TUESDAY, Feb. 8 (HealthDay News) -- Men who have had cancer are
at a slightly higher risk of bearing children with congenital
problems such as a cleft palate compared to their peers with no
history of cancer, according to new research.
But the overall risk was low, researchers from Sweden report in
the Feb. 8 online edition of the
Journal of the National Cancer Institute.
And the findings are also reassuring to male cancer survivors
who choose to conceive using assisted reproductive technologies
(ART), as they have no additional risk over their peers who
conceive naturally.
"The results of our study are reassuring in that men previously treated for cancer needing assisted reproduction to get children do not need to worry about [increasing] the risk of malformations in their children," said study co-author, Dr. Aleksander Giwercman, chairman of the Reproductive Medicine Centre and associate professor at Skane University Hospital, Lund University, Malmo, Sweden. "Furthermore, for this group of patients, in general, although the malformation risk in the offspring is indeed increased, this increase is only slight."
There has been concern that treatments such as chemotherapy and
radiation might damage sperm DNA, although the effect is usually
temporary.
As in this new study, previous research has found some -- but
not much -- increased risk of congenital abnormalities among
children of male cancer survivors. None of the earlier studies had
looked specifically at ART, which some men use because of
difficulties fertilizing an egg after their cancer. (ART includes
such procedures as in vitro fertilization, in which fertilization
of the egg and sperm occur outside the woman's body, and
intracytoplasmic sperm injection, in which a single sperm is
injected into the center of an egg to initiate fertilization.)
The study included 8,670 children who had been born in Sweden
(between 1994 and 2005) and Denmark (between 1994 and 2004) to men
who had a history of cancer. About 500 of these children were
conceived using ART.
In addition, the study authors looked at over 1.7 million
children who were born during the same time period to men with no
history of cancer, of which almost 26,000 were conceived using
ART.
Babies of male cancer survivors were 17 percent more likely to
have a "major" congenital abnormality compared to babies born to
healthy fathers, the investigators found.
However, the overall risk was very low: in absolute terms, it
was only 3.7 percent among children of cancer survivors, compared
to 3.2 percent for offspring of males without any history of
cancer, regardless of mode of conception.
The risk seemed to be highest among men who had had skin, eye
and central nervous system cancers, but there was no increased risk
with testicular cancer, the researchers noted.
Children conceived using ART also had a 20 percent increased
risk of major congenital abnormalities compared to children
conceived normally, although the method of conception didn't affect
the association between paternal history of cancer and birth defect
risk.
There was also a slightly higher risk among men who conceived
after the age of 18 and possibly for men who conceived within two
years after their cancer diagnosis, but these were not
"statistically significant," said Giwercman.
Though not proven yet, the authors indicated that the results
suggest that the malignancy itself, as opposed to the treatments,
is probably responsible for the abnormalities.
"We cannot say this for sure . . . however our preliminary results indicate that this is rather the cancer diagnosis per se and not the treatment by radio- and/or chemotherapy, which is the cause of slight increase in the malformation risk among the children," said Giwercman.
Besides the very low absolute risk of birth defects, the
findings also suggest that a paternal history of cancer may not
contribute to the "most adverse" defects, and that using ART may
not worsen the risk, the researchers added.
In an accompanying editorial, co-author Lisa Signorello of the
International Epidemiology Institute in Rockville, Md., noted that
although more study is needed, the findings "are overall quite
reassuring" for male cancer survivors.
More information
The Society for Assisted Reproductive Technology has more
on these
procedures.