© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
The study: In an analysis of data from the Childhood Cancer Survivorship Study (CCSS), researchers compared the development of heart disease in 14,358 childhood cancer survivors with 3,899 of their siblings. The survivors were originally diagnosed between 1970 and 1986. The CCSS is the largest study of childhood cancer survivors and has provided the greatest amount of data on the long-term side effects of cancer treatment.
The results: Childhood cancer survivors are 5 to 10 times more likely than their healthy siblings to develop heart disease in early adulthood, but the occurrence of heart conditions in survivors is low overall. The conditions survivors were at risk for and developed include:
- Hardening of the arteries: 10 times greater risk; occurred in 2% of survivors
- Congestive heart failure: 6 times greater risk; occurred in 4% of survivors
- Heart attack: 5 times greater risk; occurred in 1% of survivors
- Pericardial disease (inflammation of the membrane surrounding the heart): 6 times greater risk; occurred in 3% of survivors
- Valvular disease (disease that affects the flow of blood in the heart): 5 times greater risk; occurred in 4% of survivors
In addition, patients who had been treated with anthracycline drugs, such as doxorubicin (Adriamycin), or radiation therapy to the heart were 2 to 5 times more likely to develop heart disease than those who did not have these treatments.
What this means for patients
“This study shows that childhood cancer survivors in their 20s are developing the kinds of heart disease we typically see in older adults,” said lead author Daniel A. Mulrooney, MD, Assistant Professor of Pediatrics at the Masonic Cancer Center, University of Minnesota in Minneapolis. “Our findings emphasize the need to educate patients, their families, and other health-care providers about the risk of delayed side effects of cancer treatment, so that patients can be closely monitored after treatment and appropriately followed.”
Today's treatments could possibly be safer than those used in the 1970s and 1980s because many newer treatments directly target the cancer. However, information about the long-term side effects of many newer treatments is not yet available. Survivors of childhood cancer, and current patients and their families, should talk with their doctor about the possible long-term effects of treatment and develop a follow-up care plan to monitor the child's long-term health.Many doctors also recommend keeping a detailed record of diagnosis and treatment information to help with any medical care the child needs in the future.
What to ask your doctor
- Would you help compile a detailed medical record of my (or my child's) diagnosis, treatment, and adjustments to treatment?
- What are the possible long-term side effects of this treatment?
- What follow-up tests will I need, and how often will I need them?
For more information