk of late effects of cancer treatment depends on their tumor, specific treatments, age, genetic makeup and other factors. Surgeries, chemotherapies, radiation, stem cell transplants and other treatments take a toll on the body – and sometimes the mind – in many ways. Some late effects make life more difficult; others are life-threatening.
Heart and lung problems are common, as are secondary cancers.
Other late effects can include hearing problems, hormonal imbalances, difficulty growing, mental health needs or cognitive deficiencies, bone density issues and easy bone fractures, fertility and reproductive problems, and more.
We asked St. Baldrick’s Scholar Dr. Hazel Nichols to tell us about some of the reproductive health issues faced by adolescent and young adult (AYA) cancer survivors:
How does cancer treatment impact fertility?
Cancer treatments can potentially affect future fertility. For example, radiation therapy to or near the abdomen, pelvis, or spine can harm nearby reproductive organs. Radiation therapy to the brain can also damage the pituitary gland, which helps control the production of certain hormones needed for pregnancy.
Some types of chemotherapy can affect the ovaries, reducing the number of eggs and changing hormone levels. Having been treated for cancer during adolescence and young adulthood can also affect sexual health, body image, and financial stability during childbearing years.
Do patients or their families receive counseling on these options?
Counseling patients on the effects of cancer treatment on fertility and options for fertility preservation is recognized as a critical part of high-quality cancer care. National guidelines recommend fertility counseling for AYA patients before cancer treatment.
However, fertility counseling has been described as one of the most under prescribed and least implemented services in cancer care. More than half of AYA cancer survivors report needing more information for reproductive planning both before and after cancer treatment. This unmet need has been associated with lower emotional functioning and health-related quality of life.
How is your St. Baldrick’s supported research helping childhood cancer survivors?
Despite advances in fertility preservation options and recognition of fertility counseling as a part of high-quality cancer care, the incidence of post-diagnosis childbirth has remained stable for many years.
My research is working to understand what the needs and challenges are for accessing fertility-related services.
Specifically, I am examining AYA cancer survivors’ age, race, and rural residence in relation to using fertility preservation options. We hypothesized that fertility preservation will be more common at older ages and in more recent diagnosis years, and will be less common for AYAs with a rural residence or African American race. Our research helps identify barriers to use of fertility services to inform strategies to improve cancer care delivery.
We showed that, during 2004-2015, only 1.2% of female AYA cancer survivors froze eggs or embryos for fertility preservation after cancer diagnosis in North Carolina. Younger women were 6 times more likely to use fertility preservation than older women. Women who were Black or who lived in rural areas or had lower socioeconomic status or had children at diagnosis were less than half as likely to use fertility preservation. We believe these results highlight the barriers that that cost creates for accessing fertility preservation, and caution that women who have children already may less often receive fertility counseling around having additional children in the future.
June is National Cancer Survivor Month, a time to celebrate childhood cancer survivors – and to keep the focus on progress. St. Baldrick’s will continue to support research not only to find new cures, but better ones.
(2022). Disparities in fertility preservation use among adolescent and young adult women with cancer. Journal of cancer survivorship : research and practice, 10.1007/s11764-022-01187-y. Advance online publication. https://doi.org/10.1007/s11764-022-01187-y
Help kids to survive and thrive. Support research into better treatments for kids with cancer
Read more on the St. Baldrick’s blog:
What is osteosarcoma?
Osteosarcoma is the most common type of bone cancer in children. It often originates in the long bones of the body that include the thigh bone, the shinbone, or the bone that runs from the shoulder to the elbow, called the humerus.
While osteosarcoma frequently starts in a particular bone, it can potentially move to other sites in the body, such as the lungs and other bones. This movement, known as metastasis, often makes the disease more difficult to treat.
A type of childhood cancer, osteosarcoma is commonly found in children children, teens, and young adults between the ages of 10 and 30. Patients who are 10-20 years of age account for 60% of osteosarcoma cases.
You can help to find the best treatments for kids with cancer. Donate now to help them grow up and live long, healthy lives >
What is acute myeloid leukemia (AML)?
Leukemia is cancer of the blood cells. Leukemia cells divide quickly and fail to mature into normal, functioning blood cells.
Acute leukemia progresses rapidly and is classified into two general subtypes:
- When the cancer affects the lymphocytes, a type of white blood cell, it is called acute lymphoblastic leukemia, or ALL.
- When the cancer affects other blood cell types, such as red blood cells, platelet-forming cells, and other types of white blood cells, it is called acute myeloid leukemia, or AML.
What is acute lymphoblastic leukemia?
Acute lymphoblastic leukemia (ALL) is a cancer of the white blood cells that normally fight infection. The cells do not grow and develop properly, filling up the bone marrow inside bones, where blood is normally made.
ALL is the most common type of childhood cancer, accounting for 35% of all cancers in children. Each year, there are about 2,900 new cases of children and adolescents diagnosed with ALL in the United States alone.
Its signs and symptoms resemble other common illnesses, which often leads to other treatments before the leukemia diagnosis is made.
Two years ago, a group of three dedicated moms rallied some dear friends to achieve what seemed like an ambitious goal to support osteosarcoma research. As you’ll see below, they knocked that one out of the park!Battle Osteosarcoma volunteers set out to raise $150,000, then raised more than $1.3 million!
Dr. Jeffrey Toretsky is a St. Baldrick’s researcher at the Georgetown Lombardi Comprehensive Cancer Center in Washington, D.C. He explains what sarcoma is, how it’s diagnosed and treated, and how research is helping kids and adults with this type of cancer.
What is sarcoma?
A sarcoma is a bumpy tumor that occurs in the connective tissues (nerves, muscles and bones) anywhere in the body.
Sarcomas are rare, especially in young children. In kids between 10 and 20, sarcomas make up about 20-25% of childhood cancer diagnoses.
Sarcomas can start off being tiny lumps that you can’t feel. They can spread through the body, or metastasize, before they grow big enough to be seen.
Especially striking increases have been noted for malignant melanoma, the most dangerous form of skin cancer.
In fact, the CDC reports that skin cancer is now the most common form of cancer in the U.S.
As the weather gets warmer and the sun gets hotter, it is important to learn how to best protect our children from solar radiation.
Rare Cancer Day is September 30th, but the St. Baldrick’s Foundation fights rare cancers year-round.
What is rare disease?
When it comes to cancer, or even diseases as a whole, “rare” is a misleading word.
A rare disease is defined as “any disease or condition that affects fewer than 200,000 people in the United States, or about 1 in 1,500 people.” About 72% of rare diseases are genetic, and of those, 70% start in childhood.
Worldwide, people with rare diseases make up less than 6% of the population. But more than 6,000 rare diseases have been identified so far, and they affect more than 300 million around the world. If these people were a country, they would be the world’s third largest nation.
Childhood Cancer Awareness Month is the perfect time to test your knowledge — and to spread the word about why you support lifesaving research through St. Baldrick’s. And you may learn something new!
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