Childhood Cancer Survivors at Increased Risk of Developing Serious Heart Problems Early in Life.
University of Minnesota study emphasizes the need for continuous monitoring.
A Masonic Cancer Center, University of Minnesota researcher and physician has found that survivors of childhood and young adult cancers are five to ten times more likely than their healthy brothers and sisters to develop serious heart problems. The problems can develop at an early age and emphasize the need for continuous medical monitoring.
Daniel Mulrooney, M.D., assistant professor of pediatrics with the University of Minnesota’s Masonic Cancer Center and Medical School, led the research team on this study. The study compared 14,358 survivors enrolled in the Childhood Cancer Survivor Study (CCSS) to 3,899 of their siblings who did not have cancer. The findings will be presented at the 44th annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Ill.
Diseases Typically Seen in Older Adults
“Our study showed that survivors were on average 27 years of age when they started developing heart problems usually seen in older adults,” said Mulrooney. “We found survivors had a 10 times greater risk for artherosclerosis or hardening of the coronary arteries; 5.7 times higher risk of congestive heart failure; 4.9 time higher risk for myocardial infarction or heart attack; 6.3 times higher risk for pericardial disease; and 4.8 times greater risk for valvular disease. The risks were particularly high in survivors who received anthracycline drugs, such as doxorubicin, or radiation therapy to the heart as part of their cancer treatment than survivors who did not receive these treatments.
Education and Early Detection is Critical for Successful Treatment
“These findings point to a two-fold need,” said Mulrooney. “ First, the need to educate survivors, their family members, physicians and other healthcare providers about this risk for cardiovascular disease after the life-saving cancer treatment. Second, survivors need to be followed by their healthcare providers so that possible heart problems can be diagnosed early and treated accordingly.”
The CCSS comprises the largest group of childhood cancer survivors in the world. It is a National Cancer Institute-funded resource to promote and facilitate research among long-term survivors of cancer diagnosed during childhood and adolescence.
Survivors in this study were diagnosed between 1970 and 1986 of cancers including childhood leukemia, central nervous system tumors, Hodgkin’s or non-Hodgkin’s lymphomas, renal tumors, neuroblastoma, soft-tissue sarcomas, or bone cancer. These survivors were 21 years of age or younger when diagnosed, and they had survived five years or longer after their cancer treatment. For this study, they completed a written questionnaire about their cardiovascular conditions.
More Childhood Cancer Survivors Today but Long-Term, Follow-up Care is Key
Mulrooney notes that while chemotherapy and radiation therapy for childhood and young adult cancers have improved markedly in the last decade, survivors should still be monitored in a long-term, follow-up clinic as a precaution and to detect heart conditions before they become a major medical problem.
“Interestingly, we found that childhood cancer survivors who did not develop heart problems 30 years after their cancer treatment had an overall low risk,” says Mulrooney. “Only two percent of these long-term survivors reported having atherosclerosis, four percent had congestive heart failure, one percent suffered a heart attack, three percent developed pericardial disease, and four percent had valvular heart disease.”
Funds from Children’s Cancer Research Fund were used in development of the initial Childhood Cancer Survivor Study. Over the past decade, this Study has provided critical information in the devlopment of treatment for childhood cancer patients and survivors.