Effect of Chemotherapy on Gonadal Function and Sexual Function of Male Cancer Survivors: A Review Article
Urology Journal,
Vol. 21 No. 06 (2024),
27 November 2024
,
Page 361-368
https://doi.org/10.22037/uj.v21i.8030
Abstract
Purpose: The advancement of anti-cancer treatment has increased survival rates among patients, yet putting them in an increased risk for developing side effects. In addition to early side effects, anti-cancer treatments, in particular chemotherapeutic medications can cause long-term side effects; fertility and sexual dysfunction included. The aim of this study was to review existing data on the effects of different chemotherapeutic agents on fertility and sexual function of male cancer survivors who received chemotherapy at different stages of life.
Methods: We searched PubMed/MEDLINE, Scopus, and Google Scholar to detect studies focused on the effect of chemotherapy on the gonadal/testicular function and sexual function of male cancer survivors. We restricted our search to English language publications and manuscript published before the year 2000 were excluded.
Results: It has been well understood that chemotherapy impairs gonadal function in a major number of cancer survivors and gonadal dysfunction is not protected if chemotherapeutic agents are administered before puberty in males. Moreover, the effect of chemotherapy on sexual function is controversial.
Conclusion: While several articles reported the worst effect of chemotherapy on the sexual function of cancer survivors, some studies reported that chemotherapy does not impair sexual function. Higher levels of chemotherapy dose seem to be associated with more gonadal and sexual dysfunction.
- male
- Sexual Dysfunction
- Chemotherapy
- Cancer
How to Cite
References
Sodeifian F, Mokhlesi A, Allameh F. Chemotherapy and Related Female Sexual Dysfunction: A Review of Literature. Int. J. Cancer. Manag. 2022;15.
DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, et al. Cancer treatment and survivorship statistics, 2014. CA: Cancer. J. Clin. 2014;64:252-71.
Desandes E, Lacour B, Clavel J. Les cancers des adolescents et des jeunes patients: Vision épidémiologique et organisations des soins en France. Bulletin du Cancer. 2016;103:957-65.
Benedict C, Shuk E, Ford JS. Fertility issues in adolescent and young adult cancer survivors. JAYAO. 2016;5:48-57.
Brougham MF, Wallace W. Subfertility in children and young people treated for solid and haematological malignancies. Br. J. Haematol. 2005;131:143-55.
Delessard M, Saulnier J, Rives A, Dumont L, Rondanino C, Rives N. Exposure to chemotherapy during childhood or adulthood and consequences on spermatogenesis and male fertility. Int. J. Mol. Sci. 2020;21:1454.
Shetty G, Meistrich ML. Hormonal approaches to preservation and restoration of male fertility after cancer treatment. JNCI Monographs. 2005;2005:36-9.
Ries L, Eisner M. EM, Kosary CL, Hankey BF, Miller BA, Clegg L, Mariotto A, Fay MP, Feuer EJ, Edwards BK. SEER CSR. 1975;2000:2003.
Jankowska M. Sexual functioning of testicular cancer survivors and their partners–A review of literature. RPOR. 2012;17:54-62.
Wasilewski-Masker K, Seidel K, Leisenring W, Mertens A, Shnorhavorian M, Ritenour C, et al. Male infertility in long-term survivors of pediatric cancer: a report from the childhood cancer survivor study. J. Cancer. Surviv. 2014;8:437-47.
Giwercman A, Petersen PM. Cancer and male infertility. Best. Pract. Res. Clin.s Endocrinol. Metab. 2000;14:453-71.
Meistrich ML. Critical components of testicular function and sensitivity to disruption. Biol. Reprod. 1986;34:17-28.
Hacker-Klom UB, Meistrich ML, Göhde W. Effect of doxorubicin and 4′-epi-doxorubicin on mouse spermatogenesis. Mutat Res. 1986;160:39-46.
