Chemotherapy saves many lives, including those of children and teenagers with cancer. As more young people survive cancer and go on to have families, researchers are studying the long-term effects of treatment. A study from Washington State University in rats suggests that a common chemotherapy drug may raise disease risk not only in those treated, but in their descendants.
What the researchers studied
The team, led by biologist Michael Skinner, focused on ifosfamide, a chemotherapy drug used to treat several cancers, including some that affect adolescents. They treated young male rats with ifosfamide over three days, similar to a course given to an adolescent patient. The rats were then bred with untreated females, and their offspring were bred again with untreated rats, producing two generations that had never been exposed to the drug. The results were published in iScience.
What they found
- Higher disease rates in descendants. Both the children and grandchildren of the treated rats had more disease than expected, even though they were never exposed to the drug.
- Specific problems included kidney and testicular disease, delayed puberty and unusual anxiety-related behavior, with some differences between generations and between males and females.
- Epigenetic changes. The researchers found changes in the epigenome, the chemical marks that control how genes are switched on and off, in sperm across generations. These changes were linked to the chemotherapy exposure.
The researchers said this was the first study to show that disease susceptibility caused by chemotherapy could be passed down to two later generations that were never exposed.
Epigenetic changes don’t alter the DNA sequence itself. Instead, they affect how genes are read. Some of these marks can be passed through sperm or eggs, which is one way an exposure in one generation could, in theory, influence the next. If confirmed in people, epigenetic testing might one day help predict which survivors face higher risks so they can be monitored more closely.
Important caveats
This study was done in rats, and results in animals don’t always apply to people. It doesn’t show that the children or grandchildren of cancer survivors will develop disease. The researchers stressed that chemotherapy is highly effective and that no one should avoid or delay cancer treatment because of these findings. The team is now studying people who were treated for cancer as adolescents to see whether similar effects occur.
Fertility preservation matters
The researchers suggested that young cancer patients who may want children later consider fertility preservation, such as freezing sperm or eggs, before starting chemotherapy. This is already recommended for many patients because chemotherapy can affect fertility. Their findings add another possible reason to discuss it.
What this means for patients and families
- Don’t delay treatment. Follow your cancer care team’s advice. Treating the cancer comes first.
- Ask about fertility preservation early. Ideally, discuss it before treatment begins. Many cancer centers have fertility specialists who can help, sometimes very quickly.
- Keep long-term follow-up. Childhood and adolescent cancer survivors benefit from regular survivorship care to monitor for late effects of treatment.
- Share your history. Let your doctors, and later your children’s doctors, know about your cancer treatment history.
- Look after your overall health. A healthy diet, regular activity, not smoking and limiting alcohol support long-term health after cancer.
The bottom line
In rats, a common chemotherapy drug was linked to higher disease rates in two later generations, likely through epigenetic changes. It’s early research that needs confirmation in people, but it highlights the value of fertility preservation and long-term follow-up for young cancer survivors.
This article is for general information and isn’t medical advice. Talk with your healthcare provider about your individual needs.
