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Gonadal and Sexual Dysfunction in Childhood Cancer Survivors

  • Yoon, Ju Young (Center for Pediatric Cancer, National Cancer Center) ;
  • Park, Hyeon Jin (Center for Pediatric Cancer, National Cancer Center) ;
  • Ju, Hee Young (Center for Pediatric Cancer, National Cancer Center) ;
  • Yoon, Jong Hyung (Center for Pediatric Cancer, National Cancer Center) ;
  • Chung, Jin Soo (Center for Prostate Cancer, National Cancer Center) ;
  • Hwang, Sang Hyun (Department of Laboratory Medicine, National Cancer Center) ;
  • Lee, Dong Ock (Center for Uterine Cancer, National Cancer Center) ;
  • Shim, Hye Young (Division of Cancer Management Policy, National Cancer Center) ;
  • Park, Byung-Kiu (Center for Pediatric Cancer, National Cancer Center)
  • Received : 2016.05.10
  • Accepted : 2017.01.11
  • Published : 2017.10.15

Abstract

Purpose Few studies have addressed gonadal and sexual dysfunctions in childhood cancer survivors. We evaluated the prevalence rates and risk factors for gonadal failure among adolescent/young adult childhood cancer survivors and their sexual function. Materials and Methods Subjects were childhood cancer survivors aged 15-29 years who had completed therapy more than 2 years ago. Demographic and medical characteristics were obtained from the patients' medical records. In addition, hormonal evaluation and semen analysis were performed and sexual function was evaluated via questionnaire. Results The study included 105 survivors (57 males, 48 females), of which 61 were adults (age > 19 years) and 44 were adolescents. In both males and females, the proportion of survivors with low sex hormone levels did not differ among age groups or follow-up period. Thirteen female subjects (27.1%) needed sex hormone replacement, while five males subjects (8.8%) were suspected of having hypogonadism, but none were receiving sex hormone replacement. Of 27 semen samples, 14 showed azospermia or oligospermia. The proportion of normospermia was lower in the high cyclophosphamide equivalent dose (CED) group (CED ${\geq}8,000mg/m^2$) than the low CED group (27.3% vs. 62.5%, p=0.047). Among adults, none were married and only 10 men (35.7%) and eight women (34.3%) were in a romantic relationship. Though a significant proportion (12.0% of males and 5.3% of females) of adolescent survivors had experienced sexual activity, 13.6% had not experienced sex education. Conclusion The childhood cancer survivors in this study showed a high prevalence of gonadal/sexual dysfunction; accordingly, proper strategies are needed to manage these complications.

Acknowledgement

Supported by : National Cancer Center