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Oncofertility Medical Practice pp 15–23Cite as

Gonadotoxicity of Cancer Therapies in Pediatric and Reproductive-Age Males

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Abstract

The male reproductive tract is highly susceptible to the toxic effects of chemotherapy and radiation therapy, which may damage the testes directly as well as disrupt the endocrine axis by altering Leydig cell function. Approximately 1 in every 5,000 young males is at risk for infertility due to their cancer treatment. Both prepubertal and pubertal testes are vulnerable to cytotoxic agents used in cancer therapy, and the alkylating agents often used to treat pediatric cancers are highly gonadotoxic. Alkylating agents that are known to cause infertility include busulfan, cisplatin, cyclophosphamide, ifosfamide, and procarbazine. With regard to radiation therapy, even very low doses—either due to scatter or from direct irradiation—can cause significant impairment of testicular function. Assessment of the effects of chemotherapy or radiation therapy on testicular maturation and function in male cancer patients is an important part of care and involves pubertal staging, plasma hormone analysis, and semen analysis. It is essential for oncologists to consider the potential impacts of cancer treatment on fertility and provide their patients options to preserve fertility, prior to initiating chemotherapy or radiation therapy.

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Acknowledgments

This work was supported by the Oncofertility Consortium NIH/NICHD 5UL1DE019587.

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Authors and Affiliations

  1. Cancer Survivorship Program, Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Colket Translational Research Building, 3501 Civic Center Boulevard, Room 10307, Philadelphia, PA, 19104, USA

    Jill P. Ginsberg M.D.

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  1. Jill P. Ginsberg M.D.
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Correspondence to Jill P. Ginsberg M.D. .

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Editors and Affiliations

  1. Perelman School of Medicine, Obstetrics and Gynecology, University of Pennsylvania, Market St 3701, Philadelphia, 19104, Pennsylvania, USA

    Clarisa Gracia

  2. Northwestern University, Obstetrics and Gynecology, Feinberg School of Medicine, E Superior St 303, Chicago, 60611-3015, Illinois, USA

    Teresa K Woodruff

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Ginsberg, J.P. (2012). Gonadotoxicity of Cancer Therapies in Pediatric and Reproductive-Age Males. In: Gracia, C., Woodruff, T. (eds) Oncofertility Medical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9425-7_2

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  • DOI: https://doi.org/10.1007/978-1-4419-9425-7_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-9424-0

  • Online ISBN: 978-1-4419-9425-7

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