By: Dr. Jordan Robertson ND
We are now watching an entire cohort of childhood cancer survivors grow up, well past the ages we saw just a generation ago. Treatment for childhood cancers have greatly improved, with many patients living normal adult lives past their diagnosis and treatment.
The childhood survivors were also more likely to be diagnosed with a chronic disease by 40, and were at an 8.4x higher risk for premature death.
After watching this generation grow, we have been reminded of the slow, long term effects of chemotherapy and radiation, and how the damage that healthy cells ensure through these treatments can lead to long term health complications. In older adult care, we rarely consider the impact of chemo and radiation beyond a few years, because the immediate concern of cancer is right in front of us. In our childhood survivors, we are realizing that we need a plan to help these patients live a happy healthy life, and to avoid chemotherapy and radiation induced disease at a later time in their lives.
Currently the two greatest risks that present our childhood cancer survivors are secondary cancers(1), and metabolic disease(2). We are well aware of the cancer related risks to patients who have radiation (for example, secondary breast cancer after Hodgkin’s lymphoma hits almost 30% of female survivors), but more recently we have come to realize that abdominal wall radiation (that may inadvertently be directed at the pancreas) is leaving our childhood survivors at a great risk for diabetes, and metabolic disease.
The Children’s Oncology Group (https://childrensoncologygroup.org/) is a research institute that has followed thousands of childhood survivors in the United States to track the future health of childhood cancer survivors. Their findings have been startling, and have exposed a need for Naturopathic care in patients who have been previously treated from cancer (whether treated in adulthood or as children). Childhood survivors on average suffered more than other patients with conditions such as hypothyroidism, hearing loss, low bone mineral density, iron overload or low lung function. The childhood survivors were also more likely to be diagnosed with a chronic disease by 40, and were at an 8.4x higher risk for premature death. Of these premature deaths, 50% are accounted for by secondary cancer, and almost 30% are caused by cardiovascular and metabolic disease.
Studies have started to watch the incidence of diabetes and heart disease in patients diagnosed and treated for cancer below the age of 35, finding dramatically increased risk, and increased prescriptions for these diseases(3). These increases in risk is seen even when compared to the patient’s own siblings (somewhat excluding the impact of hereditary). Interestingly, these studies also go on to recommend that childhood survivors require a long-term strategy that includes diet and physical exercise – Exactly the kind of plan we provide our long term survivors with to reduce their risk of death and disease.
Beyond regular care for metabolic syndrome, there are multiple treatment options to consider for post-chemotherapy or radiation damage to healthy tissue for adults and children. Multiple herbs and nutrients have been studied to protect various tissues after cancer treatment to either restore healthy tissue, or to prevent long term complications of drug therapy. Long term survivors should also have lab work done regularly to track their fating insulin, glucose and cholesterol, as these values may help us understand the risk for metabolic disease, even if the patient appears healthy otherwise. Graduating out of your acute cancer care still leaves a lifetime of health questions and challenges that an experienced Naturopathic Doctor can help you navigate. Call us to arrange a 15-minute interview to find out how we can help.
- Moskowitz CS, Chou JF, Wolden SL, Bernstein JL, Malhotra J, Novetsky Friedman D, et al. Breast cancer after chest radiation therapy for childhood cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2014 Jul 20;32(21):2217–23.
- Scott JX, Latha MS, Aruna R. Approach to metabolic syndrome in childhood cancer survivors. Indian J Cancer. 2015 Jun;52(2):169–72.
- Kero AE, Madanat-Harjuoja LM, Järvelä LS, Malila N, Matomäki J, Lähteenmäki PM. Health conditions associated with metabolic syndrome after cancer at a young age: A nationwide register-based study. Cancer Epidemiol. 2016 Jan 23;41:42–9.