Dear OncoLink "Ask The Experts,"
concern is about the likelihood of my getting pregnant while he's on chemo. We are certainly not planning on it, and I have been on the [oral contraceptive] pill for 10 years, but what are the chances we would have an accident? And what kind of birth defects are expected? The drug guides don't really get that specific. Thank you!
Vicki Sherry, MSN, CRNP, Advanced Practice Oncology Nurse, responds:
The risk is theoretical, that is, there is no real data on chemotherapy's effect on male sperm or female eggs. Any chemotherapycan lead to birth defects. It is strongly recommended NOT to have children while your husband is taking chemotherapy. Chemotherapy works by damaging DNA and cell development. Using two forms of birth control, such as the pill and a barrier method (condoms), may increase the success rate of preventing an "accident".
There has been research on chemo's effects on fetuses. Here is a quote from a recent article:
The majority of the information on the effects of in utero exposure to chemotherapy has been derived from retrospective case reports and series. Overviews of the available data have concluded that the timing of chemotherapy exposure (first trimester versus second and third trimesters) as well as the chemotherapeutic agent or agents used affect the risk of spontaneous abortion and miscarriage as well as that of congenital abnormalities. Although there are data from a prospective series of 24 pregnant breast cancer patients treated at the University of Texas M.D. Anderson Cancer Center, there are limited case series in women with hematologic malignancies, with the largest series having 89 pregnancies, that indicate that the fetuses exposed to chemotherapy in utero in the second and third trimesters can be carried to term, be born without evidence of congenital abnormalities, and develop normally. Clearly, ongoing prospective collection of data on the children born to women undergoing therapy for cancer is necessary.
Children exposed to chemotherapy in utero. Journal of the National Cancer Institute. Monographs. (34):69-71, 2005.
Dec 14, 2011 - For survivors of childhood cancer treated with chemotherapy or gonadal radiation, there is no increased risk of congenital anomalies in their offspring, according to a study published online Dec. 12 in the Journal of Clinical Oncology.
Aug 17, 2012 - For women diagnosed with early breast cancer during pregnancy, chemotherapy seems acceptable for both mother and infant, with most adverse effects relating to premature birth, according to a study published online Aug. 16 in The Lancet Oncology.
Mar 11, 2014 - The risk of colorectal cancer in first-degree relatives of colorectal cancer patients increases if the tumors are defective in repairing their DNA and if patients developed disease early, but most of the excess risk cannot be accounted for by defects in known genes, according to research published online March 23 in the Journal of Clinical Oncology.
Dec 20, 2011 - For female survivors of Hodgkin's lymphoma, treatment with nonalkylating chemotherapy carries little risk of premature ovarian failure (POF) for those younger than 32 years, whereas alkylating chemotherapy carries a substantially increased risk of POF, according to a study published online Dec. 19 in the Journal of Clinical Oncology.
Dec 28, 2011 - High bodily levels of the trace elements nickel and selenium may lower the risk of developing the most common type of pancreatic cancer, while high levels of lead, arsenic, and cadmium could increase the likelihood of developing the disease, according to a study published online Dec. 19 in Gut.
Oct 29, 2010 - While standard models and epidemiological data have suggested that radiation-related cancer risks are higher in children and decrease with increasing age at exposure, mathematical models do not support this for all cancer types, according to research published online Oct. 25 in the Journal of the National Cancer Institute.
Jul 19, 2012 - For women who give birth to large birth weight infants, there is an increased risk of breast cancer, even after adjustment for the mother's birth weight and traditional breast cancer risk factors, according to a study published online July 17 in PLoS One.
Feb 3, 2012 - Administration of synthetic ghrelin during chemotherapy improves food intake and appetite in patients with esophageal cancer, while minimizing gastrointestinal disorders, according to a study published online Jan. 26 in Cancer.
May 13, 2010 - While patients consider the risk of error in chemotherapy to be low, they perceive the potential harm to be substantial, and most agree patients can help prevent errors, according to research published online May 10 in the Journal of Clinical Oncology.
Mar 11, 2014 - The use of erythropoiesis-stimulating agents to reduce anemia risk has rapidly increased since their approval to nearly half of advanced cancer patients undergoing chemotherapy, but they are associated with a higher risk of deep vein thrombosis and pulmonary embolism while having no effect on the rate of blood transfusion, according to a study published online Nov. 10 in the Journal of the National Cancer Institute.
Sep 20, 2012 - Drugs that normally target cancer cells defective in DNA homologous recombination repair, poly(ADP-Ribose) polymerase inhibitors, are also effective on breast cancer cells positive for human epidermal growth factor receptor 2, even in the absence of the repair defect, according to a study published in the Sept. 15 issue of Cancer Research.
Feb 19, 2013 - Since the 1970s, the risk of developing therapy-related acute myeloid leukemia after chemotherapy has varied over time, depending on the initial cancer type and treatment practices, according to a study published online Feb. 14 in Blood.