Fertility and reproductive studies of cancer patients, especially of long-term survivors of childhood and adolescent cancer, and of men and women who reproduced during cancer therapy, are studied for information on the gonadal toxicity and possible mutagenicity and teratogenicity of cancer treatment, and also to uncover hereditary patterns of cancer. Current phases include analysis of data collected from interviews with 2300 survivors of childhood and adolescent cancer and 3500 of their siblings as controls to learn about their subsequent health and fertility, and the health of their offspring. Marriage deficits were significant only among men and women who had survived brain tumors. The first marriages of men who had survived brain tumors or retinoblastoma were more likely to break up than controls. These studies have been expanded into new areas. In collaboration with the Children's Cancer Research Group (CCSG) and the National Institute of Child Health and Human Development (NICHD) a new interview study of late effects (second cancer, general health and fertility) after childhood acute lympho- cytic leukemia has been developed. Two clinical studies are in progress with Children's National Medical Center in Washington to evaluate clinical and neuropsychological functioning in survivors of medulloblastoma. and a study to determine the frequency of uterine malformations in survivors of Wilms' tumor.
