Heart Takes a Hit From Childhood Cancer
Treatment regimen may be to blame for survivors' cardiac ailments

(HealthDay News) -- Children who conquer cancer shouldn't let their guard down. As they grow up, research now shows, they're far more apt to develop heart disease than their healthier peers.

Dr. Daniel A. Mulrooney, assistant professor of pediatrics at the Masonic Cancer Center at the University of Minnesota, found that adults who had cancer as a child or teen are five to 10 times more likely to have cardiovascular disease and their heart problems appear at a much younger age than people who didn't have childhood cancer.

The finding stems from a study that examined information on 14,358 five-year survivors of childhood cancer who'd been diagnosed with one of eight types of cancer, including leukemia, lymphoma and brain malignancies, at age 21 or younger. They were compared, heart-health-wise, with a group of 3,899 healthy siblings.

The childhood cancer survivors were almost six times more likely than their healthy brothers or sisters to have congestive heart failure, about five times more likely to report having had a heart attack or valvular heart disease, six times more likely to have pericardial disease, eight times more likely to have had an angiography and 10 times more likely to have atherosclerosis, or hardening of the arteries.

The cancer survivors ranged in age from 8 to 51. The average age of those with heart problems was 27.5 years.

"We're talking about a very young population that's having very significant cardiac disease and is likely not being monitored appropriately," Mulrooney told HealthDay . "It is very important that they be followed and that risk factors and cardiovascular monitoring that we would think of in an older population be implemented in a younger population."

Dr. Karen Burns, director of a clinic at Cincinnati Children's Hospital for childhood cancer survivors, said that most of the heart problems that occur in survivors of childhood cancer are the result of treatment with a class of chemotherapy drugs called anthracyclines, which affect cardiac muscle, and from radiation, if the radiation field included the heart.

Mulrooney's study showed just how much those treatments can increase the risk of heart problems. He and his fellow researchers determined that exposure to anthracyclines increased the risk of congestive heart failure about fourfold, roughly doubled the risk of pericardial and valvular disease and almost tripled the odds of needing an angiography.

Exposing the heart to radiation treatment doubled the risk of congestive heart failure, heart attack and pericardial disease, almost tripled the risk of valvular disease and boosted the risk of atherosclerosis by a factor of more than five, the study found. The findings were presented at a meeting of the American Society of Clinical Oncology.

"We see this [increased risk of heart problems] in our long-term follow-up clinic," Mulrooney said.

"We identify patients who are at risk based on this analysis and may do an echocardiogram or a lipid panel, things we might not typically do in a 20-year-old," he said. "There are tools out there, and getting this knowledge out there as well would be helpful so primary care physicians will be more aware, oncologists and cardiologists will be aware, and patients as well."

There are an estimated 270,000 childhood cancer survivors in the United States .

On the Web

To learn more about the long-term effects of childhood cancer treatment, visit the U.S. National Cancer Institute.

SOURCES: HealthDay News ; Daniel A. Mulrooney, M.D., assistant professor of pediatrics, Masonic Cancer Center, University of Minnesota, Minneapolis; Karen Burns, M.D., clinical director, ATP5+ Clinic for Childhood Cancer Survivors, Cincinnati Children's Hospital, Cincinnati; May 15, 2008, presentation, American Society of Clinical Oncology annual meeting, Chicago
Author: Robert Preidt
Publication Date: May 31, 2009
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