Van Basten J, Hoekstra H, Van Driel M, Koops HS, Droste J, Jonker-Pool G, et al. Sexual dysfunction in nonseminoma testicular cancer patients is related to chemotherapy-induced angiopathy. J. Clin. Oncol. 1997;15:2442-8.
van Casteren NJ, van der Linden GH, Hakvoort‐Cammel FG, Hählen K, Dohle GR, van den Heuvel‐Eibrink MM. Effect of childhood cancer treatment on fertility markers in adult male long‐term survivors. Pediatr. Blood. Cancer. 2009;52:108-12.
Kenney LB, Laufer MR, Grant FD, Grier H, Diller L. High risk of infertility and long term gonadal damage in males treated with high dose cyclophosphamide for sarcoma during childhood. Cancer. 2001;91:613-21.
Isaksson S, Bogefors K, Ståhl O, Eberhard J, Giwercman Y, Leijonhufvud I, et al. High risk of hypogonadism in young male cancer survivors. Clin. Endocrinol. 2018;88:432-41.
Green DM, Liu W, Kutteh WH, Ke RW, Shelton KC, Sklar CA, et al. Cumulative alkylating agent exposure and semen parameters in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort Study. Lancet. Oncol. 2014;15:1215-23.
Chemes HE. Infancy is not a quiescent period of testicular development. Int. J. Androl. 2001;24:2-7.
Gerl A, Mühlbayer D, Hansmann G, Mraz W, Hiddemann W. The impact of chemotherapy on Leydig cell function in long term survivors of germ cell tumors. Cancer. 2001;91:1297-303.
Monti M, Rosti G, De Giorgi U, Cavallari G, Severini G, Giovanis P, et al. Sexual functions after high-dose chemotherapy in survivors of germ cell tumors. Bone. Marrow. Transplant. 2003;32:933-9.
Tasdemir C, Firdolas F, Harputluoglu H, Altintas R, Gunes A. Erectile dysfunction in testicular cancer patients treated with chemotherapy. Andrologia. 2012;44:226-9.
Eeltink CM, Lissenberg-Witte BI, Incrocci L, Braamse AM, Visser O, Zijlstra J, et al. Self-reported sexual function in sexually active male hodgkin lymphoma survivors. Sex. Med. 2020;8:428-35.
Behringer K, Müller H, Görgen H, Flechtner H, Brillant C, Halbsguth T, et al. Sexual quality of life in Hodgkin Lymphoma: a longitudinal analysis by the German Hodgkin Study Group. Br. J. Cancer. 2013;108:49-57.
Relander T, Cavallin‐Ståhl E, Garwicz S, Olsson AM, Willén M. Gonadal and sexual function in men treated for childhood cancer. Medical and Pediatric Oncology: The Official Journal of SIOP—. 2000;35:52-63.
Carpentier MY, Fortenberry JD. Romantic and sexual relationships, body image, and fertility in adolescent and young adult testicular cancer survivors: a review of the literature. J. of Adolesc. Health. 2010;47:115-25.
Rosenhan DL, Seligman ME. Abnormal psychology: WW Norton & Co; 1989.
Masters WH, Johnson VE. Human sexual response. 1966.
BÖHLEN D, BURKHARD FC, MILLS R, SONNTAG RW, STUDER UE. Fertility and sexual function following orchiectomy and 2 cycles of chemotherapy for stage I high risk nonseminomatous germ cell cancer. J. Urol. 2001;165:441-4.
Brignardello E, Felicetti F, Castiglione A, Nervo A, Biasin E, Ciccone G, et al. Gonadal status in long-term male survivors of childhood cancer. J. Cancer. Res. Clin. Oncol. 2016;142:1127-32.
Gritz ER, Wellisch DK, Wang HJ, Siau J, Landsverk JA, Cosgrove MD. Long‐term effects of testicular cancer on sexual functioning in married couples. Cancer. 1989;64:1560-7.
Pietilä S, Mäkipernaa A, Koivisto AM, Lenko HL. Growth impairment and gonadal axis abnormalities are common in survivors of paediatric brain tumours. Acta Paediatrica. 2017;106:1684-93.
Yoon JY, Park HJ, Ju HY, Yoon JH, Chung JS, Hwang SH, et al. Gonadal and sexual dysfunction in childhood cancer survivors. Cancer Research and Treatment: Official Journal of Korean Cancer Association. 2017;49:1057-64.
