The cost of a cure

by Tripp Underwood on April 20, 2010

girl in bedSince the 1970’s, advancements in medical technology have led to much higher survival rates among children cancer patients. Thanks to the invention and/or further development of cancer treatments like radiation, chemotherapy and surgery, the survival rate of children with cancer has risen dramatically in the past 30 years. But as the recipients of these treatments approach middle age, new data concerning their long term health effects is coming to light.

An analysis recently released by the Annals of Internal Medicine estimates that childhood cancer survivors are more likely to die earlier than their peers who have never undergone cancer treatment. While this information may seem disheartening, Lisa Diller, MD, senior author of the study and clinical director of Pediatric Oncology at Dana-Farber Cancer Institute and Children’s Hospital Boston points out that despite the potential dangers of lasting effects, these types of medical advancements have done far more good than harm.

The study’s findings are based on a mathematical model and copious amounts of data collected for the Childhood Cancer Survivors Study. Often early deaths can be tied to the cancer the patient overcame as a child— either in the form of recurrence, a greater susceptibility to other cancers or as a late effect of cancer treatment itself. 

“Although the diminished life-expectancy that we see in this model is concerning, it is important to remember that we are only able to observe the ‘late effects’ of treatment because there are survivors,” says Diller. “Survivorship research is the outcome of a wonderful success, in a way, the successful treatment of once uniformly fatal diseases.”

Surgery, radiation therapy and chemotherapy are all designed to kill rapidly growing cells like those found in cancer. But in young people, whose internal organs and tissue are naturally growing at a fast pace, treatment can sometimes damage healthy growing cells, and in many cases that damage can pose health complications later on in life.

Diller says one of the primary goals of her research is to help doctors recognize certain symptoms that would be considered minor for most people, but could signify more serious medical issues for childhood cancer survivors. She says if these signs are recognized and examined more quickly, physicians have a far better chance of beginning treatment before things get worse.

“A lot of primary care providers may only have one or two patients who are childhood cancer survivors, so they may not be aware of some of the warning signs to look for when treating these patients later in life,” she says. “Hopefully this model will help them in identifying these symptoms early on.”

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