Posts Tagged ‘ cancer ’

Childhood Cancer Survivors May Face Later Heart Risks

Monday, November 18th, 2013

Children who undergo treatment for cancer may be at greater risk of developing heart disease later in childhood, as well as in adulthood, according to a new study presented to the American Heart Association.  Researchers recommended that pediatricians monitor heart health carefully in their patients who have undergone cancer treatments.  More from The New York Times:

Scientists have known for some time that survivors of childhood cancer are several times more likely to develop cardiovascular disease as adults, a result of the toll that lifesaving radiation and chemotherapy treatments can have on the heart. But the new study, presented at an American Heart Association conference over the weekend, is among the first to show that the risk is elevated while the survivors are still children.

The research looked at 319 boys and girls under the age of 18 who underwent chemotherapy treatments for leukemia or cancerous tumors. At the time of the study, the participants were a minimum of five years past the time of their diagnosis.

When the children were compared with 208 siblings of similar ages, the researchers found a nearly 10 percent decrease in arterial health and other signs of premature heart disease.

Image: Baby undergoing treatment, via Shutterstock

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Optimism Growing in Childhood Cancer Outcomes

Thursday, September 26th, 2013

Cancer remains the number one cause of childhood death, but there is reason for optimism in the face of new treatments and better diagnostic tools, a new statistical analysis has found.  More from ABC News:

National Cancer Institute statistics show that in the U.S. the combined, an overall five-year cancer survival rate for children under 19 with cancer has increased from 62 percent in the mid-1970s to 84 percent today. For the most common type of childhood cancer, acute lymphoblastic leukemia, the cure rate is now over 90 percent.

“We’ve made amazing progress on pediatric cancers in just one generation. It’s the biggest success story in cancer right now,” said James Downing, M.D., co-chair of the American Association for Cancer Research’s special conference on pediatric cancer; and scientific director at St. Jude Children’s Research Hospital in Memphis.

Downing said one of the reasons such great strides have been made in pediatric cancer is that treatment protocols for younger patients tend to be vastly different from adult protocols. With adult cancer, there is a tendency to take breaks in treatment and back off if it gets too intense, he said. But many pediatric oncologists are aggressive about having their patients push through treatment until there is a cure — sometimes for up to three years without a break.

Another reason for the high success rate is that up to 60 percent of pediatric cancer patients are treated as part of a research trial, compared to just 5 percent of adults, Downing said. Such trials offer access to cutting-edge treatments and a chance for oncologist to confer with a team of oncologists, other specialists and researchers.

But Downing said he thinks the biggest advances in treatment have come from the sequencing of the human genome.

“DNA sequencing of tumors helps us define the mutations that underlie pediatric cancer to help us attack cancers where we are not yet winning and will be a major catalyst to make progress in the next several years in how to treat those cancers,” he said.

Downing admitted there are some unique challenges when treating young ones stricken with cancer.

Most cancer drugs were developed for use with older, more mature bodies so proper dosages and side effects can be tricky, he said. The cancers seen in children are vastly different from the ones seen in adults, so they aren’t always as completely studied or well understood. And it’s also difficult to know whether the chemotherapy, radiation and surgery children receive might lead to health problems later in life.

“Our challenge is to cure them so they can reduce long-term complications and live a normal life,” he said.

Image: Child undergoing chemotherapy, via Shutterstock

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Fertility Concerns Becoming Less Common Among Childhood Cancer Survivors

Wednesday, September 25th, 2013

A new body of research is revealing how survivors of childhood cancer may struggle less with infertility than they may have expected.  Earlier assessment of fertility hormones is key to success, researchers say, because radiation and chemotherapy often ages the reproductive organs, including the ovaries, more quickly than normal aging would.  But fertility is within reach for many who have been through cancer treatment as children. The New York Times has more:

Last month, a large study in The Lancet Oncology found that about two thirds of female survivors who sought out fertility treatments as adults ultimately became pregnant — a rate of success that mirrored the rate among other infertile women. Other recent studies have found that many men who experience low sperm counts after pediatric cancer, a side effect in two thirds of boys who receive chemotherapy, can undergo procedures that harvest viable sperm, allowing them to father their own children. Doctors say that while there is no doubt that childhood cancer increases the likelihood of infertility, the ovaries and testes of young cancer patients may be more resilient than they had previously thought.

“When we see cancer survivors as adults, depending on how late they are in their reproductive years, radiation and chemotherapy tends to have a pretty suppressive effect on their future fertility,” said Dr. Hal C. Danzer, a reproductive endocrinologist at the Southern California Reproductive Center. “But this speaks to the fact that the ovaries and sperm production are more resilient in young individuals. It’s very encouraging.”

But if fertility treatment is to be successful, time is of the essence. Normally, for example, women under 35 are encouraged to attempt getting pregnant for at least a year before seeing a fertility specialist. For those with a history of cancer, however, the new message should be, “Don’t wait,” said Dr. Lisa R. Diller, the chief medical officer of the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

“The ovaries after childhood cancer have taken a hit, and they are almost aging more quickly than someone of the same chronological age without cancer,” said Dr. Diller, the lead author of the Lancet study. “In the setting of having had childhood cancer, if a woman is 25 and has been trying to conceive for six months, then I would say see a specialist.”

Typically, childhood survivors tend not to address fertility issues until they are in a relationship and their treatment is many years behind them, said Dr. Aarati D. Didwania, the director of the STAR survivorship program at the Robert H. Lurie Comprehensive Cancer Center at Northwestern University.

