MINNEAPOLIS / ST. PAUL (May 16, 2008) -- A Masonic Cancer Center, University of Minnesota researcher and physician has found that survivors of childhood and young adult cancers are five to ten times more likely than their healthy brothers and sisters to develop serious heart problems. The problems can develop at an early age and emphasize the need for continuous medical monitoring.
Daniel Mulrooney, M.D., assistant professor of pediatrics with the University of Minnesota Medical School and a cancer center member, led the research team on this study. The study compared 14,358 survivors enrolled in the Childhood Cancer Survivor Study (CCSS) with 3,899 of their siblings who did not have cancer. The findings will be presented at the 44th annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, Ill.
“Our study showed that survivors were on average 27 years of age when they started developing heart problems usually seen in older adults,” Mulrooney said. “We found survivors had a 10 times greater risk for artherosclerosis or hardening of the coronary arteries; 5.7 times higher risk of congestive heart failure; 4.9 times higher risk for myocardial infarction or heart attack; 6.3 times higher risk for pericardial disease; and, 4.8 times greater risk for valvular disease. The risks were particularly high in survivors who received anthracycline drugs, such as doxorubicin, or radiation therapy to the heart as part of their cancer treatment compared with survivors who did not receive these treatments.
“These findings point to a two-fold need,” Mulrooney said. “First, the need to educate survivors, their family members, physicians, and other health care providers about this risk for cardiovascular disease after life-saving cancer treatment. Second, survivors need to be followed by their health care providers so that possible heart problems can be diagnosed early and treated accordingly.”
The CCSS comprises the largest group of childhood cancer survivors in the world. It is a National Cancer Institute—funded resource to promote and facilitate research among long-term survivors of cancer diagnosed during childhood and adolescence.
Survivors in this study were diagnosed between 1970 and 1986 with cancers including childhood leukemia, central nervous system tumors, Hodgkin’s or non-Hodgkin’s lymphomas, renal tumors, neuroblastoma, soft-tissue sarcomas, or bone cancer. These survivors were 21 years or younger when diagnosed, and they had survived five years or longer after their cancer treatment. For this study, they completed a written questionnaire about their cardiovascular conditions.
Mulrooney noted that while chemotherapy and radiation therapy for childhood and young adult cancers have improved markedly in the last decade, survivors should still be monitored in a long-term, follow-up clinic as a precaution to detect heart conditions before they become a major medical problem.
“Interestingly, we found that childhood cancer survivors who did not develop heart problems 30 years after their cancer treatment had an overall low risk,” Mulrooney said. “Only 2 percent of these long-term survivors reported having atherosclerosis, 4 percent had congestive heart failure, 1 percent suffered a heart attack, 3 percent developed pericardial disease, and 4 percent had valvular heart disease.”
Mulrooney’s research colleagues on this study included Mark Yeazel, M.D., and Paul Mitby, M.S., University of Minnesota; Toana Kawashima, M.S., and Wendy Leisenring, Ph.D., Fred Hutchinson Cancer Research Center in Seattle; Marilyn Stovall, Ph.D., University of Texas MD Anderson Cancer Center in Houston; Daniel Green, M.D., Roswell Park Cancer Institute in Buffalo, NY; Charles Sklar, M.D., Memorial Sloan-Kettering Cancer Center in New York; Leslie Robison, Ph.D., St. Jude Children’s Research Hospital in Memphis; Ann Mertens, Ph.D., Emory University in Atlanta. This study was funded with a grant from the National Cancer Institute.
The Masonic Cancer Center, University of Minnesota is part of the University’s Academic Health Center. It is designated by the National Cancer Institute as a Comprehensive Cancer Center. For more information about the Masonic Cancer Center, visit www.cancer.umn.edu or call 612-624-2620.
The Academic Health Center is home to the University of Minnesota’s six health professional schools and colleges as well as several health-related centers and institutes. Founded in 1851, the University is one of the oldest and largest land grant institutions in the country. The AHC prepares the new health professionals who improve the health of communities, discover and deliver new treatments and cures, and strengthen the health economy.
Contact: Mary Lawson, Masonic Cancer Center, 612-624-6165, mlawson@umn.edu
Sara Buss, Academic Health Center, 612-626-7037, buss@umn.edu