Significant undiagnosed disease found among survivors of childhood cancer

Researchers increasingly target metabolism in the search for new cancer treatments


  • Carrie Printz

A study by researchers at St. Jude Children's Research Hospital in Memphis, Tennessee, has found that survivors of childhood cancer experience a large amount of undiagnosed, serious disease as adults, thereby highlighting the need for lifelong screenings in this population.[1]

Researchers found that 98% of the 1,713 survivors in the study had at least 1 chronic health condition. Hundreds of these conditions were diagnosed through clinical screenings conducted as part of the St. Jude Lifetime Cohort study (St. Jude LIFE). Among the undetected health issues diagnosed were new cancers, heart and lung abnormalities, and memory and other neurocognitive problems. Approximately 80% of study participants had a life-threatening, serious, or debilitating chronic condition.

St. Jude LIFE is a long-term study that brings cancer survivors treated at St. Jude Children's Research Hospital back to the hospital for several days of extensive medical tests and assessments in an effort to better understand the challenges faced by this growing group of patients. This method has the advantage over other studies of cancer survivors that primarily rely on survivor self-reports or cancer registries because the latter lead to substantial underreporting of health problems, according to a news release issued by St. Jude's.

The study also indicates that treatments should be tailored to minimize those therapies that can contribute to future health problems. One example is a 2009 finding by St. Jude researchers that cranial irradiation could be eliminated for some patients with childhood leukemia without affecting their survival. Participants included survivors of leukemia and lymphoma, as well as tumors of the brain, bone, and other organs. Approximately half of the survivors were diagnosed with cancer more than 25 years ago, whereas one-half were aged younger than 32 years when the study assessment was completed. The health conditions diagnosed at such an early age may show a pattern of accelerated or premature aging, according to co-first author Melissa Hudson, MD, director of the division of cancer survivorship at St. Jude Children's Research Hospital.

Abnormal lung function was diagnosed in 65% of survivors known to be at risk for lung problems from their childhood cancer treatment. Meanwhile, endocrine problems involving the hypothalamus and pituitary gland were diagnosed in 61% of at-risk survivors, and heart abnormalities were diagnosed in 56% of at-risk survivors. Finally, neurocognitive problems, including memory issues, were diagnosed in 48% of survivors were considered to be at risk for these conditions.

Many of the conditions were detected early, says Dr. Hudson. She calls the findings a “wake-up call” for providers and for survivors to be proactive about their health.