07/22/10 - Survivors of Childhood Cancers May Face Increased Risk of Stillbirth, Neonatal Death

The CNN (7/22) "The Chart" blog reported that "previous studies in the Journal of Clinical Oncology found that cancer treatment decreased fertility in female childhood cancer patients." Specifically, "these studies found that if those women were treated with pelvic radiation and chemotherapy they were at risk for acute ovarian failure, premature menopause, and low birth weight."

Now, a "new study of childhood cancer survivors provides information about the risks for stillbirth and neonatal death among the offspring of the survivors," Medscape (7/22, Mulcahy) reported. "For the male survivors, there is good news: radiation to the testes did not affect the risk for these 2 adverse outcomes in their offspring." For females, however, the "data are sobering: radiation to the uterus and ovaries 'greatly increased the risk of stillbirth and neonatal death.'"

Before reaching that conclusion, researchers at the International Epidemiology Institute looked at data on "1,148 men and 1,657 women who had survived at least five years after their diagnosis," MedPage Today (7/22, Neale) reported. Investigators eventually discovered that the "elevated risk of stillbirth or neonatal death" appeared to be "confined to those who received radiation treatment before menarche," according to the paper in The Lancet.

In fact, "high radiation doses (at least 2.50 Gy) were linked with a greater than 12-fold risk for women treated before menarche," Health Imaging (7/22) reported. "For women treated with 10 Gy or more, the risk was 22 percent, reported the authors. Treatment with alkylating drugs did not increase the risk of stillbirth or neonatal death among men or women."

According to lead researcher John Boice Jr., "high-dose radiation can damage blood flow to the uterus, which reduces its size," HealthDay (7/22, Reinberg) reported. "Whether this has an effect on or causes other problems associated with stillbirths isn't clear," he added. "On the positive side, cancer treatments have changed over time and radiation therapy tends to be more targeted, while chemotherapy is now the primary choice of treatment for leukemia." The UK's Press Association (7/22) also covered the story.