Gonadal and Sexual Dysfunction in Childhood Cancer Survivors.
OBJECTIVE
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.


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 ≥ 8,000 mg/m2) 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.


CONCLUSIONS
The childhood cancer survivors in this study showed a high prevalence of gonadal/sexual dysfunction; accordingly, proper strategies are needed to manage these complications.
Center for Pediatric Cancer, National Cancer Center, Goyang, Korea.
Ju Young
JY
Yoon
Center for Pediatric Cancer, National Cancer Center, Goyang, Korea.
Hyeon Jin
HJ
Park
Center for Pediatric Cancer, National Cancer Center, Goyang, Korea.
Hee Young
HY
Ju
Center for Pediatric Cancer, National Cancer Center, Goyang, Korea.
Jong Hyung
JH
Yoon
Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
Jin Soo
JS
Chung
Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.
Sang Hyun
SH
Hwang
Center for Uterine Cancer, National Cancer Center, Goyang, Korea.
Dong Ock
DO
Lee
Division of Cancer Management Policy, National Cancer Center, Goyang, Korea.
Hye Young
HY
Shim
Center for Pediatric Cancer, National Cancer Center, Goyang, Korea.
Byung-Kiu
BK
Park
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000073116:Cancer Survivors; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D012739:Gonadal Steroid Hormones; D006066:Gonads / Q000378:metabolism / Q000503:physiopathology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D055101:Semen Analysis; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology* / Q000378:metabolism; D055815:Young Adult
D012739:Gonadal Steroid Hormones
Child; Gonads; Neoplasms; Sexual dysfunction; Survivors