The long-term prognosis and morbidity risks for people diagnosed as children or young adults with cancer, including lymphoma, were the focus of two recent studies published in JAMA Oncology. The studies recommend that greater efforts be made to improve the health and life quality of this patient population over time.
In the first paper, titled “Long-term Risk of Hospitalization for Somatic Diseases in Survivors of Adolescent or Young Adult Cancer,” Jørgen H. Olsen, MD, DMSc, and Kathrine Rugbjerg, PhD, of the Danish Cancer Society Research Center in Copenhagen, Denmark, investigated the relative and absolute excess risk for hospitalizations up to 34 years after diagnosis in this patient group compared with the general population. The cohort study, conducted in Denmark, included 33, 555 five-year survivors of adolescent or young adult cancer, diagnosed from 1943 through 2004 when they were 15 to 39 years of age. The 228, 447 people in the comparison group matched to the survivors by sex and year of birth.
After a median follow-up of 14 years, the researchers identified 53, 032 hospitalizations in cancer survivors for one or more of 97 disease categories. The team found that, in comparison with the general population, cancer survivors had an increased relative risk for hospitalization, and those with the highest risk were Hodgkin lymphoma, leukemia, and brain cancer survivors. According to the researchers, these findings underscore the great diversity of cancer-related health problems that physicians and patients should be aware of.
“Survivors of adolescent and young adult cancers face persistent risks for a broad range of somatic diseases requiring hospitalization. The morbidity pattern which — as described herein — is highly dependent on the type of cancer being treated, underscores the need for further implementation of strict evidence-based sex-, age- and cancer-specific follow-up plans for survivors, thereby increasing the likelihood for early detection and ultimately prevention of treatment-induced morbidities,” the study stated.
In the second, titled “Neurocognitive and Patient-Reported Outcomes in Adult Survivors of Childhood Osteosarcoma,” Kevin R. Krull, PhD, of St. Jude Children’s Research Hospital in Memphis, Tennessee, and colleagues conducted a cross-sectional investigation of neurocognitive, neurobehavioral, emotional, and quality-of-life outcomes in long-term survivors of childhood osteosarcoma, a cancerous tumor of the bone. The results revealed that survivors had lower mean scores in memory, attention, reading skills, and processing speed. “Long-term survivors of osteosarcoma are at risk for neurocognitive impairment, which is related to current chronic health conditions and not to original treatment with high-dose methotrexate. … Our results demonstrate the need for increased attention in this diagnosis, with prospective studies to delineate the evolution of impairment over the course of therapy and long-term survival,” the authors said.
In a related editorial, titled ” For Patients With Cancer, Cure Is Not Enough,“ Karen E. Effinger, MD, MS, and Michael P. Link, MD, of the Stanford University School of Medicine in California, wrote: “Advances in cancer therapy have led to increased survival; there are more than 9 million 5-year survivors of cancer in the United States. As this number continues to grow, focus on improved health and quality of life becomes a priority. … Going forward, we must apply our knowledge of late effects to improve monitoring and interventions for patients. While the progress made in the management of cancer in children and young adults has been gratifying, we must remember the words of Giulio D’Angio, who reminds us that ‘cure is not enough.'”