ASCO Annual Meeting
May 31, 2015
A recent analysis of information from more than 34,000 children who participated in the Childhood Cancer Survivor Study shows that modern cancer care is reducing deaths from cancer and long-term side effects. Previous research has shown that up to 18% of childhood cancer survivors die within 30 years of diagnosis. While deaths from worsening or recurrent cancers tend to slow over time, deaths from other health-related reasons, such as long-term side effects tend to increase.
In this study, researchers found that 6% of children diagnosed with cancer in the 1990s died within 15 years of diagnosis, compared with 12% of those diagnosed in the early 1970s. In addition, about 2% of survivors diagnosed in the 1990s died from other health-related reasons, compared with almost 4% of those diagnosed in the early 1970s.
Researchers also found children diagnosed with Wilms tumor, Hodgkin lymphoma, and acute lymphoblastic leukemia (ALL) had the highest decrease in the risk of death from long-term side effects. One major factor that may be responsible for the improved long-term health of cancer survivors is that doctors have reduced treatments for childhood cancers that are less aggressive without making the treatment less effective. For example, in the 1970s, 86% of patients with ALL received radiation therapy to the head, compared with only 22% in the 1990s. The dose of radiation therapy has also been reduced for the treatment of Hodgkin lymphoma and Wilms tumor. And, the dose of a type of chemotherapy called anthracyclines that are linked with heart problems has also decreased for children diagnosed with Hodgkin lymphoma, Wilms tumor, and ALL.
What this means for patients
“Fifty years ago, only one in five children would survive cancer, and today over 80% are alive five years after diagnosis. Yet, these survivors still grow up with increased risk of dying from late effects, like heart disease and second cancers,” said the lead study author Gregory T. Armstrong, MD, MSCE, a pediatric oncologist at St. Jude Children’s Research Hospital in Memphis, TN. “While the modernization of cancer therapy has probably made the most significant difference, improvements in supportive care for survivors, and screening, detection, and treatment of late effects, like new cancers and heart and lung disease, have played an important role in extending their lifespan as well.”
Dr. Armstrong was a recipient of a Conquer Cancer Foundation of ASCO Career Development Award in 2008.
Questions to ask your doctor if you are a childhood cancer survivor
- When was I diagnosed with cancer?
- What treatments did I receive?
- What are the long-term side effects? How can they be managed?
Questions to ask your child’s doctor if your child has been diagnosed with cancer
- What type of cancer does my child have?
- What is the chance of recovery?
- What are the treatment options?
- What are the long-term side effects of each treatment option?
- What can be done to lower the risk of long-term side effects?