**7. Mitigation strategies and surveillance guidelines**

Given the young age of most WT patients, it is imperative to counsel caregivers of the late fertility risks of therapy and to involve endocrinology specialists early in the care of these patients [39]. With the continued advances in novel biomarker discovery and revised tumor-risk based stratifications, RT technology, including improvements in image-guidance and increased availability of proton beam therapy, it may be possible to further reduce radiation exposure to organs-at-risk involved in fertility and gestation and thereby reduce the undesired late effects of RT on fertility in WT survivors.



**Table 3.** *The Children's oncology group long-term follow-up guidelines recommendations for surveillance of childhood cancer survivors for common RT-induced toxicities observed in WT survivors.*
