Blogs

More than two years ago, Kara DeFrias began a blog about her journey to conceive a child. Over two years, this journey was unsuccessful. In the attempt to determine the cause of her infertility, doctors discovered that Kara had uterine cancer in February of 2010, at age 34. The cancer was still relatively immature so while Kara had to undergo a hysterectomy to remove her uterus, she did not need chemotherapy or radiation. Soon after the surgery, Kara began working with Oncofertility Consortium members at the University of California, San Diego to undergo embryo banking. Since her uterus was removed, Kara and her husband have begun to look into getting a surrogate for their child and it is looking promising. Kara’s chronicles are an inspiration to other fertility preservation patients. Read them here.

Radiation therapy is a tried-and-true method for treating cancers. However, this treatment also causes tissue damage and DNA mutations to the patient. Damage to the sexual organs or DNA mutations within male sperm or female eggs may cause pregnancies to result in miscarriages, stillbirths, or neonatal death just after birth. The effects of radiation on the offspring of cancer survivors are not well studied. A recent study of patients from the Childhood Cancer Survivor Study shows that radiation to most parts of the body do not cause an increase in stillbirths or neonatal death. However, radiation to the ovaries and uterus does increase this risk.

In the paper titled “Stillbirth and neonatal death in relation to radiation

exposure before conception: a retrospective cohort study,” stillbirth or neonatal deaths occurred in 2% of pregnancies from cancer patients not treated with radiation therapy. Those with low doses of radiation to the uterus and ovaries also reported few cases of these fetal deaths (1-4% of pregnancies). However, 18% of cancer patients who received high levels of total radiation exposure reported pregnancies that resulted in stillbirth or neonatal death.

The cancer survivors in the paper that were at high risk for fetal loss were exposed to radiation levels equal or greater to 10 Gy (call gray), the unit of measurement for absorbed radiation. To give you an idea of that level of radiation, if a person was exposed to 10 Gy at one time, they would die within one month. But spread over the weeks and months of cancer treatment, this technique actually saves lives.

Interestingly, of the women treated with uterine or ovarian radiation prior to their first menstrual period, lower levels have greater effects on future pregnancies. In younger women, radiation treatment as low as 2.5 Gy can cause a 13% risk of later stillbirth or neonatal death.

In contrast to radiation, chemotherapy with the alkylating agents that most frequently cause ovarian failure did not increase the likelihood that pregnancies would result in stillbirth or neonatal death.

The study made me wonder if women treated with ovarian radiation therapy could use ovarian tissue cryopreservation. This could provide fertility preservation for women with a variety of pelvic cancers. However, the authors in the article suspect that the increase in stillbirth and neonatal death in these cancer survivors may be due to tissue damage of the uterus. Because the uterus and ovaries are so close, they could not determine if one organ or both are causing fetal death. Further research will be needed to determine the cause of increased stillbirths and neonatal death in these cancer survivors and to determine if ovarian tissue cryopreservation can preserve their fertility.

On July 21, Reps. Jan Schakowsky (IL), Ed Markey (MA) and Tammy Baldwin (WI) introduced legislation (HR.5786) that would toughen safety standards for cosmetics and give the U. S. Food and Drug Administration (FDA) the authority to check personal care products for harmful ingredients.  Current law allows the FDA to defer decisions about ingredient safety to the cosmetic industry.  In other words, the cosmetic industry is regulating itself.  According to the Campaign for Safe cosmetics,  provisions in the legislation will:

• Phase out ingredients linked to cancer, birth defects and developmental harm;
• Create a health-based safety standard that includes protections for vulnerable populations, like children;
• Close labeling loopholes by requiring full ingredient disclosure on product labels, web sites;
• Give workers access to information about unsafe chemicals in personal care products;
• Require data-sharing to avoid duplicative testing;
• Provide funding to the FDA so it has the resources it needs to provided effective oversight; and
• Level the playing field so small businesses can compete fairly.

To review the entire text of the bill, click here.

I just received a FDA email about the safety of color additives in food.   What caught my eye was the subheading:  “Without color additives, colas wouldn’t be brown, margarine wouldn’t be yellow and mint ice cream wouldn’t be green.”   I  wonder if colorless food could help reduce the obesity epidemic!!!   Seriously, to read the article, click here.