Understanding the Pulmonary Outcomes in Adult Survivors of Childhood Cancer

Medical advances have led to improved survival rates for children diagnosed with cancer - with five-year survival rates now exceeding 80% - and it is estimated that there are more than 420,000 survivors of childhood cancer alive in the United States.

Despite these improvements, late mortality rates for cancer survivors exceed those of the general population. Leading causes of death in this population include subsequent cancer, followed by pulmonary and cardiovascular events. Lung tissue is particularly sensitive to cancer treatment and the cumulative incidence for pulmonary symptoms - such as lung fibrosis, chronic cough and difficult or labored breathing with exercise - increases over time.

Heart Disease Risk High in Childhood Cancer Survivors
Children who have survived cancer are often at an increased risk of heart disease.

‘The pulmonary outcomes among childhood cancer survivors have been published in the Cancer. The study also evaluates the impact of complications such as asthma and chronic cough on daily activities.’

Tweet it Now

A team of researchers from nine leading academic hospitals and research centers have published a paper in the early online edition of the journal Cancer that describes pulmonary outcomes among childhood cancer survivors. The study also evaluates the impact of complications such as asthma, chronic cough, emphysema and recurrent pneumonia on daily activities.

Led by Andrew C. Dietz of the Center for Childhood Cancer and Blood Diseases at Children's Hospital Los Angeles, and Daniel A. Mulrooney of St. Jude Children's Research Hospital, the study shows that cumulative incidence of lung complications continues to increase up to 25 years from initial cancer diagnosis, and survivors treated with a combination of chemotherapy and radiation are at highest risk.

Based on self-reporting by more than 14,000 individuals identified through the Childhood Cancer Survivor Study, a multi-institutional retrospective cohort study, the findings suggest the need for follow-up health care with advancing age and time from diagnosis.

Chest Radiation to Treat Childhood Cancer Increases Breast Cancer Risk
Patients who received chest radiation for Wilms tumor, a rare childhood cancer, face an increased risk of developing breast cancer later in life due to their radiation exposure, finds a new study.

"While often asymptomatic, damage to the lungs may limit activities of daily living with potential impact on the overall quality of life," said Dietz.

The researchers identified 20,690 five-year cancer survivors, of whom 69% completed a baseline survey, and/or one of two follow-up surveys years later. A comparison, or control, group of 4,027 survivor siblings were also surveyed.

Highest-Risk Form of a Childhood Cancer can be Deciphered Via New Gene-Sequencing Tools
Researchers have used powerful gene-analysis tools to discover mutations in two related genes, ARID1A and ARID1B, involved in the most aggressive form of the childhood cancer.

The rates of chronic cough, oxygen need, lung fibrosis and recurrent pneumonia were elevated among survivors when compared to the control group. Survivors with some of these pulmonary events were also more likely to report limitations on their activities than siblings with the same conditions.

"This study adds to our understanding of specific, long-term risks to pulmonary health for survivors of childhood cancer, and will help refine guidelines for appropriate screening, health surveillance and counseling," said Mulrooney, adding that such knowledge will hopefully contribute to the design and testing of better, targeted interventions to decrease adverse pulmonary events in this population.

Childhood Cancer Survivors Treated With Cranial Radiation Linked to Obesity Risk
For certain childhood cancer survivors, effective counseling and weight loss interventions are necessary activities to maximize treatment outcomes.

Source-Eurekalert