Childhood cancer survivors face health risks

Most childhood cancer survivors have at least one serious health problem as young adults, especially those who had radiation treatment, researchers have found.

Dr. Huib Caron of Emma Children's Hospital in Amsterdam designed the study to assess the burden of adverse events among more than 1,300 patients who were followed for an average of 17 years.

Previous research on childhood cancer survivors often had incomplete follow-up, a small number of participants or focused on one effect.

In Wednesday'stheme issue of the Journal of the American Medical Association on chronic diseases of children, the team reported on the results of their follow-up with survivors, namely:

• 19.8 per cent had no adverse events.
• 74.5 per cent had at least adverse event.
• 36.8 per cent had at least one severe or life-threatening or disable disorder.
• 3.2 per cent died due to an adverse event.

Among patients treated with radiation only, 55 per cent had at least two severe events or one or more that was life-threatening or disabling, compared with 15 per cent for those with chemotherapy alone and 25 per cent for surgery alone.

The burden of events was also higher among survivors of bone tumours, 64 per cent, leukemia or Wilms tumour in the kidney, at 12 per cent each.

"In conclusion, childhood cancer survivors are at increased risk of many severe health problems, resulting in a high burden of disease during young adulthood," the study's authors wrote.

"This will inevitably affect the survivors' quality of life and also will ultimately reduce their life expectancy."

The researchers suggested lifelong medical surveillance of childhood cancer survivors to allow early detection of adverse events that could be helped.

Most family doctors and specialists are not familiar with the health risks that young cancer survivors face, Dr. Kevin Oeffinger of Memorial Sloan-Kettering Cancer Center in New York, and Leslie Robison of St. Jude Children's Research Hospital, in Memphis, Tenn., said in a commentary accompanying the study.

Oeffinger and Robison agreed with the study's authors that survivors should be screened for late effects that may respond to early diagnosis and treatment during the young and mid-adult years.

It is important for doctors to recognize the risks and strive not only to improve therapy that improves cure rates but also reduces long-term illness, the pair said.