Difficult to predict fertility after chemo

Dear Dr. Gott: I’m a young woman. In 1994, I was diagnosed with non-Hodgkin’s lymphoma. The tumor was localized in my chest. Treatment consisted of chemotherapy and radiation, which ended in 1995. I’ve had no recurrence to date. I’m now recently married and am considering having children. However, I’m unsure what affect past cancer treatments might have on the child. I see my oncologist regularly but am still searching for a satisfactory answer.

Dear Reader: You have been cancer-free for nine years, so I conclude that your treatment was successful. It is highly unlikely that this therapy will alter a subsequent pregnancy: The initial effects of the chemotherapy and radiation have passed.

Nonetheless, your therapy may have influenced your ability to conceive. That is, your ovaries may have been permanently damaged.

You probably haven’t been able to obtain an answer from your oncologist because no one can predict with absolute certainty whether your fertility will be reduced or whether (however unlikely) your infant might be born with a genetic abnormality, which would not be evident with a sonogram examination.

I suggest that you discuss this issue with your gynecologist. He or she can advise you about probabilities and risks. It’s my bet that your doctors’ consensus will be: Go for it, and God bless!

Dear Dr. Gott: Please discuss thumb and finger tremors. Are they the beginning of Parkinson’s disease?

Dear Reader: Tremors (rhythmic shaking or twitching) are, in general, classified as voluntary (intentional) or involuntary (resting).

Voluntary tremors are most noticeable during the performance of motor acts, such as eating or writing. They may be caused by a variety of neurological disorders, such as multiple sclerosis, or they may simply be inherited as “benign essential tremor.” Tremulousness is often caused by stimulants, such as caffeine, and can reflect nervousness or anxiety.

In contrast, involuntary tremors appear at rest only; they disappear on movement. Parkinson’s disease is the most common cause of such tremors.

Therefore, before answering your question, I’d have to know the circumstances associated with your tremors. In the event that you have a resting tremor, Parkinson’s disease is a possibility and may need to be treated with drugs, such as Sinemet.

You should see a neurologist for diagnosis. Ask your family physician to refer you.

To give you related information, I am sending you a copy of my Health Report “Medical Specialists.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.