Childhood cancer survivors 'at increased risk of early death'
Washington, (ANI): Childhood cancer survivors may face shortened lifespan, a new American study has revealed.
According to the research conducted by Dana-Farber Cancer Institute and the Harvard School of Public Health, more children today are surviving cancer than ever before, however, young patients successfully treated in the 1970s and 80s may live a decade less, on average, than the general population.
Depending on the type of cancer, the estimated loss of life expectancy ranges from four years to more than 17 years, says the study.
Causes of the premature deaths include recurrences of the initial cancer, new cancers caused by drug and radiation therapy, and other delayed complications from cancer treatments.
The study, based on a computer model, is the first to estimate the lifetime toll of childhood cancer and the gruelling but increasingly successful treatments for diseases such as kidney and bone cancers, leukaemia, and brain tumours.
Jennifer Yeh, a research fellow at the Harvard School of Public Health (HSPH) Center for Health Decision Science and first author of the report, said: "For a group of patients fortunate enough to have survived their initial cancer, to still have this considerable extra risk is disheartening."
However, Lisa Diller, clinical director of Pediatric Oncology at Dana-Farber and Children's Hospital Boston, who is the senior author of the paper, said that recent changes in treatments and the increasing use of less-toxic "targeted" therapies may lead to better long-term outcomes in the future.
She said: "The study is based on how children were treated in the 1970s and early 1980s.
"It is our hope that when we see data from more recent cohorts of patients, there will be improved life expectancy as a result of some changes that pediatric oncologists have made."
For instance, paediatric cancer doctors have been tweaking treatment regimens to minimize harm to normal tissues and organs while assuring that treatments remain effective for cancer control.
Radiation beams are being more tightly focused on the cancer, oncologists are avoiding chemotherapy agents that can damage particular organs, and some children are receiving drugs aimed at preventing toxicity to these organs along with their cancer drugs.
Yeh said there is often a "disconnect" when young patients, following successful treatment, switch to a primary care physician for adult care.
"Many times the primary care physicians aren't as familiar with the history of the treatments and the higher risks" of serious complications their patients face, she pointed out.
Diller added that because most physicians will see very few patients with a history of childhood cancer, they may not be alert to symptoms that could signal a recurrence or a new cancer.
For instance, she said, the common complaint of heartburn would normally not be cause for great concern in someone without a prior history of cancer, but in a survivor, it should be investigated as a possible indicator of stomach cancer.
Diller said: "It is not reasonable to expect a primary care doctor who has one childhood cancer survivor in his or her practice to know about all the prior treatments used and their long-term after-effects.
"As pediatric oncologists we should be arming the patient transitioning to adult primary care with personalized information about their treatment, and creating a survivorship care plan for them."
The additional risks of illness and death conferred by childhood cancer and its treatments have been studied previously, but findings were not translated into estimated life expectancy, said the scientists.
Their new research drew on data collected in the Childhood Cancer Survivor Study (CCSS) on individuals who were under age 21 when diagnosed with cancer between 1970 and 1986, and who survived at least five years.
Those patients have been followed only for 20 to 30 years, Yeh said, so lifetime outcomes aren't yet known.
Yeh said: "This study highlights the potential for comprehensive survivorship care.
"We are hopeful that this care, including appropriate screening and greater awareness among primary care physicians, can reduce the mortality risks associated with a history of childhood cancer."
The study has appeared in the April 6 issue of the Annals of Internal Medicine. (ANI)