Two-thirds of children who survive cancer go on to face higher risks of another cancer, heart disease, or other health problems as they grow up, researchers reported Wednesday.
They need to take special care of their health, watching their weight, eating especially healthily, exercising as much as possible and getting screened for cancer and heart disease, the researchers said.
The report, published in the July-August issue of “CA: A Cancer Journal for Clinicians,” finds the problems affect up to 250,000 Americans because so many people now survive childhood cancer.
Last month, the Centers for Disease Control and Prevention reported that 79 percent of children under the age of 15 with cancer now live five years or more. That compares to 56 percent in the mid-1970s.
“People are ready to close the door on cancer and forget they ever had it; yet, it affects their health for the rest of their life,” said Dr. Kevin Oeffinger of the University of Texas Southwestern Medical Center at Dallas.
Damage from radiation
Oeffinger and Dr. Melissa Hudson of St. Jude Children’s Research Hospital in Memphis, Tennessee, looked at all the studies they could find on the later health effects of childhood cancer for their report.
They found the children risk secondary cancers, heart disease, infertility, early menopause, neurocognitive defects, depression, anxiety and moderate to extreme physical pain.
Much is due to the therapy that saved their lives, Oeffinger said in a telephone interview.
“There is organ damage that occurs because of radiation or chemotherapy,” Oeffinger said.
“Some of it may take 20 or 30 years to show. It may damage one, two or three different organ systems,” he added.
Cancer survivors can help themselves, he said. “Many of the risks are modifiable,” he said.
An Internet Web site at http://www.survivorshipguidelines.org/ advises cancer survivors to eat plenty of fresh fruits and vegetables, to never smoke, to eat less meat and to exercise.
Radiation perhaps causes the most damage but often was and is the best way to cure a patient.
For instance, radiation was the best therapy available for Hodgkins disease in the 1970s, although drugs are now available, Oeffinger said. But the high doses of X-rays make survivors more likely to suffer heart damage and breast cancer later in life, he said.
Radiation to kill brain tumors also killed healthy brain cells and can cause blindness, deafness, and a 20- to 30-point drop in IQ, he noted.
“Therapies nowadays are certainly more adapted. However, we are also trying to push that cure envelope -- trying to understand how toxic we can be and still have a chance for a cure. It’s a balance,” Oeffinger said.
Survivors may also have psychological issues.
Oeffinger, a family physician who runs a special program for childhood cancer survivors, said they may face an unexpected roadblock -- insurance.
“At least half the patients I take care of don’t have insurance,” he said. When they do have it, the premiums can be high.
“It can be incredibly expensive. It’s because they have the ’C’ word in (their medical history),” he added.
Oeffinger said he advises his patients, as they enter college, to try to find jobs at big companies that are likely to provide medical insurance.
