Long after Cancer Is Gone, Treatment Continues
In the United States, cancer is still the leading cause of death by disease for children between the ages of 1 and 14. And while childhood cancer is no longer a death sentence for most of the 10,000 annual cases, surviving it comes with a trade-off later in life.
After extensive screening of about 1,700 adult survivors of childhood cancer, researchers at St. Jude Children’s Research Hospital in Memphis discovered that nearly all of them -- 98 percent – had at least one chronic health condition.
Key points of the study include:
- Overall, 98 percent of the 1,713 survivors in this study had at least one chronic health condition, hundreds of which were diagnosed through clinical screenings conducted as part of the St. Jude Lifetime Cohort Study (St. Jude LIFE).
- The health issues included previously undetected health problems, including new cancers, heart and lung abnormalities as well as memory and other neurocognitive problems.
- St. Jude researchers found that by age 45, 80 percent of childhood cancer survivors have a life threatening, serious or disabling chronic condition.
- The findings highlight the importance of regular medical checkups for survivors of childhood cancer and stress the importance of early monitoring of these known health risks.
Dr. Melissa Hudson, director of the Cancer Survivorship Division in the Department of Oncology at St. Jude, says the study encourages vigilance from both doctors and patients.
"I hope that primary care physicians who are seeing our survivors become more aware of the complexity of their health issues and the need to specifically know their cancer treatment to better anticipate those health issues," Hudson said.
She adds, "the other issue is: I think it’s important for survivors, especially if you’ve had a combination of therapies and a very complicated cancer history, have your physician at your cancer treating center provide a survivorship care plan that outlines your treatment and outlines your health risks, some recommendations for screening and the health behaviors that it’s important for you to practice.”
Kelly Friedman was 7-years-old in 1969 when she came to St. Jude with a form of leukemia that had a 4 percent survival rate at the time.
“I just remember all the sticking, the poking, the needles here and there,” she said.
Though relatively healthy, Friedman has some heart valve issues and once had a cancerous bump on her head removed. Friedman says the new research could help people make healthy life choices.
For some, the cancer study raises awareness. But others, like Richard Brown of New York City, worry about the stigma of being branded as damaged for life. Brown was 12 when he went to St. Jude with Hodgkin's lymphoma.
“There was a long time I never wanted to speak out," he said. "I never wanted to say anything having to do with cancer. Because once people hear that they automatically say, ‘Oh, well he’s an insurance risk. Or ‘He took chemotherapy, that might not be a good thing.'”
Brown, 34, can’t afford insurance, and he fears that studies like this one could help insurance companies justify high premiums for survivors. He's been keeping an eye on the evolving politics surrounding Obamacare. Though he can't be denied for pre-existing conditions, he still might not be able to afford the premiums for a person with a cancer risk.
On top of that, he says, when doctors find out he's had cancer, even a bellyache or a sore muscle can result in expensive precautionary tests which, at this point, he pays for out of pocket.
Dr. Hudson is concerned that health care costs will deter cancer survivors from getting the life-long medical attention that 98 percent of them will invariably need.