RESUMO
UNLABELLED: With the improved survival rate of childhood and young adult cancer patients, the long-term sequelae of the treatments used are increasingly important. In this review, current knowledge of the gonadotoxicity of commonly employed chemotherapeutic agents and radiotherapy regimens is examined. Differences between the effect of "high-risk" and "low-risk" agents are discussed. Tailoring treatment to suit the individual and counseling patients regarding reduced fertility have resulted in the best practice. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completing this CME activity, physicians should be better able to evaluate and use appropriate methods to estimate ovarian reserve, assess the risk of infertility caused by commonly used cytotoxic chemotherapy regimens and radiation, and counsel patients regarding the gonadotoxic effects of cancer treatment.
Assuntos
Antineoplásicos/efeitos adversos , Fertilidade/efeitos dos fármacos , Fertilidade/efeitos da radiação , Neoplasias/tratamento farmacológico , Neoplasias/radioterapia , Amenorreia/induzido quimicamente , Feminino , Humanos , Menopausa Precoce/efeitos dos fármacos , Ovário/efeitos dos fármacos , Ovário/efeitos da radiação , Insuficiência Ovariana Primária/induzido quimicamente , Radioterapia/efeitos adversosRESUMO
Uterine fibroids are the most common tumours presenting in women. The pathophysiology of fibroids is poorly understood, but disordered angiogenesis and altered smooth muscle cell proliferation are believed to play a role. In this review, current knowledge of both of these processes will be summarized. Differences between 'normal' adjacent myometrium and fibroid tumours within the same uterus are outlined. Exploiting these differences represents one of the best opportunities for the development of medical treatments that target fibroid tissue selectively.