Childhood Cancer Survivors More Likely to Have Preemies

(HealthDay News) -- New research delivers mixed news for women who survive cancer as children: The odds are good that they will bear normal babies, but they still face a higher risk of premature birth.
Women who underwent high-dose radiation therapy to their uterus seem to be the most likely to have problems. The authors of the study, published in the Oct. 18 issue of the Journal of the National Cancer Institute, found that half of babies born to a sampling of these women were premature, compared to roughly 20 percent among their sisters.
"The findings were significant, and they should become part of the arsenal of information that both patients and physicians consult to guide the appropriate long-term care of cancer survivors," said study author Lisa Signorello, an assistant professor of medicine at Vanderbilt University.
In recent decades, improvements in treatment have allowed most childhood cancer patients to survive into adulthood and consider having kids of their own. As a result, "doctors and researchers have started to turn their attention to the long-term effects of cancer treatments," Signorello said. "That is, once a patient makes it through the actual treatment, what can they expect in terms of long-term health for themselves and even for their future children?"
Some treatments can make children infertile for life, but researchers don't know much about potential risks for women who can become pregnant, she said.
Enter the new study. A team of American and Italian researchers studied a database of 2,201 children who were born to 1,265 female survivors of childhood cancer between 1968 and 2002. They compared them to 1,175 children of 601 sisters of those with cancer.
About 21 percent of the babies of all cancer survivors were born prematurely, compared to 13 percent of the other babies.
In addition to having a much higher risk of premature birth, the cancer survivors who had undergone high-dose radiation to the uterus were more likely to have babies with low birth weight (36 percent vs. 8 percent).
The babies of these women were also more likely to be smaller than they should be, based on how long they'd been in the womb.
"Radiation damages not only cancer cells but also the body's normal cells and tissues," Signorello said. "It's likely that radiation causes long-term damage to the structure of the uterus, to the musculature, and even the vascular tissues that supply blood to the uterus. On the positive side, we found that the radiation dose to the uterus needed to be quite high to result in these problems."
It's not clear how the babies fared after birth, although researchers plan to study the health of the children. Still, Signorello said, premature birth or being born too small can lead to lasting health problems.
What should survivors of childhood cancer do? The research "doesn't mean that they shouldn't get pregnant or have children. It just means they should have advice along the way," said Leslie Schover, a professor of behavioral science at the University of Texas M.D. Anderson Cancer in Houston, who wrote a commentary accompanying the study.
"A chief take-home message is that each individual situation is pretty complex, and you really should talk to your oncologist about your cancer treatment and what kinds of risks you would or wouldn't have in getting pregnant or having children after your cancer," added Schover, who studies reproductive and mental health among cancer survivors.

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