How will my child's fertility be affected by cancer and cancer treatment?

You may be wondering how your child’s illness and its treatment may affect his or her ability to have children in the future. The effects of cancer on a child’s body are very similar to those seen in adults. However, the effects can vary based on the type of cancer and the specific treatment for each type of cancer.

The types of cancer that are common in children are not usually the same as those in adults. The most common childhood cancers are leukemia, cancers of the nervous system, lymphomas, soft tissue sarcomas, kidney cancer, and bone cancer. Leukemia accounts for 31% of all cancer cases in children under the age of 15. In adult women, breast cancer, bone cancer, other sarcomas, and blood-born cancers (leukemia, lymphoma) make up the five most common kinds of cancers, while colorectal cancer, lung cancer, and cancers of the blood (leukemia and non-Hodgkin's lymphoma) are the most common kinds of cancers in men.

The effects of cancer treatment (chemotherapy and radiation) on the body are also very similar for children and adults, though you may be comforted by the fact that children tend to tolerate the side effects of cancer treatment much better than adults do.

Most of the chemotherapies used today affect all rapidly dividing cells, including those in the ovaries and testes. Prepubertal girls actually have an advantage over adolescent girls, young women, and adult women when it comes to the effect of cancer treatment on future fertility because the eggs in their ovaries are not actively growing. Boys, however, appear to be just as vulnerable as adult men to the damaging effects of radiation therapy and chemotherapy on testicular function and future sperm production.