Pediatric cancer researchers at the University of Texas Health Science Center (UTHSC) in San Antonio are developing a project to study heart problems in adults who survived childhood cancers, as there is a concern in the medical community about the long-term consequences of pediatric cancer treatments. As the survival rate of pediatric cancer continues to rise and more children with cancer are successfully treated, the average life expectancy and unintended consequences of childhood cancer therapies have not been fully researched by scientists.
“A third of long-term survivors have a life-threatening medical problem related to the treatment that saved them,” explained the co-led investigator of the study, Dr. Greg Aune, M.D., Ph.D., an assistant professor in the Department of Pediatrics and co-principal investigator on the study. “You save someone’s life at 15 but they’re dead by the time they’re 50? You have a problem there.”
Successful pediatric cancer treatment is becoming more common, which means that more oncology patients are living into adulthood. However, negative consequences of the treatments often appear years after, causing serious health problems and diminishing the possibilities of a long life.
Aune himself is an example of that, as he was diagnosed and treated for Hodgkin’s disease when he was a teenager. By the time he started his fellowship at UTHealth in pediatric hematology-oncology, the father of four was diagnosed with severe aortic stenosis and coronary artery disease. One of the reasons for Aune’s interest in this study is the history of his own health complications after surviving pediatric cancer, and as a result, the research team will focus on the study of heart problems caused by early cancer treatments.
Dr. Aune is already examining a series of studies on the late cardiac effects of chemotherapy in pediatric mice at his laboratory at Greehey Children’s Cancer Research Institute. The next step will be to extend the animal laboratory models directly to patients by enrolling survivors of childhood cancers and evaluating the diagnostic capabilities of cardiac MRI, in collaboration with the study’s other co-led investigator, Helen Parsons, Ph.D., M.P.H.
“We know that cancer survivors treated with certain drugs have a higher risk of heart problems,” explained Dr. Parsons, who is an assistant professor in the Department of Epidemiology and Biostatistics, “but we don’t yet understand the types of people who are more at risk, and we don’t know the best technology to detect these problems early.”
Even though there are already studies that suggest that cardiac MRI may be a better diagnostic tool for determining heart health in adult survivors of pediatric cancer than echocardiography, the current standard of care, these previous studies had very low Hispanic participation, thus leading to incomplete data. And since South Texas has a unique population that includes a large percentage of Hispanics, she said, the researchers hope to see how to best care for this growing population of cancer survivors.
During the study, patients will be submitted to a health survey and a survivorship exam that will examine their symptoms of possible late consequences of cancer treatment. They will also be submitted to an echocardiogram to evaluate the pumping capacity of the heart, as well as a cardiac MRI for comparison.
The researchers are currently looking to enroll 30 participants who are at least 18 years old, not pregnant, diagnosed with cancer before 2009, and that were treated with certain chemotherapy drugs. The study will be conducted at the UTHealth Science Center, University Health System, and Christus Santa Rosa.