Advances in treatment for childhood cancers has progressed remarkably over the years, resulting in much greater survival rates than ever before. In fact, death from childhood cancer has declined nearly 70% over the past four decades.1
There are multiple types of childhood cancer and a variety of effective treatments. The most common types are leukemia and lymphoma (cancers that affect blood cells), as well as brain and other central nervous system tumors. Treatments vary depending on the type of cancer and how advanced it is. Possible options include surgery, radiation therapy, chemotherapy, immunotherapy, and stem cell transplant.1
Long-term or late effects of childhood cancer treatment
Most survivors of childhood cancer do not develop further complications. However, there are some long-term or late health effects (those that don’t manifest until months or years after treatment) that can result from the treatments of childhood cancer. It is therefore important for parents and healthcare providers to monitor children over time for these complications.2 There is substantial ongoing research that studies these effects, as well as ways to minimize them.
Factors influencing long-term or later health problems
There are several factors that affect whether children might develop long-term or late effects of childhood cancer treatment:
The type and length of treatment
The location of the cancer
The child’s gender and age when they were treated
The overall health of the child2
Heart effects of childhood cancer treatment
The powerful chemotherapy medicines and radiation therapies that doctors use to treat cancer in children can also have the unfortunate side effect of damaging otherwise healthy tissues, as well.
Certain chemotherapy agents can sometimes cause chronic heart failure and heart muscle injury. Likewise, chest radiation can sometimes cause scarring, inflammation, or coronary heart disease.4
These are possible complications that can sometimes result from childhood cancer treatment:
Weakened heart muscle
Damage to the heart valves
Hardening of the arteries in the heart
Congestive heart failure
Chest pain or heart attack3
High blood pressure among survivors of childhood cancer
Because of the documented heart complications that can affect childhood cancer survivors, researchers want to learn as much as possible about prevention and early detection. It’s also important to understand more about additional risk factors that could put additional stress on an already weakened heart.
A recent study showed that people who had survived childhood cancer were more than 2.6 times as likely to develop high blood pressure as members of the general population.5,6 This is important because high blood pressure increases the risk of heart problems and is a treatable condition.
The study was authored by Todd M. Gibson and colleagues from the epidemiology/cancer control department at St. Jude Children’s Research Hospital in Memphis, TN. The researchers followed more than 3,000 adult 10-year childhood cancer survivors who are enrolled in an ongoing study at St. Jude’s.
The study showed that the frequency of high blood pressure increased with age. At 30, 13% of the survivors had high blood pressure; at age 40, the number had increased to 37%; and by age 50, it was more than 70%.5 These numbers are more typical of people in the general population who are 10 years older than the study participants, according to Dr. Gibson.6
Surprisingly, there was not a significant association between chemotherapy or radiation therapy and the risk of high blood pressure, meaning that many factors likely influence the risk of hypertension in childhood cancer survivors.
Childhood Cancers. National Cancer Institute. https://www.cancer.gov/types/childhood-cancers#types Accessed April 1, 2018.
Long-Term and Late Effects of Treatment for Childhood Leukemia or Lymphoma Facts. Leukemia & Lymphoma Society. Available at https://www.lls.org/sites/default/files/file_assets/FS15_LongTermandLateEffects_FactSheet.pdf Published March 2013. Accessed April 1, 2018.
PDQ® Pediatric Treatment Editorial Board. PDQ Late Effects of Treatment for Childhood Cancer. Bethesda, MD: National Cancer Institute. Updated November 17, 2018. Available at: https://www.cancer.gov/types/childhood-cancers/late-effects-pdq. Accessed April 1, 2018.
Physical Effects. Leukemia & Lymphoma Society. Available at: https://www.lls.org/childhood-blood-cancer/long-term-and-late-effects-of-treatment-for-childhood-cancer-survivors/physical-effects. Accessed April 1, 2018.
Todd M. Gibson, Zhenghong Li, Daniel M. Green, et al. Blood Pressure Status in Adult Survivors of Childhood Cancer: A Report from the St. Jude Lifetime Cohort Study. Cancer Epidemiol Biomarkers Prev; 26(12); 1705–13. Available at http://cebp.aacrjournals.org/content/26/12/1705. Accessed April 1, 2018.
Adult Survivors of Childhood Cancer Are More Likely to Develop High Blood Pressure. American Association for Cancer Research. Published November 22, 2017. http://www.aacr.org/Newsroom/Pages/News-Release-Detail.aspx?ItemID=1115#.WsE2WmaZORu. Accessed April 1, 2018.