A new study published in the American Heart Association's journal Circulation explores the relationship between childhood cancer, metabolic conditions and heart issues. While previous research has looked into how the chemotherapy treatment anthracyclines related to heart failure rates, this study took a broader look at these topics. It investigated all types of cardiac events and heart disease subtypes in about 7,300 patients who survived childhood cancer. A few of the heart diseases included in this inquiry are arrhythmias, pericardial disease, coronary artery disease, valve abnormalities, cardiomyopathy and heart failure.
When compared to cancer-free peers, childhood cancer survivors have up to a threefold increase for a cardiac event of any kind and up to a tenfold increased risk for heart failure. Patients who have cancer in their youth who are exposed to higher doses of anthracycline chemotherapy or who have diabetes, hypertension or a combination of the two, were found to be much more more likely to get heart disease later in life.
The average age of diagnosis for the patients with childhood cancer was seven. The 7,300 childhood cancer survivors were compared to more than 36,000 people of the same gender, age and postal code who didn’t have cancer. The follow-up time for this evaluation was an average of 10 years. The research team used data from Ontario's health care system, specificaly, a pediatric cancer registry called Pediatric Oncology Group of Ontario Networked Information System (POGONIS),, to identify five-year cancer survivors who were diagnosed before they turned 18, and who were treated in a pediatric cancer center between the years of 1987 and 2010.
The researchers found that a variety of factors can prematurely age the heart of these patients, including a higher likelihood of having a metabolic condition like hypertension, diabetes or unhealthy levels of fat in the blood. When chemotherapy or radiation that threaten the heart’s health are added to these metabolic risk factors, it can accelerate the development of heart illnesses.
"While anthracycline chemotherapy may induce heart disease, many patients require this cancer treatment to survive… Doctors should address heart disease risk factors - such as diabetes and hypertension - that can be modified… The close connections between lifestyle, metabolic disorders and cardiac disease warrant careful follow-up and monitoring of the childhood cancer survivor population," said Paul Nathan, M.D., M.Sc., senior study author and oncologist in hematology/oncology and senior associate scientist in the Child Health Evaluative Sciences program at Canada’s The Hospital for Sick Children, EurekAlert reports.
About 11,060 U.S. children under the age of 15 will be diagnosed with cancer in 2019, the American Cancer Society reports. In the U.S., approximately 610,000 people die from heart disease annually (about 1 in every 4 deaths), according to the CDC.
Factors like physical activity, diet, smoking and alcohol use were not accessed in this study.