By Bill Berkrot and Ransdell Pierson
DALLAS, Nov 17 (Reuters) – Children who survive cancer
treatment face increased heart health risk and should take
measures soon after life-saving therapy to reduce the risk of
serious problems later in life, according to research presented
at a major medical meeting.
The five-year survival rate from childhood cancer has soared
from 58 percent in 1975 to 1977, to 83 percent in the period
from 2003 to 2009.
While earlier research had shown that childhood cancer
survivors face heart disease and other potentially serious
health problems decades after treatment, a new study found that
chemotherapy takes a toll on artery health while survivors are
still children, leaving them vulnerable to premature
atherosclerosis and heart disease.
“We may need to start the clock earlier monitoring these
children,” said Donald Dengel, lead author of the study
presented on Sunday at the American Heart Association scientific
meeting in Dallas.
“Healthcare providers who are managing chemotherapy-treated
childhood cancer survivors need to monitor cardiovascular risk
factors immediately following completion of their patients’
cancer therapy,” said Dengel, a professor at the University of
Minnesota.
Researchers used measures of the brachial and carotid
arteries to test artery stiffness, thickness and function of 319
Americans ages 9 to 18 who had survived leukemia or other
cancers, and compared the findings to 208 siblings not diagnosed
with cancer.
Signs of premature heart disease, demonstrated by a decline
in artery function, was more prevalent among those children and
teenagers who had survived cancer, researchers found.
Childhood leukemia survivors had a 9 percent decrease in
arterial health after completing chemotherapy compared with the
non-cancer group.
“Given the increased risk, children who survive cancer
should make lifestyle changes to lower their cardiovascular
risk,” Dengel said.
Such changes would include a heart-healthy diet and regular
exercise.
However, more studies would be needed to assess whether
blood vessel health can be improved by lifestyle changes in
these survivors as has been shown in studies of childhood
obesity. It may be that damage caused by chemotherapy cannot be
reversed, Dengel said.
“I really don’t think it’s the cancer per se, it’s the
treatment” that is causing the problems, Dengel added.
A pilot study has begun in which childhood cancer survivors
will be given cholesterol lowering statins after puberty to see
if that can reduce the risk of future heart problems.
“It may serve them better to be more aggressive,” Dengel
said.
The study did have limitations, researchers noted.
Because of differences in cancer treatments, they were
unable to attribute changes in arterial health to any particular
chemotherapy.
In addition, most of the children in the study were white,
so the findings were not necessarily applicable to other racial
or ethnic groups.
Children in the study, which was funded by the National
Institutes of Health and other research groups, had survived at
least five years since their initial cancer diagnosis,
researchers said.
They said it was the first such study to look at heart
health of childhood cancer survivors while they were still
children.
(Reporting by Bill Berkrot; Editing by Maureen Bavdek)
