1: Reproductive Health and Cancer

Reproductive health involves:

  • Management of patients who are pregnant
  • Preservation of fertility in men and women

General Issues

Reproductive health involves both fertility and sexual function. Disorders of both can occur due to:

  • Local effects of malignancy on external/internal genitals (eg. mass effect, invasion of reproductive organs)
  • Hormonal effects of malignancy
    • Invasion/dysfunction of hypothalamic-pituitary-gonadal axis (eg. pituitary tumour, craniopharyngioma)
    • Ectopic production of hormones by tumour (eg. prolactinoma, sex-cord stromal tumours)
  • Treatment effects:
    • Surgical
      • Structural damage to internal/external genitals
      • Damage to nerves innervating these structures (eg. radical prostatectomy and parasympathetic nerves to penis)
      • Removal of hormone producing structures (pituitary, gonads)
    • Radiotherapy
      • Shares similar complications to surgery (local, neural, hormonal)
      • Added complication of soft tissue fibrosis (eg. vaginal stenosis)
    • Chemotherapy
      • Effects are typically on the gonads
      • Alkylating agents have the highest incidence of infertility in both men and women
      • Combination regimes containing alkylating agents have very high rates of infertility
      • Younger women resist chemotherapy agents due to a higher number of follicles

1: Management of Pregnant Patients

2: Fertility Issues in Men

3: Fertility Issues in Women