The Grapevine

Surviving Cancer In Childhood Increases Heart Disease Risk In Adulthood

Researchers from Germany have investigated the long-term health of those who survived cancer during their childhood in comparison to the rest of the population. The study found the survivors, as adults, were at increased cardiovascular risk compared to the general population.

The study stated medical advancements have significantly improved the treatment and survival rates for those diagnosed with cancer during childhood. But this also meant more attention was drawn to observing adverse late effects in survivors.

A total of 951 German childhood cancer survivors were examined between October 2013 and February 2016. The individuals, who were between the ages of 23 to 48, were a part of the study named “cardiac and vascular late sequelae in long-term survivors of childhood cancer.” Researchers checked the participants’ medical history and assessed whether they smoked and if any family member had a history of heart problems. The results were compared with that of over 15,000 people from the general population.

"Our results show that these survivors of childhood cancer have a substantially elevated burden of prematurely occurring traditional cardiovascular risk factors and cardiovascular diseases," said Johannes Gutenberg University Mainz, Germany, Professor Joerg Faber, who co-led the study.

The risk of cardiovascular disease typically increases as we get older. The findings indicated survivors of childhood cancer may have an even greater risk than the average person, which may possibly lead to an earlier death.

High blood pressure and blood lipid disorders were identified as important factors that led to the development of heart diseases and strokes. These conditions appeared earlier in participants than they did in the general population, with 23 percent diagnosed with hypertension and 28 percent diagnosed with dyslipidemia.

"We also found that a remarkable number attended their clinical examination for this study with previously unidentified cardiovascular risk factors and cardiovascular disease. For example, only 62 out of 269 were aware of having dyslipidemia. Consequently, 207, approximately 80 percent, were only diagnosed at that point. This applies to high blood pressure in the arteries as well," explained co-author Professor Philipp S. Wild, who also works at the Johannes Gutenberg University Mainz.

Dyslipidemia, characterized by abnormal amounts of cholesterol or fats (lipids) in the blood, can increase chances of clogged arteries in the heart. But early warning signs in patients may be missed when long-term follow up is more focused on the potential return of their cancer.

"Usually survivors are followed for only five to ten years after completion of therapy, and this is focused on the risk of the cancer returning and the acute adverse effects of their treatment, rather than on other conditions," added Professor Faber. "Current guidelines recommend cardiovascular assessments only for sub-groups known to be at risk, such as for patients who were treated with anthracycline therapy and/or radiation therapy."

Chemotherapy and radiation therapy, used to treat cancer in children, are known to affect heart cells and blood vessels. With regards to preventive measures, Professor Wild recommended early systematic screening focusing on blood pressure and lipid measurements. 

"This might help to prevent long-term cardiovascular diseases by intervening early, for instance by modifying lifestyles and having treatment for high blood pressure," he said.