Common cancer treatments such as radiation and chemotherapies are known to have intense side-effects that can impact not only short-term quality of life with symptoms like hair loss, changes in taste, smell, and appetite, and fatigue, but long-term health outcomes.
Certain chemotherapies, specifically a class of drugs called anthracyclines, are known to weaken heart health by:
Radiation targeting the chest (such as in breast or lung cancers) can cause blood vessels and heart valves to thicken and become inflamed.
These side-affects are known as cardiotoxicities. Because cancer survivors are growing in number and in life expectancy thanks to modern medicine, we’re seeing these long-term side effects in survivors – sometimes decades after their cancer treatments have ended. Unfortunately, it’s difficult to know what treatments will produce long-term side-effects and very few have been closely studied.
Cancer is difficult to treat not because the methods are ineffective but because they can dramatically impact surrounding healthy tissue. Oncologists are always performing a balancing act between aggressive, effective cancer treatment and treating potential side effects and healthy tissue damages.
Of course, the medicines that can counter these effects may interfere with the effectiveness of the cancer treatments. As a result, doctors must constantly assess risk versus reward and mitigation versus impact.
Of course, not all these medicines are administered in tandem with cancer treatment. Some are given as part of follow-up prevention when pediatric patients grow into adulthood.
Cancer treatment has come a long way in just the past few decades. Pediatric cancer treatment is a whole different animal, as pediatric treatments come after child-specific trials of approved adult treatments. To put it bluntly, medical professionals know relatively little about the long-term effects of many modern cancer treatments. There just hasn’t been enough time to know.
With that said, we’re seeing some promising results in pediatric cancer survivors – survivors whose health and progress can be charted for decades after their diagnoses.
While the long-term cardiac implications of various cancer treatments aren’t known, it’s certainly not all bad news. In fact, recent studies demonstrate that pediatric cancer survivors have better heart health when treated with dexrazoxane.
Dexrazoxane injections are in a class of drugs called cardioprotectants or chemoprotectants. It was introduced in the 1990s. It is specifically administered to protect the heart from damages caused by chemotherapies. The fact that dexrazoxane is effective isn’t surprising.
What is surprising is that decades after its introduction, we’re seeing just how long those protections last. In a study of over 1,000 pediatric cancer patients, children were treated with the chemotherapeutic drug doxorubicin, which is known to damage heart tissue. Some patients also received dexrazoxane and were studied to see if the drug protected heart health with limited interference with the chemotherapy’s effectiveness.
Ultimately, the study gave us one of the most significant conclusions to come from cancer research in the past fifty years.
The results?
Over 80% of pediatric cancer patients will become long-term survivors.
The outcomes for childhood cancer patients are significantly better than ever before. Not only will most childhood cancer patients survive, but they will live long lives afterwards. With that said, cardiovascular disease is the leading cause of (non-cancer) death in pediatric cancer survivors. According to Dr. Steven Lipshultz, A. Conger Goodyear Professor and Chair of pediatrics, “cardiotoxicity associated with cancer therapeutics can be pervasive, persistent and progressive.”
What the dexrazoxane study shows is that pediatric cancer survivors can be protected from chemotoxicities for almost 20 years after treatment. And that’s only what’s been studied so far!
As studies like these increase alongside modern medicine, our hope rises – not only for children to recover and “kick” cancer, but to live long, healthy, happy lives in the wake of both cancer and its intensive treatment options.
With one of chemotherapy’s most dangerous side-effects now known to be curbed by dexrazoxane, we have renewed hope that further studies will reveal more and more effective ways to pair cancer treatments with chemoprotectants – protectants that result in longer, happier, healthier lives for survivors.