Abstract
Although it is well recognized that certain cancer treatments result in infertility, the impact of this condition specific to psychological, developmental, and behavioral outcomes among survivors of childhood cancer remains largely understudied. This book chapter provides a brief review of the cancer treatments most threatening to fertility, while aiming to summarize the literature regarding reproductive decision-making (including fertility preservation and procreation) in the pediatric and adolescent oncofertility context, along with the research on infertility-related psychological distress among survivors and their families. In terms of development, the impact that cancer and its treatment may have on a survivor’s identify as a romantic partner and/or parent is considered, while the relationship between perceptions of physical attractiveness and its impact on psychosexual development is presented. Behaviorally speaking, the relationship between cancer treatment in childhood and later sexual functioning in adulthood is reported for both males and females, and its implications for overall quality of life are discussed. Recommendations for clinicians are provided.
I am now sterile because of the chemo, radiation, and the bone marrow transplant. I found out several months ago definitively that I am sterile. There was some question because often all of the cancer drugs will put a woman into temporary menopause that reverses once she is off of the meds. Since I was 18 when I was diagnosed, I never had a chance to have a child, and now I never will. That is very upsetting to me. And, yes, I realize that there are other options like adoption or in vitro, but cancer has robbed me of the chance to have a child of my own. That is probably the hardest thing I have had to deal with as a result of my cancer. I get sick more often than other people, and I stay sick longer, and I have less energy all around, but being sterile is the hardest thing to accept. I still often feel broken and stolen from because of the cancer. It took three years of my life, my fertility, and the opportunity to live a normal life. I think I do pretty well at life, but I think it’s harder for me than it is for normal people. I have had to go through a lot to get where I am, and I find that I don’t connect with people who haven’t had hardships very well. I look at a lot of people my age and just don’t understand how they can be the way they are and how they can be concerned with such trivial things.
- Shelly, Pediatric Cancer Survivor
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Klosky, J.L., Foster, R.H., Nobel, A.M. (2012). Pediatric Oncology and Reproductive Health. In: Quinn, G., Vadaparampil, S. (eds) Reproductive Health and Cancer in Adolescents and Young Adults. Advances in Experimental Medicine and Biology, vol 732. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2492-1_12
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