• 2/4/2006
  • New York, NY
  • Anne Harding
  • Reuters UK (today.reuters.co.uk)

Children who survive cancer face a four-fold increased risk of developing cancers as adults, and these malignancies appear at an earlier-than-normal age, a new study shows.

But careful screening — as well as awareness of potential early symptoms — can help ensure that disease is caught early, when it’s much easier to treat, Dr. Nina S. Kadan-Lottick told Reuters Health in an interview.

“Most of these subsequent cancers are amenable to screening and intervention, so knowledge is power,” said Kadan-Lottick, of Yale University School of Medicine in New Haven, Connecticut.

She and her colleagues report on follow-up of 13,136 people who had survived for at least five years after being diagnosed with a childhood cancer between 1970 and 1986. Seventy-one patients developed a subsequent cancer, at an average age of 27.

Kadan-Lottick stressed that while childhood cancer survivors do face increased cancer risk, “the vast majority of survivors do very well and will never have one of these outcomes.”

Patients with neuroblastoma were 24 times more likely to develop a second cancer, and had a more than 300-fold increased risk of kidney cancer. Hodgkin’s lymphoma survivors were at more than four-fold increased risk of gastrointestinal cancer. Survivors of soft tissue sarcoma, neuroblastoma or leukemia were all at about a 20-fold increased risk of head and neck cancer.

Two-thirds of patients who developed a second cancer had previously received radiation therapy to that part of the body, a known cancer risk. However, the rest had either never been given radiation, or had radiation to a different part of the body from where the second cancer occurred.

This suggests that certain types of chemo may increase cancer risk, or that some patients may have a genetic risk of developing carcinoma or responding to chemo by developing cancer, Kadan-Lottick noted. There were too few cases of cancer in the current study to answer these questions, she added. “That’s what we would like to focus future efforts at understanding.”

The researcher emphasized that intensified screening among childhood cancer survivors, such as colonoscopies to watch for gastrointestinal cancer and urine tests for kidney malignancy, can help identify disease at an early stage, when it is most curable. Patients can also be made aware of potential symptoms, such as swelling of lymph nodes or difficulty swallowing for head and neck cancer.

Source:
Journal of Clinical Oncology, January 20, 2006.