THIS DID NOT MAKE MY DAY BUT WE HAVE TO TAKE THIS CHANCE.

Tuesday, May 17, 2005 - Page updated at 12:00 a.m.
Childhood-cancer survivors often seriously ill later
By The Washington Post and The Associated Press

Two-thirds of children who are cured of cancer in childhood end up with at least one long-term health problem arising from their treatment. One-third have severe complications such as mental retardation, lung damage or congestive heart failure. In all, they are four times as likely to have serious health problems as their siblings.
That is the sobering conclusion of the biggest and most detailed look yet at the long-term health of childhood-cancer survivors. It was presented yesterday at the American Society of Clinical Oncology meeting in Orlando, Fla.
Researchers hope the data, drawn from the experiences of about 10,000 cancer survivors, will offer useful information to doctors treating this ever-growing population. About 75 percent of children treated for cancer survive at least five years, and there are now about 270,000 survivors of childhood cancer in the United States.
"If someone is a survivor of childhood or adolescent cancer, you need to be followed by a doctor who is familiar with the risks, and the vast majority are not," said Kevin Oeffinger, a physician at the University of Texas Southwestern Medical Center in Dallas who led the study.
Cancer treatments have vastly improved in recent years, so today's patients shouldn't suffer as many future problems, specialists say.
Radiation is responsible for much of the damage, and doses were much higher decades ago than they are today, Oeffinger said.
Surgery can be disfiguring, and when done to remove a brain tumor it can cause brain damage. Chemotherapy with a class of drugs called anthracyclines can weaken the heart muscle and cause congestive heart failure. Drugs called alkylating agents can cause sterility.
The new study looked at the experiences of 10,397 survivors older than 18 who had been diagnosed with cancer between 1970 and 1986. They and about 3,000 of their siblings were sent questionnaires about their health. Details of their cancer treatment were collected from the 25 U.S. hospitals and one Canadian hospital.
At the time they were questioned, their average age was 27 and they were an average of 18 years removed from their cancer treatment. Leukemia was the most common cancer (29 percent), followed by Hodgkin's lymphoma (18 percent) and brain tumors (13 percent). Two-thirds had received chemotherapy and just under two-thirds had gotten radiation.
Oeffinger and his colleagues found that by 30 years after treatment, one-third had severe or life-threatening health problems or had died of a disease different from their original cancer. Severe problems included blindness or deafness, disabling breathing problems, congestive heart failure, sterility and amputation.

Life-threatening problems included second cancers, heart attacks, strokes, organ failure requiring transplant, and brain damage so severe that survivors could not function independently.
Some of the deaths were from cancers different from the original ones. Other studies have shown that 20 percent of women who get radiation to the chest in childhood for Hodgkin's lymphoma develop breast cancer by age 45.
The study couldn't prove that later health problems arose from the cancer treatment, but the comparison with siblings indirectly suggests it was a major factor. The survivors were 4.2 times as likely to die or have severe or life-threatening problems as their brothers and sisters.
The researchers believe that if more physicians knew the long-term health risks faced by childhood-cancer survivors, they could intervene in ways that might limit or delay the complications.
Copyright © 2005 The Seattle Times Company