Researchers raise concerns about faster aging, possible early-onset dementia, for children and young adult cancer survivors

Adolescent and young adult cancer survivors age faster than their peers who did not have cancer, according to a new study, which also describes how accelerated aging occurs both at the cellular level and in brain function, such as memory, attention, and ability to process information.

The journal Nature Communications recently published the research, led by University of Rochester Wilmot Cancer Institute investigator AnnaLynn Williams, PhD, and co-corresponding author Kevin Krull, PhD, from St. Jude Children’s Research Hospital.

Ongoing research at Wilmot holds potential good news for the future: Young adults may be able to reverse accelerated aging by quitting smoking, exercising, improving their nutrition, and making other healthy lifestyle changes, Williams said.

“Young cancer survivors have many more decades of life to live,” she said. “So, if these accelerated aging changes are occurring early on and setting them on a different trajectory, the goal is to intervene to not only increase their lifespan but improve their quality of life.”

Many cancer survivors who were treated as children or young adults are trying to finish their education, build careers, establish independence, or start a family—and defects in brain health can make those things challenging.

“It’s kind of like a perfect storm,” Williams said. “This is why we see many survivors having worse educational and employment outcomes than their siblings.”

A cancer survivor herself, Williams is an assistant professor in the Department of Surgery and part of Wilmot’s Cancer Prevention and Control research program, a national leader in managing symptom burdens for survivors.

Of the approximately 1,400 patients in the St. Jude study group, all were at least five years past treatment, and some were decades-long survivors. The majority had acute lymphoblastic leukemia (ALL) or Hodgkin lymphoma.

Researchers confirmed that the survivors aged faster on a cellular/biological level no matter what treatment they received as children. In fact, results showed that chemotherapy, which can change DNA structure and broadly damage tissue and cells, speeds up aging fastest.

The team also discovered that cellular aging is intricately linked to brain function. For example, survivors with higher biological age (as opposed to the age on their birth certificates) struggled the most with memory and attention.

For survivors treated with radiation directly to the brain, the goal is to stop any deficits from getting worse, Williams said.

The next steps are to determine the ideal time to intervene, and that work is ongoing at Wilmot.

For example, Williams recently conducted a pilot study including tissue and cell samples collected before and after treatment from 50 people with Hodgkin lymphoma and compared them to 50 healthy peers. She collaborated with John Ashton, PhD, MBA, director of the Genomics Shared Resource at Wilmot, to analyze the data for clues to determine when accelerated aging starts. Is it during treatment? Or a few years later?

Other Wilmot investigators are conducting similar research for women with breast cancer and in older adults with leukemia, with the goal of reversing the aging. One recent study has already shown the value of exercise to reverse aging associated with cancer.

The National Cancer Institute funded Williams’ study.