MINNEAPOLIS / ST. PAUL -- Investigators from a national collaborative effort to study survivors of childhood cancer will present results from six separate studies at the American Society of Clinical Oncology (ASCO) meeting in Orlando, Fla., May 19. Results from the Childhood Cancer Survivor Study (CCSS) have found that the majority of survivors of childhood cancer report overall general good health, but the therapies that were used to cure some survivors may put them at increased risk for long-term complications, including impaired pulmonary function, obesity, physical limitations, reduced quality of life, depression and special educational needs.
"We are pleased to find that survivors are reporting general good health," said the project's principal investigator, Les Robison, Ph.D., professor of pediatrics and associate director of the University of Minnesota Cancer Center. "Identifying potential complications that can arise from childhood cancer treatments, however, gives health professionals and survivors information that can be important to their health many years after their diagnosis and treatment."
The CCSS, funded by the National Cancer Institute, consists of investigators from 25 medical centers in the United States and Canada and is coordinated by investigators at the University of Minnesota Cancer Center. CCSS investigators gathered information from more than 14,000 study participants who were diagnosed with cancer between 1970 and 1986, before reaching the age of 21. Each participant has been recruited through one of the participating centers, where he or she was diagnosed and/or treated. The study requires that all participants must have survived at least five years from their initial cancer diagnosis. The information CCSS investigators gather is being used to develop prevention strategies and assess follow-up needs.
CCSS investigator Melissa Hudson, M.D., of St. Jude Children's Research Hospital, will present recent results indicating that the majority of survivors over the age of 18 years reported that they considered their general health to be good, with only 11 percent reporting their general health to be fair or poor and 12 percent reporting experiencing major medical conditions. Female survivors were found to be at higher risk of impaired health, including mental health, anxiety and physical activity. Survivors of brain tumors, Hodgkin's disease, bone tumors and soft tissue sarcoma were at highest risk for adverse health outcomes.
Research headed by Ann Mertens, Ph.D., of the University of Minnesota Cancer Center, has revealed that pulmonary complications resulting from some forms of chemotherapy and radiation used to treat childhood cancers can occur months to years after treatment. Childhood cancer survivors reported significantly higher occurrence of lung fibrosis, emphysema, pneumonia, pleurisy and need for supplemental oxygen compared to sibling controls.
An evaluation headed by Kevin Oeffinger, M.D., of the University of Texas, Southwestern, reveals that survivors of childhood acute lymphoblastic leukemia are significantly more likely to be overweight or obese when compared to siblings. Female survivors treated with cranial radiation before the age of five years were four times more likely to be obese, while male survivors were twice as likely to have a body mass index of greater than 30. These results indicate that some leukemia survivors may be at increased risk of experiencing cardiovascular and other obesity-related complications later in life.
Researchers lead by Raj Nagarajan, M.D., of the University of Minnesota Cancer Center, have evaluated the long-term physical function and quality of life of survivors of childhood bone tumors, some of whom underwent amputation and some who had limb-sparing surgery. Among the survivors followed an average of 20 years after their diagnosis and surgery, no significant differences were observed among those treated with amputation or no amputation. Female survivors and those diagnosed and treated at older ages were found to score lower on measures of physical function and quality of life.
Brad Zebrack, Ph.D., of the UCLA School of Medicine, will report the results of an investigation of psychological outcomes in long-term survivors of childhood leukemia and lymphoma. This study revealed that the majority of survivors are psychologically healthy.
However, when compared to sibling controls, survivors were found to have a significantly increased risk for reporting depressive symptoms and symptoms indicating somatic distress. Increasing intensity of cancer chemotherapy was found to add to the risk of these symptoms.
Pauline Mitby, M.P.H., from the University of Minnesota department of pediatrics, evaluated the utilization of special educational services and educational attainment among long-term survivors of childhood cancer. She and her colleagues will report that 23 percent of childhood cancer survivors were enrolled in special education programs compared to 8 percent of siblings and that survivors treated with cranial radiation or chemotherapy directed to the central nervous system were more likely to utilize special educational services, particularly female survivors.
The University of Minnesota Cancer Center is a National Cancer Institute-designated Comprehensive Cancer Center. Awarded more than $68 million in peer-reviewed grants during fiscal year 2001, the center conducts cancer research that advances knowledge and enhances care. The center also engages community outreach and public education efforts addressing cancer. For more information on cancer in general, visit the Web site at http://www.cancer.umn.edu.
Contacts:
Brenda Hudson, Academic Health Center,
612-624-5680
Melanie Boulay, Cancer Center, 612-626-1107
Deane Morrison, University News Service,
612-624-2346