Two-thirds of children who survive cancer develop other chronic health problems, such as heart disease and blindness, because of radiation and the treatments that saved their lives, according to new research.
The research shows the tremendous medical, financial and emotional burdens that those treated in the 1970s and 1980s are now facing. One study found that 1 in 10 survivors are saddled with $25,000 in cancer-related debt.
"We've concentrated so much on our 5- and 10-year survival that we haven't paid attention to the impact of our treatments," said Dr. Len Lichtenfeld, deputy medical director of the American Cancer Society.
Today's patients shouldn't suffer as many problems, specialists say, because cancer treatments have vastly improved in recent years.
Survival is at an all-time high. More than 3 out of 4 children are cured of cancer today, up from 58 percent in 1975.
"But the individuals cured currently pay a large and unacceptable price for that," said Dr. Harmon Eyre, the cancer society's medical director.
Nearly 10 million Americans have survived cancer, including 270,000 who were diagnosed when they were 15 or younger.
Researchers across the country studied 10,397 of them who were diagnosed and treated between 1970 and 1986 and 3,034 of their siblings who did not have cancer.
By age 45, cancer survivors were from two to six times more likely than their healthy brothers and sisters to develop various health problems. Examples include heart disease, kidney problems requiring transplants or dialysis, blindness, infertility, mental retardation, paralysis, blood clots, lung problems and even another cancer.
Those who had Hodgkin's disease fared the worst, followed by those treated for brain tumors, said the lead researcher, Dr. Kevin Oeffinger of the University of Texas Southwestern Medical Center in Dallas.
Radiation is responsible for much of the damage because doses were much higher decades ago than they are today, he said. Chemotherapy drugs also have taken a toll. Some, like the widely used breast cancer medication adriamycin, are known to cause heart problems.
Less toxic drugs are needed, and cancer survivors and their doctors need to watch more carefully for health problems and try to prevent them, said Dr. David Johnson, a Vanderbilt-Ingram Cancer Center doctor who is president of the American Society of Clinical Oncology.
"We want to make primary care physicians aware of these problems as well as patients," said Johnson, himself a cancer survivor, diagnosed with lymphoma 15 years ago.
The National Cancer Institute funded the study, discussed at the society's annual meeting.
A separate one, funded by the Lance Armstrong Foundation, found that half of survivors said their financial and emotional issues were harder to face than the physical issues, and that these needs weren't met by their doctors.
"We focus predominantly on the medical issues of cancer, yet what this survey says is that the non-medical issues are as prevalent," said Dr. Steven Wolff of Meharry Medical College in Nashville.
He presented the research, which was based on an Internet survey of more than 1,000 randomly selected cancer survivors.
Nearly half of them said they still talk about cancer at least once a month and that their lives are affected by it "more than a little." More than half reported having to deal with chronic pain and depression.
As cancer doctors, said Johnson, "We are very well equipped to deal with their physical needs. We aren't so well-equipped to deal with their psychological needs."