Childhood cancer survivors have more illnesses as adults

People who survived childhood brain cancer were 13 times more likely to die within 30 years than others their age, a study found.

The most common cause of death was recurrence of their brain cancer, according to research in the July 1 issue of the Journal of the National Cancer Institute. Others developed new malignancies, and more than 80 percent developed chronic medical conditions including hearing loss, endocrine problems, impaired attention or difficulty with organization and emotions.

Tumors of the central nervous system, which are mostly found in the brain, are the second most common type of childhood cancer after leukemia, said the lead author of the study, Gregory Armstrong of St. Jude Children's Research Hospital in Memphis, Tenn. While medical treatment enables 74 percent of the children to survive at least five years, doctors have been concerned about the impact of their diagnosis and treatment on long-term health.

"Curing their cancer is the top priority, but among survivors, it's helping them live well. That is a crucial goal," said Armstrong.

Most previous studies of long-term health in survivors of childhood brain cancer have been much smaller and followed them for 10 years or less.

The researchers included 2,821 people in the study who were diagnosed and treated from 1970 to 1986 and had already survived five or more years after their cancer was found. The median age of the children at diagnosis was 7.5 years for those who completed a baseline questionnaire, and five-year survivors were followed over 30 years.

The researchers found that the rate of death from all causes among the 2,821 survivors was 13.5 percent after 15 years and rose steadily to reach 25.8 percent after 30 years. That three-decade mortality rate was 13 times higher compared with the U.S. population of those the same age, the study said.

The most common cause of death was recurrence of a brain tumor, followed by other new cancers, the research found.

Since these patients were first diagnosed with cancer, surgical techniques have improved, Armstrong said. Doctors now limit the dose of radiation patients receive and target the radiation to the tumor, sparing normal tissue. Physicians also use more chemotherapy drugs in an attempt to lower the amount of radiation needed, Armstrong said.

"Hopefully these three things will improve long-term outcomes," he said.