Most childhood cancer survivors face serious health problems in adulthood

The research documented a variety of concerns for young cancer survivors, ranging from later hormonal issues to reproductive health challenges, problems with muscles and bones, cognitive decline and more.

Among childhood cancer survivors with subsequent health problems, the researchers write, about one-third will experience “serious or life-threatening chronic health problems.” The most common were endocrine disorders, subsequent neoplasias (abnormal growths), and cardiovascular diseases.

Many new cancers appeared in places that had undergone radiation during treatment, with radiation fields in the chest, brain, neck, and abdomen or pelvis being of “particular concern.” Those with higher doses of radiation were at greater risk, experiencing everything from breast cancer to central nervous system tumors and basal cell carcinoma.

The type of childhood cancer also affected the risk.

The researchers write that those diagnosed with a brain tumor, treated with cranial irradiation, or who underwent an allogeneic hematopoietic stem cell transplant (a treatment that provides stem cells from a healthy donor to a sick recipient) were at greatest risk.

Mental health was another concern, with depression rates ranging from 2.3 to 40.8 percent compared to a national average of 9.6 percent. The risk of suicide was also higher among those who had had cancer as children, with the highest risk in people aged 28 and older. Compared with the general population, adults who survived childhood cancer had a 1.4 times higher risk of death by suicide than their counterparts who had not been ill as children.

Given the current risk, the researchers recommend that survivors “receive lifelong care focused on health promotion and early detection of potential complications of cancer treatment.”

They encourage providers to inform patients about the possible long-term effects of treatment and say survivors should get annual physical exams and preventive care.