Perils follow childhood cancer

The cure for a child's cancer often leads to future health problems.
WASHINGTON -- Danielle Eichner of Rockville, Md., is a survivor. A decade ago, when she was 11, doctors diagnosed her with acute leukemia and warned that death was imminent. But chemotherapy kept her alive. She graduated from high school, is attending college and soon will launch a career as an art therapist.
Only now, after a landmark study of childhood cancer survivors, are Eichner and her parents realizing how the drugs and radiation that saved her life might affect her in the future.
The study concluded that many young adults who conquered cancer as children suffer chronic health issues more commonly seen in the elderly, including osteoporosis, hearing loss, thyroid problems and heart damage. More than one in four have potentially life-threatening conditions.
"They had to grow up so fast," said Danielle's mother, Marilyn Eichner. "And then to tell them, 'Oh, by the way, you survived, but you might get a second cancer, you might have heart failure, you might have to have a hip replacement' -- it's just too much."
The research findings, drawn from the reports of nearly 10,400 people whose cancers were diagnosed between 1970 and 1986, alter the context of a stunning medical success over the past 35 years -- a period when children's survival rates from cancer went from virtually zero to nearly 80 percent.
Despite drugs that are less toxic and technology that can precisely target malignant masses, youngsters and teen-agers currently in treatment are likely to confront the same concerns, experts say.
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"I don't feel I can give them a lot of comfort," said Max Coppes, executive director of the Center for Cancer and Blood Disorders at Children's Hospital in D.C. "This fine line [between a cure and its possible side effect] is infinitely more painful and difficult."
The Childhood Cancer Survivor Study has prompted many survivors and their families to reconsider what the future holds, some with equanimity, others with sadness, fear or denial.
The childhood cancer study looked at men and women whose malignancies had been diagnosed before their 21st birthdays. They were among the first generation of childhood-cancer survivors. Their average age at the time of the study was 26.

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