Chronic illnesses in childhood cancer survivors — a result of harsh but life-saving treatments — can make them feel roughly two decades older.
By Kate Wheeling
(Photo: Justin Sullivan/Getty Images)
Dozens of children are diagnosed with cancer every day in the United States. Today, more of those kids are surviving to adulthood than ever before, but, until now, little work had been done to assess how their quality of life in adulthood compared to adults who never had cancer. In a new study, researchers have found that cancer survivors who wind up with chronic illnesses from their treatment appear roughly 20 years older on quality-of-life ratings.
Since the 1960s, the rate of survival for one of the most commonly diagnosed childhood cancers — leukemia — has gone from less than five percent to more than 90 percent. “It’s the first generation of adults who are growing up and then growing old having been childhood cancer survivors,” says Lisa Diller, a pediatric oncologist at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center and principal author on the new study. “We know very little about what happens when they pass through middle age, and what their issues will be as they face the normal diseases of aging or the chronic diseases caused by their childhood cancer treatment.”
Cancer survivors who wind up with chronic illnesses from their treatment appear roughly 20 years older on quality of life ratings.
Researchers have known for some time that childhood cancer survivors are at a higher risk for certain chronic diseases than the general population, including heart and lung diseases, infertility, and even new forms of cancer. But it had been unclear how that risk impacts survivors’ health-related quality of life. To find out, the research team looked at data from over 7,000 survivors collected by the Childhood Cancer Survivor Study, and estimated their health utility score — a proxy for overall health-related quality of life that takes into account the number and severity of a patient’s chronic diseases. They compared the health utility scores of cancer survivors to those of a sample of nearly 13,000 members of the general population, estimated with data from the Medical Expenditures Panel Survey.
The study supported something researchers have long suspected about childhood cancer: It appears to accelerate aging. “Childhood cancer survivors 18 to 29 years old self-report health-related quality of life more like people in their 40s, where you’re starting to see some of the effects of aging rear their ugly head,” Diller says. And the best predictor of a low quality-of-life score in survivors was the presences of one or more chronic diseases.
That’s an encouraging finding for survivors, because it suggests that it’s not the cancer itself that affects their health later in life, but the secondary conditions they can develop — usually as a result of their treatment. With that in mind, pediatric oncologists can focus on finding new treatments or tweaking current therapies to avoid chronic illnesses in the future, according to Diller.
Some progress has already been made; young cancer patients today likely receive a much different treatment protocol than the survivors in this study. “I’m hoping that in 2030 and 2040 when someone re-does this study, we won’t see this [aging] effect,” Diller says.