scholarly journals Possible Mechanisms of Subsequent Neoplasia Development in Childhood Cancer Survivors: A Review

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5064
Author(s):  
Jarmila Kruseova ◽  
Ales Vicha ◽  
Barbara Feriancikova ◽  
Tomas Eckschlager
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Survival Rates ◽  
Childhood Cancer Survivors ◽  
Good Prognosis ◽  
Malignant Neoplasms ◽  
Term Survival ◽  
Improved Outcomes ◽  
Prediction And Prevention ◽  
Life Threatening

Advances in medicine have improved outcomes in children diagnosed with cancer, with overall 5-year survival rates for these children now exceeding 80%. Two-thirds of childhood cancer survivors have at least one late effect of cancer therapy, with one-third having serious or even life-threatening effects. One of the most serious late effects is a development of subsequent malignant neoplasms (histologically different cancers, which appear after the treatment for primary cancer), which occur in about 3–10% of survivors and are associated with high mortality. In cancers with a very good prognosis, subsequent malignant neoplasms significantly affect long-term survival. Therefore, there is an effort to reduce particularly hazardous treatments. This review discusses the importance of individual factors (gender, genetic factors, cytostatic drugs, radiotherapy) in the development of subsequent malignant neoplasms and the possibilities of their prediction and prevention in the future.

scholarly journals Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2019 ◽  
Vol 37 (24) ◽  
pp. 2120-2130 ◽  
Author(s):  
Chaya S. Moskowitz ◽  
Joanne F. Chou ◽  
Joseph P. Neglia ◽  
Ann H. Partridge ◽  
Rebecca M. Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
De Novo ◽  
Childhood Cancer Survivors ◽  
Childhood Cancer Survivor ◽  
Malignant Neoplasms ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.

Utility of a Cancer Predisposition Screening Tool for Predicting Subsequent Malignant Neoplasms in Childhood Cancer Survivors

2021 ◽  
pp. JCO.21.00018
Author(s):  
Noelle Cullinan ◽  
Ian Schiller ◽  
Giancarlo Di Giuseppe ◽  
Mohammed Mamun ◽  
Lara Reichman ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Conditional Logistic Regression ◽  
Childhood Cancer Survivors ◽  
Cancer Predisposition ◽  
Malignant Neoplasms ◽  
Primary Cancer ◽  
Primary Malignancy ◽  
Control Approach ◽  
Cancer Predisposition Syndrome

PURPOSE Childhood cancer survivors (CCS) are at risk of developing subsequent malignant neoplasms (SMNs) resulting from exposure to prior therapies. CCS with underlying cancer predisposition syndromes are at additional genetic risk of SMN development. The McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) tool identifies children with cancer at increased likelihood of having a cancer predisposition syndrome, guiding clinicians through a series of Yes or No questions that generate a recommendation for or against genetic evaluation. We evaluated MIPOGG's ability to predict SMN development in CCS. METHODS Using the provincial cancer registry (Ontario, Canada), and adopting a nested case-control approach, we identified CCS diagnosed and/or treated for a primary malignancy before age 18 years (1986-2015). CCS who developed an SMN (cases) were matched, by primary cancer and year of diagnosis, with CCS who did not develop an SMN (controls) over the same period (1:5 ratio). Potential predictors for SMN development (chemotherapy, radiation, and MIPOGG output) were applied retrospectively using clinical data pertaining to the first malignancy. Conditional logistic regression models estimated hazard ratios and 95% CIs associated with each covariate, alone and in combination, for SMN development. RESULTS Of 13,367 children with a primary cancer, 317 (2.4%) developed an SMN and were matched to 1,569 controls. A MIPOGG output recommending evaluation was significantly associated with SMN development (hazard ratio 1.53; 95% CI, 1.06 to 2.19) in a multivariable model that included primary cancer therapy exposures. MIPOGG was predictive of SMN development, showing value in nonhematologic malignancies and in CCS not exposed to radiation. CONCLUSION MIPOGG has additional value for SMN prediction beyond treatment exposures and may be beneficial in decision making for enhanced individualized SMN surveillance strategies for CCS.

scholarly journals The tell-tale heart: molecular and cellular responses to childhood anthracycline exposure

2014 ◽  
Vol 307 (10) ◽  
pp. H1379-H1389 ◽  
Author(s):  
Merry L. Lindsey ◽  
Richard A. Lange ◽  
Helen Parsons ◽  
Thomas Andrews ◽  
Gregory J. Aune
Keyword(s):  
Childhood Cancer ◽  
Pediatric Cancer ◽  
Medical Condition ◽  
Survival Rates ◽  
Cell Types ◽  
Childhood Cancer Survivors ◽  
Resident Cell ◽  
Increased Risk ◽  
Life Threatening ◽  
Artery Disease

