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As the number of cancer survivors increases, so does the demand for preserving male fertility after radiation. It is important for healthcare providers to understand the pathophysiology of radiation-induced testicular injury, the techniques of fertility preservation both before and during radiation, and their role in counseling patients on the risks to their fertility and the means of mitigating these risks. Impaired spermatogenesis is a known testicular toxicity of radiation in both the acute and the late settings, as rapidly dividing spermatogonial germ cells are exquisitely sensitive to irradiation. The threshold for spermatogonial injury and subsequent impairment in spermatogenesis is ~ 0.1 Gy and the severity of gonadal injury is highly dose-dependent. Total doses < 4 Gy may allow for recovery of spermatogenesis and fertility potential, but with larger doses, recovery may be protracted or impossible. All patients undergoing gonadotoxic radiation therapy should be counseled on the possibility of future infertility, offered the opportunity for semen cryopreservation, and offered referral to a fertility specialist. In addition to this, every effort should be made to shield the testes (if not expected to contain tumor) during therapy. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether oral cryotherapy (OC) mitigates oral mucositis (OM) resulting from busulfan chemotherapy. SAMPLE & SETTING: Electronic health records of patients undergoing busulfan conditioning for blood and marrow transplantation were reviewed for this descriptive study. The post-OC group received OC with busulfan, but the pre-OC group did not. METHODS & VARIABLES: Demographic and disease characteristics for both groups were summarized using descriptive statistics. Wilcoxon rank-sum test was performed for continuous and ordinal measures, and chi-square tests were performed for categorical outcomes between the two groups. RESULTS: This study found a decrease in the severity of OM as assessed by the World Health Organization OM scale. This study also found a reduction of total parenteral nutrition and opioid pain medication use, as well as a decrease in length of stay and airway protection–related intensive care unit transfers. An increase in day 11 methotrexate administration for graft-versus-host disease prophylaxis was observed in the post-OC group. IMPLICATIONS FOR NURSING: OC is a safe and easily implemented intervention that can decrease OM in patients receiving busulfan chemotherapy. [ABSTRACT FROM AUTHOR]

As the number of cancer survivors increases, so does the demand for preserving male fertility after radiation. It is important for healthcare providers to understand the pathophysiology of radiation-induced testicular injury, the techniques of fertility preservation both before and during radiation, and their role in counseling patients on the risks to their fertility and the means of mitigating these risks. Impaired spermatogenesis is a known testicular toxicity of radiation in both the acute and the late settings, as rapidly dividing spermatogonial germ cells are exquisitely sensitive to irradiation. The threshold for spermatogonial injury and subsequent impairment in spermatogenesis is ~ 0.1 Gy and the severity of gonadal injury is highly dose-dependent. Total doses < 4 Gy may allow for recovery of spermatogenesis and fertility potential, but with larger doses, recovery may be protracted or impossible. All patients undergoing gonadotoxic radiation therapy should be counseled on the possibility of future infertility, offered the opportunity for semen cryopreservation, and offered referral to a fertility specialist. In addition to this, every effort should be made to shield the testes (if not expected to contain tumor) during therapy., Competing Interests: Competing interests: N/A. Conflict of interest: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. The authors declare no potential conflicts of interest, including financial interests, activities, relationships and affiliations., (© 2023 Greater Poland Cancer Centre.)