Guidelines can predict early menopause in child cancer survivors

Girls with cancer who are most likely to become infertile after treatment can be identified using guidelines developed almost 20 years ago, new research shows.

The criteria – developed in Edinburgh – will help to select which girls should be offered the opportunity to freeze some tissue from their ovaries for use in the future.

Doctors are optimistic that the frozen tissue could one day help young cancer survivors to have children of their own.

Some cancer treatments can affect by bringing on . Freezing samples of ovary tissue before patients start treatment is the only option to try to preserve their fertility.

At least 30 babies have been born from frozen taken from adult women but the procedure remains unproven in girls and .

Taking the initial samples of ovaries to be frozen involves a surgical technique and is still relatively experimental. It is therefore crucial that doctors can accurately predict which patients are most likely to benefit and when it can be safely performed.

Guidelines were developed almost 20 years ago to select which girls should be offered the procedure, based on their age, type of and their chances of being cured of their cancer. Now that the girls are older, doctors are able to validate their predictions.

Researchers – led by the University of Edinburgh – validated the criteria by looking back at more than 400 with cancer who were under 18 years of age when diagnosed. They found that the criteria accurately predicted all but one of the patients who entered early menopause.

The study, funded by the Medical Research Council, is published today in the journal Lancet Oncology.

The lead researcher is Professor Hamish Wallace of the University of Edinburgh's Department of Child Life and Health and Consultant Paediatric Oncologist at the Royal Hospital for Sick Children (RHSC), where the research was carried out. He said: "Advances in lifesaving treatments mean that more and more young people with cancer are surviving the disease. Here we have an opportunity to help young women to have families of their own when they grow up, if they so choose."

More information: W.H.B.Wallace et al. Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation. The Lancet Oncology, 15 August 2014 www.thelancet.com/journals/lan… (14)70378-X/fulltext

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