Can a man with gallbladder cancer have children?

According to statistics, more than half of young male cancer patients have not had children at the time of diagnosis and have the desire to have children. How to preserve fertility during the disease and after treatment and how to ensure the health of the next generation are challenges currently faced by tumor diagnosis and treatment. So can men with gallbladder cancer have children? Let's take a look at the following introduction.

Effects of cancer on male fertility

Cancer can affect male fertility through a variety of pathways, including endocrine and nutritional changes. Some testicular cancers can secrete human chorionic gonadotropin (β-HCG), which can inhibit the secretion of pituitary gonadotropin, thereby affecting sperm production and sperm function. Similarly, patients with Hodgkin lymphoma also have similar endocrine changes, leading to decreased levels of pituitary gonadotropin and blood testosterone.

Cancer is a common cause of malnutrition, and a lack of certain vitamins, minerals, trace elements, etc. can also affect testicular development and sperm quality.

High metabolism and cancer fever caused by cancer can also damage male reproductive function. Some cancer cells can reduce sperm motility and cause damage to Leydig cells (testicular interstitial cells) by producing sperm antibodies or secreting cytokines. Long-term cancer fever can lead to insufficient sperm motility, reduced sperm count, and even azoospermia. However, whether some cancers such as leukemia and sarcoma have a direct impact on male fertility is still controversial.

Take testicular cancer as an example. In 2008, there were 8,090 new cases in the United States, making it the most common cancer in men aged 25 to 40. In addition to the general impact on male fertility, testicular cancer also affects sperm formation by destroying surrounding tissues, secreting β-HCG, increasing the temperature in the scrotum, and changing local blood flow. These changes affect not only the affected testicle, but also the contralateral testicle.

Effects of cancer treatment on male fertility

Radiotherapy Radiotherapy is one of the main treatments for Hodgkin lymphoma, seminoma, and gallbladder cancer. The damage to fertility caused by radiotherapy depends on the radiation dose received by the gonads and the radiotherapy method. Spermatogenic cells are more susceptible to radiation damage than Leydig cells. When the radiation dose reaches 0.1~0.2Gy, it will affect the spermatogenic ability of the testicles; >1.2Gy will significantly prolong the recovery time of spermatogenic ability; >4Gy may cause irreversible damage. Sperm counts usually reach their lowest value 4~6 months after the end of radiotherapy, and return to pre-treatment levels after 10~24 months. In addition, radiotherapy will significantly increase sperm DNA damage, which can last for 1~2 years after treatment. Fractionated radiotherapy causes greater damage to the testicles than single equal-dose radiotherapy; combined radiotherapy and chemotherapy cause significantly greater damage to fertility than radiotherapy or chemotherapy alone.

Chemotherapy Chemotherapy mainly acts on rapidly proliferating cells, so it will inevitably cause damage to germ cells. This damage is mainly related to the type and dose of the chemical drugs and the cell cycle they act on. The damage to spermatogenic stem cells will be permanent. A variety of chemotherapy drugs can reduce the number of sperm through the blood-testis barrier and cause testicular interstitial fibrosis. Large doses of alkylating agents such as nitrogen mustard and cyclophosphamide can cause long-term azoospermia in more than 90% of patients. The spermatogenic damage caused by non-alkylating agents such as doxorubicin and bleomycin is generally temporary, and 90% can recover within 1 to 5 years after chemotherapy.