June 4, 2012
(USA TODAY) -- Children diagnosed with cancer remain at risk from a variety of serious, long-term complications, even years after doctors pronounce them cured. Now, new research shows that girls treated with radiation for pediatric tumors face a later risk of breast cancer six to seven times as high as that of other women.
The findings affect not only women who were treated with therapeutic radiation as children but the thousands of children and adolescents in treatment today. Nearly 60,000 American women alive today had chest radiation for any pediatric cancer, according to a study presented today in Chicago at the annual meeting of the American Society of Clinical Oncology. About 12,500 children and adolescents are diagnosed with cancer each year.
Before the 1970s, few children with cancer even survived. Yet the research reflects a growing sensitivity that "cure is not enough," says Michael Link, outgoing president of the oncology society.
As these survivors have grown up and hit middle age, doctors are finding a substantially increased risk of breast cancer, even among girls who received what was considered a "lower" dose of radiation, says study author Chaya Moskowitz of New York's Memorial Sloan-Kettering Cancer Center.
Jeanne Miller, 37, survived Hodgkin lymphoma at age 16. Last August, she was diagnosed with breast cancer. Doctors recommended a double mastectomy.
"We need to know how to take care of survivors and change childhood cancer therapies, so this doesn't happen to the next group of survivors," says Lisa Diller of Boston's Dana-Farber Cancer Institute. "Children treated for Hodgkin lymphoma today are treated with therapies that try to maintain the excellent cure rates but use as little radiation as possible."
Miller says she is grateful that doctors caught the tumor at the earliest stage.
The Children's Oncology Group recommends women treated with higher doses of radiation begin breast cancer screenings at age 25, or eight years after finishing radiation, whichever comes later, using both mammograms and MRI, or magnetic resonance imaging. Typically, medical societies recommend women at normal risk for breast cancer begin getting screening at age 40 or 50.
Moskowitz says doctors may need to re-evaluate those guidelines for pediatric cancer survivors.
Miller's doctor gives her regular checkups, she says, because some of the chemo drugs she took are known to damage the heart. Her doctor, study co-author Kevin Oeffinger, also of Memorial Sloan-Kettering, has promised her that breast cancer won't slow her down. Miller, of Fairfield, Conn., says she's back to exercising and is enjoying a weekend at the beach. Oeffinger has told her "that this would be a blip on my life's radar screen," Miller says, "and that I would celebrate my 90th birthday."
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