The study to be released Thursday in the New England Journal of Medicine discovered that 30 years after their diagnosis, 40% of childhood cancer survivors have a serious health problem and one-third have multiple problems. Only about 1 in 3 remains healthy.
“This is the dark side to being cured of cancer as a young person," said Philip Rosoff of the Duke University School of Medicine in a commentary in The New England Journal of Medicine.
Patients treated from 1970 to 1986, when they were below the age of 21, later developed exceptionally high rates of heart disease, second cancers, infertility, damaged joints, learning disorders and other problems.
These findings can be put in contrast of the stunning success of treating many childhood tumors. Nearly 20,000 children are diagnosed with cancer in the United States alone each year. The cure rate is currently more than 75 % as compared to 50 years ago.
The health experts have known for years that cancer treatments in childhood can trigger new tumors later in life. But the novel Childhood Cancer Survivor Study, based on data from 26 medical centers, discovered other, long-term health impairments.
About their new findings, the research team, led by Kevin Oeffinger of Memorial Sloan-Kettering Cancer Center in New York, said, “It is now clear that damage to the organ systems of children caused by chemotherapy and radiation therapy may not become clinically evident for many years.”
When 10,397 survivors with an average age of 26.6 were compared to their brothers and sisters, the researchers found "cancer survivors were eight times as likely as their siblings to have severe or life-threatening chronic health conditions." Those with bone tumors, nerve cancer, brain cancer and Hodgkin's disease, which affects the immune system
, were at highest risk.
Survivors were 54 times more likely than their siblings to need a major joint replacement and 15 times more times more likely to have a second malignancy and congestive heart failure, 10 times more likely to have heart disease or thinking problems, and nine times more likely to have suffered a stroke or kidney failure. The investigators expect the adverse effects to increase as this population ages.
Despite the facts that the study did not include anyone who started treatment after 1986, the findings are still relevant for children being treated today, the team of researchers said. Therapies have doubtlessly improved, but some of the same drugs are still in use, and radiation remains crucial for certain cancers.
“Our hope and anticipation is that patients undergoing therapy today will not have quite that burden, but they will certainly face long-term health conditions,” said Dr. Oeffinger.
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