“A lot of young women will come in and say, ‘I’m married, we’ve been trying for six months, is this related to my treatment?’ ” she said.

Traditionally, the fertility discussion has involved finding out which cancer therapies patients received and what their hormonal status is like, so doctors can estimate their likelihood of being infertile. Then they can talk about their options, Dr. Didwania said, and whether they need to resort to things like surrogacy, using donor eggs and sperm, or adoption.

But the new goal in the field of cancer fertility, or oncofertility, is to be as proactive as possible, said Dr. Teresa K. Woodruff, chief of the division of fertility preservation at the Northwestern University Feinberg School of Medicine.

Oncologists are increasingly making a point of bringing up the subject of fertility at the time of diagnosis, discussing options like freezing eggs, sperm and embryos before treatment. In younger patients who have not gone through puberty, some fertility clinics offer the option of freezing ovarian and testicular tissue, which can be reimplanted when patients get older.

Studies show that up to two thirds of young patients are now counseled about fertility before starting their cancer treatment.

“Today 80 percent of kids will survive,” Dr. Woodruff said. “Now that patients are thriving and have decades of life ahead of them, fertility is a high priority for them.”

Image: Pregnant couple, via Shutterstock

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Half of New Moms Breastfeed, CDC Says

Monday, August 5th, 2013

Half of American new mothers now breastfeed their newborns for the recommended period of at least six months, according to data analyzed by the Centers for Disease Control and Prevention.  More from Today.com:

It’s a big increase from just 35 percent in 2000 and is good news for babies and moms alike, as breastfeeding boosts the immune system, may lower the risk of obesity and is even linked with higher intelligence.

“This is great news for the health of our nation because babies who are breastfed have lower risks of ear and gastrointestinal infections, diabetes and obesity, and mothers who breastfeed have lower risks of breast and ovarian cancers,” said Centers for Disease Control and Prevention director Dr. Tom Frieden.

The American Academy of Pediatrics recommends that newborns get nothing but breastmilk until they are six months old. The AAP recommends that mothers continue to breastfeed, along with giving other food, after six months for at least a year or even longer “as mutually desired by mother and infant.”

Studies show that babies given nothing but breastmilk for the first four months of life have a 72 percent lower risk of severe pneumonia and other lower respiratory tract infections for their first year. If moms stop breastfeeding between four and six months, their babies have four times the risk of pneumonia compared to moms who breastfeed for a year or longer.

Breastmilk contains the nutrients that a newborn baby needs and also transfers disease-fighting antibodies from mother to baby – something that’s very important for the first few months before an infant can be vaccinated. There’s also a growing body of evidence that beneficial bacteria, and perhaps also viruses and fungi, from a mother’s milk and skin can affect her baby’s health.

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Pediatric Melanoma Cases Rising, Difficult to Diagnose

Monday, July 29th, 2013

The number of children diagnosed with melanoma, the most serious form of skin cancer, is rising about 2 percent each year, and the disease is escaping the notice of many pediatricians who do not expect to see it in their young patients, according to a new study published in the journal Pediatrics.  More from ABC News:

Melanoma makes up 5 percent of skin cancer diagnosis but a majority of skin cancer deaths.

In 2013, the American Cancer Society estimated, 76,690 new melanomas will be diagnosed and 9,480 people are expected to die from the disease.

Children make up a tiny fraction of these cases, but a study recently published in the journal Pediatrics found that cases of pediatric melanoma are increasing. Between 1973 and 2009, the study found, cases of pediatric skin cancer rose, on average, 2 percent each year.

Melanoma is also the second most common form of cancer for adolescents and young adults between 15 and 29 years old, according to a 2007 study from the National Cancer Foundation.

Unfortunately, pediatric melanoma can be very difficult to diagnose because the warning signs are often very different than those for adult melanoma. In addition, experts say, testing biopsies in a pathology lab can be inconclusive and occasionally these cancers are only definitively diagnosed after they’ve grown or spread.

A major factor in surviving a cancer diagnosis is early detection, but the early signs of pediatric melanoma often masquerade as inconsequential skin problems….

….Dr. Ashfaq Marghoob, director of Memorial Sloan-Kettering’s regional skin cancer clinic in Hauppauge, N.Y., and spokesman for the Skin Cancer Foundation, said melanoma presents very differently in children versus adults.

“You’re asking these doctors to look for zebras,” said Marghoob. “If you usually see horses you’re not looking for zebras. Their mind is not in tune with looking for these melanomas. The morphology of melanoma in kids is different from adults.”

A 2011 study presented at the Pediatric Dermatology Annual Meeting found that 60 percent of children between the ages of 0 and 10 in the study with melanoma did not meet the common melanoma-detection criteria. The criteria is broken down by the “ABCDE warning signs,” which stands for Asymmetry, Border irregularity, Color variation and Diameter over six millimeters, and Evolution of the lesion.

For children between the ages of 10 and 20, approximately 40 percent did not strictly meet the ABCDE criteria.

Instead, many children in the study had tumors that were symmetrical and amelanosis (lacking pigment). The differences were so significant that the study’s authors proposed creating alternative ABCD criteria for pediatric patients, where A is for amelanosis, B for bumps or bleeding, C for uniform Color, and D for various Diameters or de novo (or new) Development.

Image: Dermatologist examining child, via Shutterstock

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