Healthy lifestyles reduce chronic health risks for childhood cancer survivors

Healthy lifestyles can reduce the risk of cardiovascular disease and other complications in childhood cancer survivors. These are the findings of two new international studies.

Children who survive cancer are at increased risk of cardiovascular disease and other chronic health problems later in life - often as a result of the treatment that saved their lives.

Two new international studies, led by researchers at the University of Gothenburg and St. Jude Children's Research Hospital, now show that a healthy lifestyle can have a protective effect.

In one study, published in Nature Communications, over 18,000 childhood cancer survivors were followed for up to 30 years. The results show that a large proportion of chronic health problems emerging following childhood cancer can be linked to lifestyle factors such as physical inactivity, obesity, smoking and high alcohol intake - and that these factors together account for a proportion of the burden of disease in adulthood that is comparable what previous cancer treatments such as radiation and chemotherapy account for.

Lifestyle plays a big role

This reveals that lifestyle plays a much bigger role than previously thought. Unlike the treatments already given, the lifestyle can actually be changed."

Aron Onerup, Pediatrician and Researcher at the University of Gothenburg and former Postdoctoral Fellow at St. Jude Children's Research Hospital in Memphis, USA

The second study, published in JACC: CardioOncology, focuses on people treated for Hodgkin's lymphoma as children or adolescents. The study included over 2,300 survivors of the disease, a type of cancer that emerges in the lymph nodes.

The study shows that lack of regular exercise in this group contributes to a 1.4 times higher incidence of cardiovascular disease compared to the total disease burden in the general population, or twelve times more than can be explained by insufficient exercise in the general population - despite the fact that the differences in lifestyle habits were not large.

"This means that physical activity can make a big difference in reducing the extra risk that emerges after cancer treatment and modify the negative effects from cancer treatments. Our results provide strong scientific support for offering survivors structured support for healthy lifestyles," says Aron Onerup.

Long-term support needed

Together, the studies highlight that healthy lifestyles - especially physical activity and a healthy weight - can be crucial in preventing serious diseases in childhood cancer survivors. The researchers believe that the results should lead to lifestyle support becoming an integral part of long-term follow-up after childhood cancer.

"This is something we have partly taken into account in the national healthcare program for long-term follow-up after childhood cancer by emphasizing the importance of mapping lifestyle habits," says Aron Onerup. "What we are now working on is to develop and test ways to support these individuals to adopt long-term healthy lifestyles, through interventions both in childhood, adolescence, and in adulthood."
Aron Onerup is a Researcher within Pediatrics at Sahlgrenska Academy at the University of Gothenburg and a Specialist Physician at the Pediatric Cancer Center at Queen Silvia Children's Hospital, Sahlgrenska University Hospital, in Gothenburg.