Cancer treatments got gentler, yet kids’ survival improved

The move to make cancer treatments gentler for children has paid a double dividend: More kids are surviving than ever before, and without the long-term complications that doomed many of their peers a generation ago, new research shows.Radiation and chemotherapy have saved countless children from leukemia and other types of cancer, but some of these treatments can damage the heart or other organs, problems that prove fatal years later.In the 1990s, a push began to try to prevent these “late effects” by giving smaller, more targeted doses of radiation, avoiding certain drugs and changing the way chemo is given. But doctors worried: Would gentler treatments hurt a child’s survival odds? The new study, which tracked more than 34,000 childhood cancer survivors over several decades, gives a happy answer: No.

The field needs good news and this study gives it. We have actually reduced treatment, reduced therapy.

Dr. Greg Armstrong of St. Jude Children’s Research Hospital in Memphis, Tennessee

Survival continued to improve, even with scaled-back treatments. And fewer kids died from second cancers or heart or lung problems 15 years after their initial treatment ended. Doctors in the 1990s scaled back certain treatments for certain types of patients to try to spare them late effects. The study compared survival odds before and after that change. Researchers found that the death rate 15 years after treatment ended kept declining, from about 12 percent for those treated from 1970-74 to 6 percent for those treated from 1990-94. Deaths from late effects of cancer treatment, such as heart problems, also declined over that period, from 3.5 percent to 2.1 percent.

Fifty years ago less than 30 percent of kids would survive childhood cancer but now we know that over 80 percent will.

Dr. Greg Armstrong

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