Childhood Cancer Survivors Still Face Health Risks

The largest study ever conducted of adult survivors of childhood cancer shows that they are as much as eight times as likely to suffer from severe or even life-threatening health conditions as their healthy siblings. The study, which is being published in the New England Journal of Medicine, evaluated the health of more than 10,000 adults-average age 26-who had been cancer patients as children.
The numbers are stark. About one in four survivors developed severe or life-threatening conditions in the years after their treatment, compared with just 5% of their siblings who had never had cancer. By contrast, only one in three survivors had no apparent problems with their health at the time of the study, compared with 63% of their siblings.
Children who had survived Hodgkin's disease were more likely to suffer secondary cancers and heart disease as adults. Youngsters with tumors of the brain or spine were more likely to have memory and other cognitive problems. What it means: As devastating- and thankfully uncommon-as it is to learn that a child has cancer, the bad news is softened somewhat by the fact that two-thirds of children with cancer can be cured of their disease, according to the National Cancer Institute. Indeed, medical advances over the past several decades have shown that aggressive treatment with radiation, chemotherapy and surgery seems to work better at fighting cancers in children than they do in many adults. Children are also better able to recover after therapy than most adults.
But there is a dark side to being cured of cancer at such a young age. The treatments, while necessary for survival, can themselves lead to life-long health problems, such as secondary cancers, heart disease and kidney problems. In some cases, these conditions can be fatal as well. Anyone who has had cancer as a child should be monitored by specialists even after they become adults. "Many cancer survivors and many clinicians are not aware of the risk," Dr. Kevin Oeffinger, a physician at Memorial Sloan Kettering Cancer Center in New York and one of the study's authors, said in a phone interview. "But there are health problems that we can prevent or can detect early and more easily manage."
Oeffinger recommends regular visits every one to two years with a specialist who follows adult survivors of pediatric cancer or a clinician who is willing to work with such a specialist. These doctors will pay particular attention to radiation dosage and location. Some chemotherapeutic agents also have more long-lasting effects than others-such as the anthracylines (e.g. adriamycin), the cyclophosphamides (cytoxan) and bleomycin.
[Time]