title: Gonadal function, fertility, and reproductive medicine in childhood and adolescent cancer patients: a national survey of Japanese pediatric endocrinologists.
abstract: An increasing number of pediatric cancer patients survive, and treatment-related infertility represents one of the most important issues for these patients. While official guidelines in Japan recommend long-term follow-up of childhood cancer survivors (CCSs), their gonadal function and fertility have not been clarified. To address this issue, we organized a working panel to compile evidence from long-term survivors who received treatments for cancer during childhood or adolescence. In collaboration with members of the CCS Committee of the Japanese Society for Pediatric Endocrinology (JSPE), we conducted a questionnaire survey regarding reproductive function in pediatric cancer patients. A cross-sectional survey was sent to 178 JSPE-certified councilors who were asked to self-evaluate the medical examinations they had performed. A total of 151 responses were obtained, revealing that 143 endocrinologists were involved in the care of CCSs. A quarter of the respondents reported having experienced issues during gonadal or reproductive examinations. Several survivors did not remember or fully understand the explanation regarding gonadal damage, and faced physical and psychological distress when discussing the risk of becoming infertile. Pediatric endocrinologists had anxieties regarding their patients' infertility and the risk of miscarriage, premature birth, and delivery problems. Only a limited number of endocrinologists had experience with managing childbirth and fertility preservation. Many councilors mentioned the necessity for inter-disciplinary communication among healthcare providers. Both endocrinologists and oncologists should set and follow a uniform clinical guideline that includes management of fertility of CCSs.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan; Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyoshi
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Department of Pediatric Endocrinology and Metabolism, Osaka City General Hospital, Osaka, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Yorifuji
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Horikawa
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Takahashi
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nagasaki
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Department of Pediatrics, Isehara Kyodo Hospital, Kanagawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ishiguro
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Department of Pediatrics, Tohoku University Hospital, Sendai, Japan.
authors.forename: Ikuma
authors.initials: I
authors.lastname: Fujiwara
authors.affiliation: Childhood Cancer Survivor Committee of the Japanese Society for Pediatric Endocrinology; Department of Pediatrics, Toranomon Hospital, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Ito
authors.affiliation: Department of Medical Statistics, Faculty of Medicine, Toho University, Tokyo, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Oba
authors.affiliation: Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: Department of Pediatric Hematology/Oncology, Osaka City General Hospital, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujisaki
authors.affiliation: Consultation, Counseling and Support Service Center, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Shimizu
authors.affiliation: Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Pediatric Hematology and Oncology Research, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Kimikazu
authors.initials: K
authors.lastname: Matsumoto
authors.affiliation: Center of Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sago
authors.affiliation: Center for Clinical Research and Development, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Takimoto
authors.affiliation: Department of Urology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Yokoya
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, Hamamatsu, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Ogata
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
keywords: adolescent; childhood cancer survivor; fertility; pediatric endocrinologist; questionnaire survey