Improving the quality-of-life for cancer survivors
Through our support of research and the Long-Term Follow-Up Clinic at the University of Minnesota, the first clinic of it’s kind in the world, physician researchers can learn more about the medical, neurocognitive, and emotional late-effects of childhood cancer treatments and provide health care based on risk factors associated with prior cancer treatment.
Childhood cancer, the leading killer of children by disease, is the penultimate childhood health struggle. Unfortunately, the struggle may not end when the therapy does, and long-term effects of cancer treatment may pose life-long heath risks as significant as the cancer itself. Intensive therapies used to treat cancer—like surgery, chemotherapy, radiation therapy, and blood and marrow transplants—not only destroy the cancer cells but may also damage healthy cells in the process. A child undergoing cancer treatment may experience ongoing issues well into adulthood.
To learn more, a group of physicians from 26 of the most respected pediatric cancer institutions in the United States conducted the largest study of survivors of childhood cancer, surveying more than 14,000 survivors and comparing their health to those of their siblings. The Childhood Cancer Survivor Study—partially funded by Children’s Cancer Research Fund—found that childhood cancer survivors are more likely to develop “late effects” involving not only cardiovascular complications but other issues, as well, such as infertility, hearing and vision loss, stroke, secondary cancers, cognitive disabilities, and mental and emotional difficulties.
Cardiovascular disease is the leading non-cancer cause of late mortality among survivors of childhood and adolescent cancer. Our researchers took a lead role in examining cardiovascular outcomes among survivors and found they were five to ten times more likely to develop serious heart problems than their healthy brothers or sisters. Researchers assessed the incidence of and risks for congestive heart failure, myocardial infarction, pericardial, and valvular disease among these adult survivors of childhood and adolescent cancers.
“Our study showed that survivors of childhood cancer were, on average, 27 years of age when they started developing the kind of heart problems more often seen in older adults,” says Children’s Cancer Research Fund-supported lead investigator Dr. Daniel Mulrooney. “We found survivors had 10 times the risk for artherosclerosis (hardening of the coronary arteries), a 5.9 times higher risk of congestive heart failure, 6.3 times the risk for pericardial disease, and 4.8-fold greater risk for valvular disease compared to their siblings. These risks were particularly high among survivors who had received anthracycline drugs, such as doxorubicin, or high-dose radiation therapy to the heart as part of their cancer treatment.”
This study points to the need to educate survivors, their families, and their healthcare providers about the risk of cardiovascular disease, as well as other ongoing health risks following cancer treatment. These patients need appropriate surveillance and monitoring so that late outcomes of cancer therapy can be diagnosed early and treated accordingly.
According to Childhood Cancer Survivor Study investigators, here are some facts regarding cardiovascular risk among childhood cancer survivors:
• Survivors of childhood cancer are at risk of developing premature cardiovascular disease.
• Exposure to anthracyclines and/or high doses of cardiac radiation is associated with increased risk of late adverse cardiac outcomes.
• Further study will help clarify associations between cardiac outcomes and treatments unique to particular diagnoses.
• Cardiac toxicity may occur years following diagnosis, and the incidence increases over time.
• Childhood and adolescent cancer survivors should be monitored for early cardiovascular disease.
Additional late effects include:
Medical late effects:
- Endocrine (hormone) issues
- Cardiovascular (heart) disease
- Visual or hearing impairment
- Secondary cancers
- Bone health concerns
Neurocognitive late effects:
- Problem solving
- Paying attention
Emotional and social late effects
- Difficulty reintegrating into school or family after treatment
- Post-traumatic stress
Taken with permission from http://www.cancer.umn.edu
With childhood cancer survivors now numbering nearly 300,000, Children’s Cancer Research Fund is committed to supporting research that improves the quality of life of childhood cancer survivors, now and in the future.