Female Reproductive Health After Childhood, Adolescent, and Young Adult Cancers: Guidelines for the Assessment and Management of Female Reproductive Complications

• Type of Material: Article
• Authors: Monika L. Metzger, St Jude Children's Research Hospital; Lillian R Meacham, Emory University; Briana Patterson, Emory University; Jacqueline S. Casillas, University of California Los Angeles; Louis S. Constine, University of Rochester; Nobuko Hijiya, Northwestern University; Lisa B. Kenney, Dana Farber Cancer Institute; Marcia Leonard, University of Michigan; Barbara A. Lockart, Ann and Robert H. Lurie Children’s Hospital of Chicago; Wendy Likes, University of Tennessee; Daniel M. Green, St Jude Children's Research Hospital
• Language: English
• Date: 2013-03-20
• Publisher: American Society of Clinical Oncology
• Publication Version: Final Published Version
• Copyright Statement: © 2013 by American Society of Clinical Oncology.
• Final Published Version (URL): http://dx.doi.org/10.1200/JCO.2012.43.5511
• Title of Journal or Parent Work: Journal of Clinical Oncology
• ISSN: 0732-183X
• Volume: 31
• Issue: 9
• Start Page: 1239
• End Page: 1247
• Keywords: Science & Technology; CRYOPRESERVED OVARIAN TISSUE; HODGKINS-DISEASE; VERSUS-HOST-DISEASE; REPLACEMENT THERAPY; ANTI-MULLERIAN HORMONE; FERTILITY PRESERVATION; Life Sciences & Biomedicine; Oncology; TERM-FOLLOW-UP; CENTRAL PRECOCIOUS PUBERTY; ACUTE LYMPHOBLASTIC-LEUKEMIA; BREAST-CANCER
• Research Categories: Health Sciences, Oncology; Health Sciences, Obstetrics and Gynecology

Abstract

Purpose: As more young female patients with cancer survive their primary disease, concerns about reproductive health related to primary therapy gain relevance. Cancer therapy can often affect reproductive organs, leading to impaired pubertal development, hormonal regulation, fertility, and sexual function, affecting quality of life. Methods: The Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer (COG-LTFU Guidelines) are evidence-based recommendations for screening and management of late effects of therapeutic exposures. The guidelines are updated every 2 years by a multidisciplinary panel based on current literature review and expert consensus. Results: This review summarizes the current task force recommendations for the assessment and management of female reproductive complications after treatment for childhood, adolescent, and young adult cancers. Experimental pretreatment as well as post-treatment fertility preservation strategies, including barriers and ethical considerations, which are not included in the COG-LTFU Guidelines, are also discussed. Conclusion: Ongoing research will continue to inform COG-LTFU Guideline recommendations for follow-up care of female survivors of childhood cancer to improve their health and quality of life.