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Cancer Treatment in Girls Leads to High-Risk Pregnancy

ABC News reported on a study recently published by The Lancet that suggests women who receive “irradiation of the uterus and ovaries at a high dose” before puberty have a greater risk of suffering miscarriage or stillbirth.

Lead author of the study, Lisa Signorello of the International Epidemiology Institute, wrote that the increased risk is “probably related to uterine damage” caused by radiation.  “Careful management is warranted for pregnant women treated with high doses of pelvic irradiation before they have reached puberty,” she says.  Despite the elevated chance of losing a pregnancy, female cancer survivors shouldn’t be too pessimistic.  Of the participants studied, only three percent of women reported stillbirth or neonatal death.

Two percent of the male survivors studied reported losing pregnancies, but researchers insist “there was no increased risk of an adverse outcome among the offspring of men who had their testes irradiated after a childhood cancer diagnosis.”

SD blogger Paula recently wrote about Violet Lee, a 2-year-old undergoing chemotherapy against a life-threatening immune disease.  Violet’s mother made the choice to have one of her ovaries removed and frozen in the hopes of having it implanted later, keeping Violet’s fertility intact.  As Paula pointed out, doctors don’t know whether or not this procedure will work, and based on this Lancet article, it may be that reproductive troubles for female cancer survivors are based in the uterus, not the ovaries.  

“We could not directly assess whether uterine damage (e.g., to the musculature, vasculature, or endometrium) or oocyte damage was the cause of the association with stillbirth or neonatal death, although we believe a uterine effect was most likely,” Signorello wrote.

Photo: American Childhood Cancer Organization

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