Arush MWB, Solt I, Lightman A, Linn S, Kuten A. Male gonadal function in survivors of childhood Hodgkin and non-Hodgkin lymphoma. Pediatr. hematol. Oncol. 2000;17:239-45.
Nurmio M, Keros V, Lähteenmäki Pi, Salmi T, Kallajoki M, Jahnukainen K. Effect of childhood acute lymphoblastic leukemia therapy on spermatogonia populations and future fertility. J. Clin. Endocrinol. Metab. 2009;94:2119-22.
Longhi A, Macchiagodena M, Vitali G, Bacci G. Fertility in male patients treated with neoadjuvant chemotherapy for osteosarcoma. J. Pediatr. Hematol. Oncol. 2003;25:292-6.
Ridola V, Fawaz O, Aubier F, Bergeron C, de Vathaire F, Pichon F, et al. Testicular function of survivors of childhood cancer: a comparative study between ifosfamide-and cyclophosphamide-based regimens. Eur. J. cancer. 2009;45:814-8.
Gaffan J, Holden L, Newlands E, Short D, Fuller S, Begent R, et al. Infertility rates following POMB/ACE chemotherapy for male and female germ cell tumours–a retrospective long-term follow-up study. Br. J. Cancer. 2003;89:1849-54.
Brydøy M, Fosså SD, Klepp O, Bremnes RM, Wist EA, Wentzel-Larsen T, et al. Paternity and testicular function among testicular cancer survivors treated with two to four cycles of cisplatin-based chemotherapy. Eur. Urol. 2010;58:134-41.
Namekawa T, Imamoto T, Kato M, Sazuka T, Fuse M, Sakamoto S, et al. Testicular function among testicular cancer survivors treated with cisplatin-based chemotherapy. Reprod. Med. Biol. 2016;15:175-81.
Bujan L, Walschaerts M, Moinard N, Hennebicq S, Saias J, Brugnon F, et al. Impact of chemotherapy and radiotherapy for testicular germ cell tumors on spermatogenesis and sperm DNA: a multicenter prospective study from the CECOS network. Fertil. Steril. 2013;100:673-80. e2.
Rafsanjani KA, Faranoush M, Hedayatiasl AA, Vossough F. Gonadal function and fertility in males survivors treated for Hodgkin's disease in Iran. Saudi. Med. J. 2007:1690-3.
Ishikawa T, Kamidono S, Fujisawa M. Fertility after high-dose chemotherapy for testicular cancer. Urology. 2004;63:137-40.
Howell SJ, Shalet SM. Spermatogenesis after cancer treatment: damage and recovery. JNCi Monographs. 2005;2005:12-7.
Abedi A-r, Fallah-Karkan M, Allameh F, Ranjbar A, Shadmehr A. Incidental prostate cancer: a 10-year review of a tertiary center, Tehran, Iran. Res. Reports. Urol. 2018:1-6.
Heinrich A, DeFalco T. Essential roles of interstitial cells in testicular development and function. Andrology. 2020;8:903-14.
Poganitsch-Korhonen M, Masliukaite I, Nurmio M, Lähteenmäki P, Van Wely M, Van Pelt A, et al. Decreased spermatogonial quantity in prepubertal boys with leukaemia treated with alkylating agents. Leukemia. 2017;31:1460-3.
Stukenborg J-B, Alves-Lopes J, Kurek M, Albalushi H, Reda A, Keros V, et al. Spermatogonial quantity in human prepubertal testicular tissue collected for fertility preservation prior to potentially sterilizing therapy. Hum. Reprod. 2018;33:1677-83.
Meistrich M. Relationship between spermatogonial stem cell survival and testis function after cytotoxic therapy. British. J. Cancer. 1986;7:89.
Cao Y, Wang X, Li S, Wang H, Yu L, Wang P. The effects of l‐carnitine against cyclophosphamide‐induced injuries in mouse testis. BCPT. 2017;120:152-8.
Van Alphen M, Van de Kant H, De Rooij D. Depletion of the spermatogonia from the seminiferous epithelium of the rhesus monkey after X irradiation. Radiat. Research. 1988;113:473-86.
