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Odds good for child cancer survivors

/ Source: The Associated Press

Kelly Wood is the new face of childhood cancer, a survivor from the first generation of youngsters diagnosed when treatment advances greatly improved the odds of reaching adulthood. Now 29 and the mother of a 2-year-old son, Wood typifies what many of these “pioneers” can expect — some lingering health problems but otherwise fairly normal lives, a study suggests.

Nearly 44 percent of the 9,535 survivors studied had at least one significant health problem related to their cancer, including amputations, organ damage or anxiety over the possibility of a recurrence of the cancer.

“The cancer therapy that did a good job of killing the cancer cells also can affect those developing cells and tissues in ways that we may not recognize until 20 or 30 years later,” said Dr. Kevin Oeffinger of the University of Texas Southwestern Medical Center, the study’s senior author.

Still, nearly 90 percent of survivors said their health was good.

In many cases, “they’re people who have adjusted and are doing very well,” said co-author Dr. Melissa Hudson of St. Jude’s Children’s Research Hospital in Memphis, Tenn.

The study was published in Wednesday’s Journal of the American Medical Association.

'They're pioneers'

The study is the first long-term analysis of the health of survivors of eight major types of cancer, Oeffinger said. The participants were diagnosed between 1970 and 1986.

“They realize that they’re pioneers,” Oeffinger said. “People treated in the ’50s and ’60s did not have the chance of making it into their adult life.”

Wood, a study participant, was diagnosed with leukemia at 2 and had three years of radiation and chemotherapy before her cancer went into remission. The treatment saved her life but left her heart muscle weak and damaged her lungs and thyroid gland.

The Dallas-area woman takes medicine for all three conditions and says she does not have the stamina for rigorous exercise. Though some childhood cancer survivors become infertile after treatment, Wood was happy to learn she could get pregnant and is raising a healthy little boy.

“I’m doing pretty good,” she said. “I went to school and did everything that everybody else did.”

'Enhanced appreciation of life'

Cancer strikes an estimated one in 300 to 350 youngsters before age 20. Government data estimate that nearly 250,000 U.S. adults survived childhood cancer. Nearly 70 percent of children with cancer survive for at least 10 years.

The high quality of life reported by survivors “may reflect an enhanced appreciation of life after therapy,” Dr. Cindy Schwartz of Johns Hopkins Hospital in Baltimore said in an accompanying editorial.

Overall, 17 percent of the patients surveyed reported mental health problems, 13 percent reported anxiety and 12 percent reported impairments in daily functioning, some of them caused by amputations. The percentages were higher for some cancers requiring particularly aggressive or invasive treatment, including nervous-system and bone cancers.

Doctors have learned that some types of cancer, including Hodgkin’s disease, require less radiation than previously thought, so more recent survivors would probably have even better outcomes, Hudson said.

“Some of these patients by today’s standards were probably overtreated,” she said.