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Childhood cancer cures increase risk for adultsBy ASSOCIATED PRESS © St. Petersburg Times, published March 28, 2001 NEW ORLEANS -- Survivors of childhood cancer face six times the usual risk of getting entirely new cancers in early adulthood -- almost certainly because of the chemotherapy and radiation treatments that cured them, a large study found. Doctors' ability to cure childhood malignancy has been one of the clearest successes of the war on cancer. About 1 in every 1,000 Americans in their 20s is a cancer survivor. Several earlier reports have shown a surprisingly high cancer risk as young patients grow older, but the latest study, involving more than 13,000 survivors, gives the most comprehensive assessment yet of this unexpected downside of a medical victory. When doctors began regularly curing childhood leukemia in the mid-1970s, little thought was given to the possibility of future ill effects. But now they routinely try to use the least damaging treatment that will still cure the disease. "It's clear that people treated for cancer in childhood are at increased risk of cancer later in life," said Dr. Joseph Neglia of the University of Minnesota. He presented the findings Tuesday at a meeting of the American Association for Cancer Research. His research shows that while new cancer -- especially breast cancer -- occurs more often than expected in these patients, it still is rare. And the benefits of having cancer cured in childhood far outweigh any later risk. Overall, the cancer survivors have a 3 percent risk of developing an entirely new cancer over the next 20 years. This is about six times greater than would be expected among people this age. The researchers based their findings on a follow-up of 13,581 children and adolescents from 25 hospitals in the United States and Canada who had survived at least five years after treatment for leukemia and other cancers. Their average age is now in the late 20s. Among the study's findings: Breast cancer was 16 times more common than expected and often occurred when women reached their late 20s and 30s. The researchers recommended that girls who got radiation to their chests have a mammogram by 25. Bone cancer was 19 times more common than usual and thyroid 11 times more common among the cancer survivors. The highest extra cancer risk was seen in children who were treated for Hodgkin's disease. They had an almost 8 percent chance of new cancer during 20 years of follow-up. The risk was lowest among longtime survivors of non-Hodgkin's lymphoma.
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