Survival from cancer in young people: An overview of late effects focussing on reproductive health.

This paper provides a summary of the areas of survival from childhood, teenage and young adult cancer and the significant late-effects that can arise from treatment with particular focus on the area of reproductive health and the impact on both fertility and pregnancy. To complete this review, Web of Science and MEDLINE were used. Search terms included: "survival AND childhood OR teenage OR young adult cancer", "late effects", "childhood cancer", "teenage and/or young adult cancer", "and fertility after cancer", "pregnancy after cancer" and "fertility preservation". Additionally, clinical expertise from the authors was drawn upon. Childhood cancer is thankfully a rare occurrence; however, the incidence is increasing. Survival rates remain high and this means that a growing population of childhood and young adult cancer survivors is reaching adulthood. For some of these adults, whilst cured of their cancer they are now facing a future with lasting effects on their health from their treatments. These effects, commonly referred to as Late Effects are defined as health problems related either directly to the underlying cancer or to its treatment and which occur months or years after treatment has finished. Reproductive health is an important consideration for these patients, and whilst many will be able to conceive naturally, some will exhibit impaired fertility after their treatments. This can include difficulties at all points along the path from conception to delivery of a live, healthy offspring. High quality, large population evidence is sparse in many areas relating to fertility risk from treatment and into the maternal and fetal health of childhood cancer survivors. Yet given the potential for complications the authors advocate consideration of fertility at the time of diagnosis and prior to potentially gonadotoxic treatment. This article is protected by copyright. All rights reserved.