With over 75 percent of children diagnosed with cancer surviving into adulthood, more and more parents ask questions about the quality of life survivors can expect in the future, including: Will my child be able to have children down the road?
They’re right to be concerned. The therapies that are so effective at saving children’s lives can themselves cause a host of problems that don’t manifest until years later. These late effects of cancer treatment include particularly harsh impacts on fertility.
“Cancer treatment impairs ovarian function by reducing the number of eggs in them,” says Elizabeth Ginsburg, MD, a fertility specialist at Brigham and Women’s Hospital who collaborates with Lisa Diller, MD, the chief medical officer of Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “It’s as though it pushes the ovaries further down the age curve. So while a woman who has survived childhood cancer may be 20 years old, her ovaries act like they’re 35 or 40.”
Boys are not exempt from these concerns. “Boys are at the same relative risk for infertility due to treatment,” says Richard Yu, MD, PhD, who works on male infertility in the Boston Children’s Department of Urology. “The same chemotherapy and radiation treatments that affect the ovaries can also wipe out the sperm stem cells in the testes.” …Read More
Robotic assisted laparoscopic partial nephrectomy can be safely and effectively performed in pediatric patients for renal tumors while preserving renal function. Classically, cases such as the two described below have been managed with an open, invasive approach or by radical nephrectomy. These two cases, cared for in collaboration with specialists from Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, demonstrate the effectiveness of renal preservation using robotic assisted laparoscopic surgery applied for renal masses in two different pediatric patients. …Read More
Survivors of pediatric cancer can face many increased risks — second cancers, heart disease, fertility loss, etc. — depending on the kind of cancer they were treated for and the treatments that were used.
“I think this paper raises this issue as one for awareness in the clinical setting and for future study,” said Lynda Vrooman, MD, a pediatric oncologist and cancer survivorship specialist with the Hematologic Malignancy Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “There are not, that I am familiar with, currently guidelines that inform recommendations for screening for autoimmune disorder in survivors or current clear strategies for reducing risk. This paper raises this as an issue for awareness moving forward and for further investigation.”
Akiko Shimamura, MD, PhD, first became fascinated with hematology as a pediatric resident at Johns Hopkins Hospital, an interest that blossomed into a career dedicated to the study and treatment of bone marrow failure (BMF) syndromes, first at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and then at Seattle Children’s Hospital/Fred Hutchinson Cancer Research Center. Last fall, she moved back to Boston to take the helm of the Bone Marrow Failure (BMF) Program at Dana-Farber/Boston Children’s, bringing with her a perspective on pediatric BMF/myelodysplastic syndrome (MDS) that centers on collaboration as a path to deeper understanding of BMF/MDS biology and an approach to patient care.
Notes invited Shimamura to talk about her thoughts on the current and future state of BMF/MDS research and management. Below is a summary transcript of what she had to say. …Read More