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Childhood Cancer Survivors Unhealthy as Adults

Researchers Say Survivors Have More Physical and Emotional Problems
WebMD Health News

May 16, 2005 (Orlando, Fla.) -- Adult survivors of childhood cancer have more physical and emotional problems than other men and women, according to two new studies.

In one study, researchers found that two out of three adults who beat childhood cancer develop cirrhosis, heart disease, and other serious health problems.

A separate study showed that nearly three-fourths of cancer survivors experience serious emotional problems such as depression, anxiety, and other lingering psychiatric problems.

There are more than 270,000 adults who are survivors of childhood cancer in the U.S., according to researchers, who presented their studies here Monday at the annual meeting of the American Society for Clinical Oncology.

According to the National Cancer Institute, over the past 20 years there has been some increase in the incidence of children diagnosed with all forms of cancers. During this same time, however, death rates declined dramatically and five-year survival rates have increased for most childhood cancers. The improvement in survival is due mostly to advances in treatment resulting in a cure.

Health Problems of Cancer Survivors

The Childhood Cancer Survivor Study included 10,397 people who were diagnosed with a childhood cancer between 1970 and 1986. They had survived a variety of cancers, chiefly brain or bone tumors or blood cell cancers such as leukemia or lymphoma.

Compared with their siblings, the survivors "were almost twice as likely to have some health condition," says researcher Kevin C. Oeffinger, MD, professor of family medicine at the University of Texas Southwestern Medical Center in Dallas.

When he looked at more serious medical problems, the outlook was even bleaker. The cancer survivors were 4.4 times more likely to have heart failure, secondary cancers, mental retardation, or other "severe, life-threatening or disabling" medical conditions than their brothers and sisters.

Some of the survivors needed kidney transplants, others were legally blind, and still others suffered paralysis, he says.

Radiation a Major Culprit

Large doses of radiation used to diagnose and treat some of the cancers seem to be the main reason, Oeffinger tells WebMD. Some of the toxic drugs used to kill cancer cells are also to blame, he says.

Sandra J. Horning MD, the incoming president of the American Society for Clinical Oncology and professor of medicine at Stanford University, says some "fairly dramatic changes" in doses and delivery of radiation as well as in chemotherapy regimens put children today at lower risk of secondary health problems.

Since the 1970s and 1980s "there has been a tremendous change" in radiation, which is now more targeted to the area of a tumor.

"Also, we use lower doses and have lessened the duration of some chemotherapy regimens," she says.

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