Childhood cancer survivors may not survive long says new study

By Dr. Ananya Mandal, MDApr 6 2010

Children who have survived a cancer are at a higher risk of an early death says two new studies. The first report published in the April 6^th issue of the Annals of Internal Medicine, said that there was a cumulative effect of the disease, a childhood cancer and its treatment on the risk of death in 15 year old patients who have been cancer free for at least 5 years.

This finding was derived from a computer generated model that the authors have developed. They said that a childhood cancer and its treatment shorten the lifespan by an average of 10 years. The type and nature of cancer is another determining factor here according to them. For example, survivors of kidney cancer died about four years earlier than the general population, while bone and brain cancer survivors died about 18 years earlier. They say that it is not only the deleterious effects of the cancer but also the toxic effects of the cancer chemotherapy. The authors urge doctors to keep a past history of childhood cancer in mind while treating such patients.

Jennifer Yeh, a research fellow at Harvard School of Public Health in Boston was one of the laed authors of this study. She said that there is a 28% reduction in life expectancy after surviving a childhood cancer. She said, “Survivors of childhood cancer continue to face excess mortality risks in their adult years…Monitoring the health of the growing population of childhood cancer survivors and evaluating newer therapies for patients newly diagnosed with cancer can help to minimize the impact of these late effects on survivors’ life expectancy.” The study also revealed that a childhood-cancer survivor who reaches the age of 40 has a 3.3-fold higher risk of dying before the age of 50 than those in the general population. A person who reaches the age of 60 has a 1.4-fold higher risk of dying before the age of 70. Yeh said, “This suggests that as survivors age, the elevated risk of dying declines and approximates general population levels…Our estimates are based on data for survivors treated 20 to 40 years ago. Patients who received treatment more recently may have more favorable outcomes.’’

In yet another study published in the same issue of the journal, an elevated risk of breast cancer among young women who had chest radiation for cancer when they were children or young adults were noted. The authors urge physicians to be vigilant about breast cancer in these women. These results are obtained from a number of past studies. They found that in women treated with chest radiation at a young age, the rate of breast cancer by age 40 to 45 years was as high as 20 percent.

They said that traditional MRI and mammography beginning at age 25 may be the best screening approach for these women may be beneficial but also questioned an additional radiation exposure though these screening methods. According to senior author Dr. Kevin C. Oeffinger, from Memorial Sloan-Kettering Cancer Center, New York, regular screening for breast cancer is still a must in these women, and "further research is required to better define the harms and benefits of lifelong surveillance." There are more than 300,000 childhood-cancer survivors in the U.S., Oeffinger said.