Children and Cancer: What Happens the Second Time Around?
For almost 10 years, Neglia and his colleagues have been studying the health and well-being of nearly 14,000 people from the U.S. and Canada who have survived childhood cancer for at least five years. The average length of survival since cancer therapy among these study participants is 15 years.
So far, 298 of these individuals who survived a childhood cancer have gone on to develop different cancers later in life. The most common of these are breast, thyroid, and brain cancer. Both Kaman and Neglia emphasized the importance of keeping these findings in perspective. That is, the risk of developing a cancer later in life after being treated for cancer in childhood is still small and is far outweighed by the great benefits of that initial treatment.
But overall, these individuals appear to have a six times greater risk of developing another cancer compared to a similar people who did not have childhood cancer. Those at highest risk for developing another cancer later in life are those who had Hodgkin's disease or who received radiation therapy in childhood. Those treated for leukemia in childhood are at greatest risk for developing a brain tumor later on.
"We did not find any association at all between age at therapy and the risk of breast cancer," said Neglia. "Previous studies have suggested that young girls treated for Hodgkin's disease with radiation therapy to the chest during times of breast development may be most susceptible [to developing breast cancer later on]. That actually has led to gender and age-specific recommendations for therapy. Our results contradict this finding and really stress the importance of close follow-up for any girl who received radiation to the chest at any point in childhood."
"Patients [who had cancer in childhood] need to know what the treatment was [that] they received, and they need to speak to a ... physician who is actually versed in these long-term consequences of therapy, to discuss what, if any, recommendations for follow-up are important," said Neglia. "An example of this is that any woman who received radiation to the chest during childhood [should] receive a mammogram, probably, at age 25."