Long term follow up
As cancer survival rates improve, there is an increasing number of cancer survivors of reproductive age. Cancer and cancer treatment can have a wide range of impacts on a young person’s reproductive, endocrine, sexual, psychological and/or emotional health. The nature and severity of these effects depends on many factors including the cancer type, age at diagnosis, treatment modality, dose and duration, complications and patient specific risk factors.
All AYA cancer survivors should have access to regular monitoring and assessment of reproductive, endocrine and sexual health in order to:
- identify physical and psychosocial concerns
- implement appropriate interventions and
- provide information and support as their needs change.
Females who have had cancer treatment should be counseled that they may have a shortened reproductive life span. Pregnancy following cancer should generally be managed by a multidisciplinary team as a ‘high risk’ pregnancy.
Survivors who are infertile should be provided with information about assisted reproduction and other options for parenting such as sperm/egg/embryo donation, surrogacy and adoption, and offered infertility counselling.
Reduced fertility or loss of fertility due to cancer treatment may lead to emotional distress. Early referral for counseling is recommended.
- Partridge AH, Gelber S, Peppercorn J, Sampson E, Knudsen K, Laufer M, et al. Web-based survey of fertility issues in young women with breast cancer. J Clin Oncol 2004 Oct 15;22(20):4174-83 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/15483028.