Quimioterapia en bebés y futura infertilidad

odisea Dom 15 Dic 2013, 00:56

Hola chicas,
A raíz de una pregunta sobre los efectos de las radiografías en bebés doy rienda suelta a una pregunta que me surgió en su momento y que nunca he formulado porque... ¿para qué?

Bien es sabido por estos lares que a Simone se le sometió a dosis de quimio para matar aquel "bicho" impronunciable (no sé, me lo imagino como bicho y así lo visualizo). Una nunca se tiene que preguntar por los efectos secundarios de toda la metralla puesta en el cuerpo de un bebé porque cuando "es lo que hay" para que preocuparse de más, ¿no?

En su momento, y a sabiendas de que la quimio puede producir infertilidad, se me ocurrió si esto podría tener consecuencias futuras para Simone. Nunca pregunté porque en ese momento la respuesta era irrelevante. Aunque la respuesta hubiera sido un claro "sí", ¿qué mas daba? Pero siempre me quedé con la duda. Por un lado, imagino que la falta de desarrollo sexual del bebé hace que le ponga a salvo de ese posible efecto secundario. Aunque, claro, los óvulos ya estarán empezando a desarrollarse en el cuerpo incluso en el propio embrión, ¿no? Por otro lado, dudo de que existan incluso muchos estudios sobre este tema.

¿Alguien ha oído hablar sobre esto alguna vez? En búsquedas así superficiales en la red, todo se refiere a adultos. Supongo que algún día le preguntaré a algún médico. La verdad es que nunca lo he hecho y, no por vergüenza, sino porque es un tema del que nunca me acuerdo.

Besos y gracias!

odisea Dom 15 Dic 2013, 00:56

Este post simplemente para cambiar un poco el título del post.

Besos!

**Atenea** Dom 15 Dic 2013, 08:49

Odisea,

yo creo que es importante que hables de ello con los médicos que trataron a la peque porque sólo ellos conocen todos los detalles: duración del tratamiento, fármacos empleados, etc. De todas maneras, por si te sirve, he encontrado esto:

http://www.cancer.org/treatment/childrenandcancer/whenyourchildhascancer/children-diagnosed-with-cancer-late-effects-of-cancer-treatment

Sexual development and fertility

Females

In females, organs important for sexual development and pregnancy include the ovaries and the uterus (womb). The ovaries, which are in the lower abdomen, make female hormones (such as estrogen and progesterone). These hormones influence sexual development (including menstrual periods and fertility) and play a major role in keeping the heart, bones, and other parts of the body healthy. The ovaries also contain eggs, which are needed to have children. The uterus serves as a place for babies to grow during pregnancy. Either of these organs can be affected by cancer treatments.

The ovaries can be affected by both chemotherapy and radiation therapy. It's important for parents to discuss the possible long-term effects with your child's health care team before treatment. The degree of problems mostly depends on the intensity of treatment and the girl's age and stage of puberty when they were treated. Girls who have not yet been through puberty are less affected.

Radiation treatment to the abdomen or pelvis can directly damage the ovaries, so protecting the ovaries is a major concern when treating the nearby areas with radiation. Radiation to the head can also affect the pituitary gland, which in turn can interfere with the hormones needed for the ovaries to work as they should.

High doses of certain chemo drugs can damage the ovaries. In girls who are already menstruating, this can make menstrual periods irregular or stop, which may be temporary or more long lasting. Other chemo drugs (or lower doses of chemo) may not cause problems.

Girls who get treatments that affect the ovaries are at risk for early or delayed puberty and start of menstruation, irregular menstrual periods, early menopause, and reduced fertility, as well as other health problems. Doctors may recommend hormone replacement therapy to help with some of these issues if they remain after cancer treatment.

The uterus can be affected, too, especially if radiation is given to the abdomen. Late effects can include a uterus that is smaller than normal or which may not stretch during pregnancy as it should. This can increase the risk of miscarriage, low birth-weight babies, and premature birth.

Reproduction

Many survivors of childhood cancer may be concerned about their ability to have a child. Most childhood cancer survivors can go on to have healthy children, though there may be some risks.

Some men who were treated for cancer as children may have decreased fertility due to low sperm counts. In women, problems that could affect fertility include irregular menstrual periods, early menopause, changes in the uterus, and other treatment-related issues that could affect pregnancy outcomes. The causes of some of these problems are discussed above. Problems can vary greatly from patient to patient, and careful monitoring for any problems both during and after treatment is important.

For some who are treated for cancer as children, there may be ways to help preserve fertility or increase the chances of having their own children later in life. As mentioned above, sperm banking before treatment may be an option for some older boys. Some women who want to have children may be encouraged to try and get pregnant early in their childbearing years to improve the chances of success. Researchers are also studying newer ways of preserving or restoring fertility in people treated for childhood cancers. For more information about some of these approaches, see our document, Fertility and Women With Cancer or Fertility and Men With Cancer.

Most studies have not found an increased risk of congenital (inborn) health problems in the children of cancer survivors. But this is an area of active study, as some of the treatments given today may use different drugs or doses not yet proven safe to future offspring.

Un fuerte abrazo.

Bird Dom 15 Dic 2013, 09:43

Preguntaré.

Besos:

Isabel

odisea Dom 15 Dic 2013, 23:59

Gracias chicas,
Me parece que me voy a animar a enviarle un email a la Dra. Astigarraga (la que luchó contra el monstruo, si recordais). Porque ella sabrá exactamente los riesgos debido a la cantidad de medicación suministrada, como me dice Atenea. La quimio a Simone no se le "radió" en ninguna zona, sino que fue metida vía parenteral a través de su "brobiac" o como se diga (es decir, el acceso a una vía central). Yo no entiendo nada de quimio (ni quiero entender) pero creo que es una forma muy común de introducir la medicación: a través de vía central abierta...

No obstante estaré atenta a la respuesta de Isabel a través de su "espía" (mil gracias a las dos).

Besos!

Invitado Lun 16 Dic 2013, 13:33

No tengo no la menor idea... pero espero las respuestas porque me parece muy interesante.

Un beso muy fuerte

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