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Gynecologic Issues in Adolescents with Cancer

Obstet Gynecol; ePub 2018 Aug; ACOG, et al

Among females aged <20 years, the diagnosis of cancer and its treatment may have immediate or delayed adverse effects on reproductive health, and gynecologists should be aware of the increased risk of adverse reproductive health effects from each type of therapy. This according to a new committee opinion from the American College of Obstetricians and Gynecologists (ACOG) that examined gynecologic issues in children and adolescent cancer patients and survivors. Among the recommendations and conclusions:

  • Cancer and its treatment may have immediate or delayed adverse effects on reproductive health.
  • Gynecologists may be consulted for the following issues: pubertal concerns; menstrual irregularities; heavy menstrual bleeding and anemia; sexuality; contraception; ovarian function, including fertility preservation; breast and cervical cancer screening; hormone therapy; and graft-versus-host disease.
  • In addition to pretreatment fertility conservation counseling, sexually active young women should be thoroughly educated about the risks of becoming pregnant during cancer treatment and strongly encouraged to use effective contraception.
  • The science of fertility preservation is a rapidly evolving field; therefore, a referral to a health care provider with experience in oncofertility is recommended to explore the full range of available options.
  • Childhood cancer survivors who maintain fertility should be counseled about the health risks to offspring in addition to potential pregnancy-related complications.
  • Approximately 75% of pediatric cancer survivors experience at least 1 late effect on their health or quality of life.
  • A multidisciplinary approach to cancer survival care is encouraged.

Citation:

Gynecologic issues in children and adolescent cancer patients and survivors. ACOG Committee Opinion No. 747. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2018;132:e67–77.