Since the modern era of cancer chemotherapy that began in the mid-1940s, survival rates for children afflicted with cancer have steadily improved from 10% to current rates that approach 80% ( 60 ). Unfortunately, many long-term survivors of pediatric cancer develop chemotherapy-related health effects; 25% are afflicted with a severe or life-threatening medical condition, with cardiovascular disease being a primary risk ( 96 ). Childhood cancer survivors have markedly elevated incidences of stroke, congestive heart failure (CHF), coronary artery disease, and valvular disease ( 96 ). Their cardiac mortality is 8.2 times higher than expected ( 93 ). Anthracyclines are a key component of most curative chemotherapeutic regimens used in pediatric cancer, and approximately half of all childhood cancer patients are exposed to them ( 78 ). Numerous epidemiologic and observational studies have linked childhood anthracycline exposure to an increased risk of developing cardiomyopathy and CHF, often decades after treatment. The acute toxic effects of anthracyclines on cardiomyocytes are well described; however, myocardial tissue is comprised of additional resident cell types, and events occurring in the cardiomyocyte do not fully explain the pathological processes leading to late cardiomyopathy and CHF. This review will summarize the current literature regarding the cellular and molecular responses to anthracyclines, with an important emphasis on nonmyocyte cardiac cell types as well as those that mediate the myocardial injury response.

scholarly journals Exploring food preparation practices in families with and without school-aged childhood cancer survivors

2019 ◽  
Vol 23 (3) ◽  
pp. 410-415
Author(s):  
Margaret Raber ◽  
Karla Crawford ◽  
Tom Baranowski ◽  
Shreela V Sharma ◽  
Vanessa Schick ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Survival Rates ◽  
Childhood Cancer Survivors ◽  
Nutrition Intervention ◽  
Food Preparation ◽  
Nutrition Interventions ◽  
Meal Preparation ◽  
Increased Risk ◽  
Healthy Family

AbstractObjective:Survival rates for paediatric cancers have increased dramatically since the 1970s, but childhood cancer survivors (CCS) are at increased risk for several chronic diseases throughout life. Nutrition interventions promoting healthy family meals may support wellness for survivors, but little research has explored CCS family food preparation habits. The goal of the present study was to describe and compare food preparation practices of CCS and non-CCS families.Design:Observational.Setting:Typical evening meal preparation events were observed and recorded in participant homes. Recordings and notes were analysed using the Healthy Cooking Index (HCI), a measure of nutrition-optimizing food preparation practices relevant to survivor wellness. Demographics, BMI and nutrient composition of prepared meals were also collected.Participants:Forty parents with a CCS or non-CCS child aged 5–17 years were recruited.Results:There were no major differences between the CCS and non-CCS families with regard to summative HCI score or specific food preparation behaviours. Meals prepared by CCS and non-CCS families had similar nutrient compositions.Conclusions:The study revealed areas for practical nutrition intervention in CCS and non-CCS families. Future studies should consider adopting and tailoring nutrition intervention methods that have been successful in non-CCS communities.

scholarly journals Second Cancer Risk in Childhood Cancer Survivors Treated With Intensity-Modulated Radiation Therapy (IMRT): An Updated Analysis of More Than 10 Years of Follow-Up

2021 ◽  
Author(s):  
Kathryn Tringale ◽  
Dana Casey ◽  
Gregory Niyazov ◽  
Jessica Lavery ◽  
Chaya Moskowitz ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Radiation Treatment ◽  
Intensity Modulated Radiation Therapy ◽  
Childhood Cancer Survivors ◽  
Malignant Neoplasms ◽  
High Dose ◽  
Intensity Modulated ◽  
Second Malignant Neoplasms

Background It is unclear how intensity-modulated radiation therapy (IMRT) impacts long-term risk of second malignant neoplasms (SMNs) in childhood cancer patients. Procedure Patients aged 10 years, many solid SMNs after IMRT in childhood cancer survivors develop in the high dose region. These data serve as a foundation for comparison with other modalities of radiation treatment (e.g., proton therapy).

Cardiac complications in childhood cancer survivors treated with anthracyclines

2015 ◽  
Vol 25 (S2) ◽  
pp. 107-116 ◽  
Author(s):  
Vivian I. Franco ◽  
Steven E. Lipshultz
Keyword(s):  
Cancer Survivors ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Management Strategies ◽  
Survival Rates ◽  
Childhood Cancer Survivors ◽  
Cardiac Complications ◽  
Cardiac Abnormalities ◽  
Survivors Of Childhood Cancer

AbstractCardiovascular complications are among the leading causes of morbidity and mortality among survivors of childhood cancer, after cancer relapse and secondary malignancies. Although advances in cancer treatment have improved the 5-year survival rates, the same treatments, such as anthracyclines, that cure cancer also increase the risk for adverse cardiovascular effects. Anthracycline-related cardiotoxicity in survivors of childhood cancer is progressive and can take years to develop, initially presenting as sub-clinical cardiac abnormalities that, if left undetected or untreated, can lead to heart failure, myocardial infarction, or other clinical cardiac dysfunction. A higher cumulative dose of anthracycline is associated with cardiotoxicity in children; however, sub-clinical cardiac abnormalities are evident at lower doses with longer follow-up, suggesting that there is no “safe” dose of anthracycline. Other risk factors include female sex, younger age at diagnosis, black race, trisomy 21, longer time since treatment, and the presence of pre-existing cardiovascular disease and co-morbidities. Cardioprotective strategies during treatment are limited in children. Enalapril provides only temporary cardioprotection, whereas continuous anthracycline infusion extends none. On the other hand, dexrazoxane successfully prevents or reduces anthracycline-related cardiotoxicity in children with cancer, without increased risks for recurrence of primary or second malignancies or reductions in anti-tumour efficacy. With more childhood cancer survivors now reaching adulthood, it is vital to understand the adverse effects of cancer treatment on the cardiovascular system and their long-term consequences to identify and establish optimal prevention and management strategies that balance oncologic efficacy with long-term safety.

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