O'Flaherty C, Hales BF, Chan P, Robaire B. Impact of chemotherapeutics and advanced testicular cancer or Hodgkin lymphoma on sperm deoxyribonucleic acid integrity. Fertil. Steril. 2010;94:1374-9.
Pryzant RM, Meistrich ML, Wilson G, Brown B, McLaughlin P. Long-term reduction in sperm count after chemotherapy with and without radiation therapy for non-Hodgkin's lymphomas. J. Clini. Oncol. 1993;11:239-47.
Whitehead E, Shalet SM, Blackledge G, Todd I, Crowther D, Beardwell CG. The effects of Hodgkin's disease and combination chemotherapy on gonadal function in the adult male. Cancer. 1982;49:418-22.
Aslam I, Fishel S, Moore H, Dowell K, Thornton S. Fertility preservation of boys undergoing anti-cancer therapy: a review of the existing situation and prospects for the future: opinion. Hum. Reprod. 2000;15:2154-9.
Drasga RE, Einhorn LH, Williams SD, Patel DN, Stevens EE. Fertility after chemotherapy for testicular cancer. J. Clin. Oncol. 1983;1:179-83.
Lampe H, Horwich A, Norman A, Nicholls J, Dearnaley D. Fertility after chemotherapy for testicular germ cell cancers. J. Clin. Oncol. 1997;15:239-45.
Yamaguchi K, Fujisawa M. Anticancer chemotherapeutic agents and testicular dysfunction. Reprod. Med. Biol. 2011;10:81-7.
De La Calle JV, Soufir JC, Chodorge F, Boisseau C, Kercret H, Jégou B. Reproductive effects of the anti-cancer drug procarbazine in male rats at different ages. Reprod. 1988;84:51-61.
Stumpp T, Freymüller E, Miraglia SM. Sertoli cell function in albino rats treated with etoposide during prepubertal phase. Histochem. Cell. Biol. 2006;126:353-61.
Tsatsoulis A, Shalet SM, Morris ID, De Kretser D. Immunoactive inhibin as a marker of Sertoli cell function following cytotoxic damage to the human testis. Horm. Res. Paediatr. 1990;34:254-9.
Wallace EM, Groome NP, Riley SC, Parker AC, Wu FC. Effects of chemotherapy-induced testicular damage on inhibin, gonadotropin, and testosterone secretion: a prospective longitudinal study. J. Clin. Endocrinol. Metab. 1997;82:3111-5.
Brämswig JH, Heimes U, Heiermann E, Schlegel W, Nieschlag E, Schellong G. The effects of different cumulative doses of chemotherapy on testicular function. Results in 75 patients treated for Hodgkin's disease during childhood or adolescence. Cancer. 1990;65:1298-302.
Howell SJ, Radford JA, Ryder WDJ, Shalet SM. Testicular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency. J. Clin. Oncol. 1999;17:1493-.
Mitchell R, Saunders P, Sharpe R, Kelnar C, Wallace W. Male fertility and strategies for fertility preservation following childhood cancer treatment. Endocrinopathy after childhood cancer treatment. 2009;15:101-34.
Ragheb AM, Sabanegh Jr ES. Male fertility-implications of anticancer treatment and strategies to mitigate gonadotoxicity. Anti-Cancer. Agents. Med. Chem. 2010;10:92-102.
Hansen SW, Berthelsen J, Von Der Maase H. Long-term fertility and Leydig cell function in patients treated for germ cell cancer with cisplatin, vinblastine, and bleomycin versus surveillance. J. Clin. Oncol. 1990;8:1695-8.
Evenson DP, Arlin Z, Welt S, Claps ML, Melamed MR. Male reproductive capacity may recover following drug treatment with the L‐10 protocol for acute lymphocytic leukemia. Cancer. 1984;53:30-6.
Viviani S, Santoro A, Ragni G, Bonfante V, Bestetti O, Bonadonna G. Gonadal toxicity after combination chemotherapy for Hodgkin's disease. Comparative results of MOPP vs ABVD. Eur. J. Cancer. Clin. Oncol. 1985;21:601-5.
