Study finds childhood cancers relate to physical problems later in life

A University of Minnesota Cancer Center study is the first to show how the prevalence of some physical impairments that childhood-cancer survivors experience as adults relate to the type of cancer they had and the treatment they received. The findings indicate long-term follow up care and physical rehabilitation may be important for more than 20 percent of childhood-cancer survivors.

This study of nearly 11,500 childhood-cancer survivors is published in the current issue of Annals of Internal Medicine. Kirsten Ness, Ph.D., a cancer epidemiologist with the University of Minnesota Cancer Center and Department of Pediatrics, led the study team study.



Ness analyzed information reported by 11,481 survivors enrolled in The Childhood Cancer Survivor Study, an ongoing follow-up study of survivors of childhood cancer coordinated by the University of Minnesota. These survivors were treated for primary brain cancer, leukemia, Hodgkin disease, non-Hodgkin's lymphoma, kidney tumor, neuroblastoma, and soft-tissue sarcoma or malignant bone cancer before age 21 and had survived at least five years after diagnosis. Their information was compared to that provided by 3,839 siblings of childhood-cancer survivors.



"Overall, we found that about 20 percent of the survivors had physical limitations and trouble performing activities of daily living, such as running, climbing stairs, bending, lifting, stooping, walking, eating or dressing," Ness says. "But, almost 40 percent of survivors of bone tumors and 30 percent of survivors of brain tumors reported having these difficulties." According to Ness, survivors of brain and bone cancers were most likely to report physical limitations and difficulty doing routine activities to the point of limiting their ability to attend work or school. Brain cancer survivors also were most likely to report difficulty with performing personal care.



"Survivors of leukemia reported the least problems," Ness says. Lymphoma survivors were in the middle.



She notes that survivors who received radiation therapy or a combination of radiation therapy and chemotherapy were more likely to have difficulty than survivors treated with surgery alone.



"The findings of this study indicate that medical side effects occurring later in life and interfering with physical ability are common after treatment of childhood cancer," Ness says.



To overcome or lessen the severity of these problems, she offers these suggestions to adults who had cancer as children:



- Have regular check-ups throughout your life to identify problems that can be corrected, and to receive a referral for rehabilitation services that can help improve physical function.



- Share the details of your cancer history and treatment with your current physician, and discuss whether further testing for medical late effects could benefit you.