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:
This was written by Hudson’s mom, Jessica McKearney.
I work as a Nurse Practitioner and Kyle works as a Project Manager. We live in a small town in Northeast Iowa. Before March 2019, Hudson was an energetic, Mickey Mouse and car loving toddler. He was spirited, happy, loved to dance and kept us on our toes. In November 2018, Hudson became a big brother to his sister Violet. Two under two was exciting and exhausting. Hudson was caring, empathetic, and always wanted to be with Violet. They had an incredible bond, and we were grateful to have two happy and healthy toddlers.
Have you heard of a St. Baldrick’s Hero Fund and wondered what it was — and maybe whether you should have one? Here are the basics, along with how a few families feel about their experience.
What does your support of childhood cancer research really mean? See what Carlos Sandi has to say about what a difference the St. Baldrick’s Foundation and specifically the St. Baldrick’s – Stand Up to Cancer Pediatric Cancer Dream Team, have made to his family.
FINDING LIFE AFTER DEATH: After losing twin boys to cancer the Deckers harness the power of hope to honor them.
For a parent, losing a child shatters your core beliefs, assumptions about the world, and your expectations of how life should unfold. Losing two children only 18 months apart… truly devastating.
April 10th is National Siblings Day. You know, your parents’ other children who push your buttons just right, make you laugh when you least expect it, or get you in trouble with mom and dad? Yeah, those people – your brother or sister, older or younger, today’s the day to show them that they are an important person in your life!
For National Siblings Day, we checked in with the brothers and sister of some of the 2020 St. Baldrick’s Ambassadors! Childhood cancer impacts the entire family, and we want to share what it feels like to be a sibling of a kid with cancer. Meet some remarkable kids who opened up to us about their experience!
Jack Callahan has been through a ton in just four years on Earth. Six rounds of chemotherapy, then a major surgery, plus three rounds of chemo with three stem cell transplants. Radiation – he’s only part of the way through 33 treatments of that –and hearing loss and hair loss; he spent a total of 117 nights in the hospital in 2019.
For parents Emily and Michael, though, you’d think Valentine’s Day isn’t top of mind today – you may be right, but that doesn’t mean that the young couple isn’t staying connected through this new reality. Both working parents had to scale back their hours, and the family must shuttle back and forth between home in Charlottesville, Virginia and treatments at Children’s Hospital of Philadelphia.
Yet, on this Valentine’s Day, we thought we’d share Emily’s perspective: how do they all manage to juggle the stresses and emotional strain of a kid with cancer?
“I’m an accidental tourist in the childhood cancer world,” says Patrick Sullivan, who chairs the Patient Advocacy committee for the St. Baldrick’s Foundation — Stand Up 2 Cancer Pediatric Cancer Dream Team. “It’s not a place I’d ever thought I’d be in, until I heard that my son had rhabdomyosarcoma in 2007.”Patrick Sullivan and his son, Finn.
Patrick’s role is more than just tourist, though. When the Pediatric Cancer Dream Team was created, its goal was to push the envelope, to marry the emerging fields of genomics and immunotherapy to create targeted therapies for cancers. It was also important to the Dream Team to involve patient advocates, to inspire and work alongside the researchers, to maximize the Dream Team’s success. Along the way, each researcher was paired with a young investigator on the team, to help the advocates better understand the science and to help the young investigators better communicate their work to families and the lay public.
The Mom of a St. Baldrick’s Ambassador Tells Us Why There’s Need for Research to Help Pediatric Cancer Survivors
Editor’s Note: As we commemorate Childhood Cancer Awareness Month, and launch the #DFYchildhoodCancers campaign, we’d like to introduce you to Katrina Knott, whose daughter, Arianna, is one of the five St. Baldrick’s “Ambassadors” for 2019. As you’ll read in her story, survivorship issues in pediatric cancer need attention – and funding – for those like Arianna, whose challenges are many.Arianna during treatment
Ellie is just like every other Mom in that she juggles all sorts of things, from kids’ schedules to work/life balance. Except she does it all while caring for a child with cancer. On her own blog, she tells stories of her family’s day-to-day with style, grace, and compassion.
Today, as we celebrate Mother’s Day, and especially the Moms who have the added complexity of pediatric cancer, we’ve decided to let her tell a Mother’s Day story on the St. Baldrick’s blog.
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