Fertility and Reproductive Outcomes of Adolescent and Young Adult Cancer Survivors in Texas
Abstract
Adolescent and young adult (AYA, ages 15-39 years) cancer survivors fall into a "no man s land" in healthcare, caught between pediatric and adult cancer care. Compared to both children and older adults, AYAs have experienced no improvements in cancer survival for decades. They report many concerns about the long-term effects of cancer treatment, including potential threats to fertility and reproductive health. Because they received cancer treatment during childbearing years, AYA cancer survivors must make difficult decisions about parenthood. Cancer treatment can negatively affect reproductive organs and the ability to have children. More than half of AYA survivors want future children, but we know very little about fertility and reproductive health after a cancer diagnosis. Simple questions, such as "what are the chances of having children after cancer?" remain unanswered. My project will address these challenges by studying a large, diverse population of young men and women diagnosed with cancer over a 20-year period. As a cancer epidemiologist, I study patterns of new cancer cases and deaths to identify important risk factors. My long-term career goal is to become an expert and national leader in cancer research, with a focus on cancers diagnosed in younger adults. After joining the faculty at University of Texas Southwestern Medical Center in July 2016, I have used existing data to publish 20 papers on older adults with cancer (total of 40 publications). Several of my recent studies show that AYA cancer survivors are a unique population that researchers often ignore. This Career Development Award allows me to expand my research and develop new knowledge in adolescents and young adults with cancer. I have proposed three training goals and activities, including courses at the University of Texas School of Public Health and workshops at the Texas Department of State Health Services, which will give me experience needed to complete the project. I also put together a mentoring team of three senior scientists with expertise in AYA cancers, birth defects, and methods to link data sources. My mentoring team has successfully worked together in the past on studies of childhood cancer and birth defects. Results from my project will answer important questions about parenthood that young men and women must ask while also dealing with a new cancer diagnosis. These questions have never been answered in a large, diverse population of AYA cancer survivors, like those living in Texas (6,400 diagnoses each year). In addition, my project will provide much-needed information on whether the children of AYA survivors have higher risk of birth defects. This information is important because many AYAs describe a fear of birth defects as a reason for not having children. A negative result will lessen these fears. If I discover an increased risk of birth defects, healthcare systems and providers can use this information to educate AYAs about their fertility and reproductive health. I will work with nurses and providers to apply results to fertility preservation and counseling in the After Cancer Experience Program, which provides care to hundreds of AYAs in Dallas. My project is very relevant to the military and their beneficiaries – 90% are children, adolescents, or young adults. Like AYA cancer survivors, active duty military are a unique population and experience an unequal share of cancer. For example, rates of testicular and thyroid cancer and melanoma are higher among military compared the general U.S. population. Methods that I will use in this study can also be adapted to study fertility and reproductive health among active duty military.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 16, 2019
- Source ID
- W81XWH1910324
Entities
People
- Caitlin C Murphy
Organizations
- United States Army
- University of Texas Southwestern Medical Center