Van der Kaaij M, Heutte N, Stang NL, Raemaekers JM, Simons A, Carde P, et al. Gonadal function in males after chemotherapy for early-stage Hodgkin's lymphoma treated in four subsequent trials by the European Organisation for Research and Treatment of Cancer: EORTC Lymphoma Group and the Groupe d'Etude des Lymphomes de l'Adulte. 2007.
O'flaherty CM, Chan PT, Hales BF, Robaire B. Sperm chromatin structure components are differentially repaired in cancer survivors. J Androl. 2012;33:629-36.
Meistrich ML. Potential genetic risks of using semen collected during chemotherapy. Hum. Reprod. 1993;8:8-10.
Paoli D, Gallo M, Rizzo F, Spanò M, Leter G, Lombardo F, et al. Testicular cancer and sperm DNA damage: short‐and long‐term effects of antineoplastic treatment. Andrology. 2015;3:122-8.
Martinez G, Walschaerts M, Le Mitouard M, Borye R, Thomas C, Auger J, et al. Impact of Hodgkin or non-Hodgkin lymphoma and their treatments on sperm aneuploidy: a prospective study by the French CECOS network. Fertil. Steril. 2017;107:341-50. e5.
Romerius P, Ståhl O, Moëll C, Relander T, Cavallin-Ståhl E, Gustafsson H, et al. Sperm DNA Integrity in Men Treated for Childhood CancerSperm DNA Damage in Childhood Cancer Survivors. Clin. Cancer. Res. 2010;16:3843-50.
Thomson AB, Campbell AJ, Irvine DS, Anderson RA, Kelnar CJ, Wallace WHB. Semen quality and spermatozoal DNA integrity in survivors of childhood cancer: a case-control study. The Lancet. 2002;360:361-7.
Shnorhavorian M, Schwartz SM, Stansfeld B, Sadler-Riggleman I, Beck D, Skinner MK. Differential DNA methylation regions in adult human sperm following adolescent chemotherapy: potential for epigenetic inheritance. PloS one. 2017;12:e0170085.
Shelley M, Burgon K, Mason M. Treatment of testicular germ-cell cancer: a cochrane evidence-based systematic review. Cancer Treat Rev. 2002;28:237-53.
Lee SJ, Schover LR, Partridge AH, Patrizio P, Wallace WH, Hagerty K, et al. American Society of Clinical Oncology recommendations on fertility preservation in cancer patients. J. Clin. Oncol. 2006;24:2917-31.
Meistrich ML, Wilson G, Huhtaniemi I. Hormonal treatment after cytotoxic therapy stimulates recovery of spermatogenesis. Cancer Res. 1999;59:3557-60.
Prahalathan C, Selvakumar E, Varalakshmi P. Protective effect of lipoic acid on adriamycin-induced testicular toxicity. Clin. Chim. Acta. 2005;360:160-6.
Allameh F, Abedi A, Karimi M, Fallah-Karkan M. Testicular sperm for intracytoplasmic sperm injection in oligozoospermic men with high sperm DNA fragmentation, to do or not to do. MHJ. 2019;3:e4-e.
Van Casteren N, van Santbrink E, Van Inzen W, Romijn J, Dohle G. Use rate and assisted reproduction technologies outcome of cryopreserved semen from 629 cancer patients. Fertil. Steril. 2008;90:2245-50.
Neal MS, Nagel K, Duckworth J, Bissessar H, Fischer MA, Portwine C, et al. Effectiveness of sperm banking in adolescents and young adults with cancer: a regional experience. Cancer. 2007;110:1125-9.
Geens M, Goossens E, De Block G, Ning L, Van Saen D, Tournaye H. Autologous spermatogonial stem cell transplantation in man: current obstacles for a future clinical application. Hum. Reprod. Update. 2008;14:121-30.
Feng L-X, Chen Y, Dettin L, Pera RAR, Herr JC, Goldberg E, et al. Generation and in vitro differentiation of a spermatogonial cell line. Science. 2002;297:392-5.
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