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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Patient Information [NCI] - Cardiovascular System

Heart and blood vessel late effects are more likely to occur after treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause heart and blood vessel late effects:

Radiation to the chest and certain chemotherapy drugs increase the risk of heart and blood vessel late effects.

The risk of health problems involving the heart and blood vessels increases after treatment with the following:

  • Radiation to the chest or spine: The risk of problems depends on the part of the heart that was exposed to radiation, the amount of radiation given, and whether the radiation was given in small or large doses.
  • Radiation to the brain or neck: The risk of problems depends on the part of the brain or neck that was treated with radiation and the amount of radiation given.
  • Chemotherapy: Chemotherapy with anthracyclines such as doxorubicin, daunorubicin, idarubicin, epirubicin, and mitoxantrone. The risk of problems depends on the total dose of anthracycline given. It also depends on whether a drug called dexrazoxane was given during treatment with anthracyclines to lessen heart and blood vessel damage.
  • Stem cell transplant.
  • Biologic therapy.

Childhood cancer survivors who were treated with both radiation to the chest and chemotherapy using anthracyclines are at greatest risk. New treatments that decrease the amount of radiation given and use lower doses of chemotherapy may decrease the risk of heart and blood vessel late effects.

The following may also increase the risk of heart and blood vessel late effects:

  • Being female.
  • Being young at the time of treatment (the younger the child, the greater the risk).
  • Having other risk factors for heart disease, such as a family history of heart disease, being overweight, smoking, or having high blood pressure, high cholesterol, or diabetes.

Late effects that affect the heart and blood vessels may cause certain health problems.

Childhood cancer survivors who received radiation or certain chemotherapy drugs are at risk of late effects to the heart and blood vessels. These include the following:

  • Abnormal heartbeat.
  • Weakened heart muscle.
  • Inflamed heart or sac around the heart.
  • Damage to the heart valves.
  • Coronary artery disease (hardening of the heart arteries).
  • Congestive heart failure.
  • Chest pain or heart attack.
  • Blood clots or stroke.
  • Carotid artery disease.
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