Long-term Detrimental Effects of Cancer Treatments

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Dec 29, 2004

My series of articles on New Cancer Treatments is in response to the knowledge that the traditional treatments of radiation, chemotherapy, and to a lesser extent surgery, can lead to adverse, often permanent, adverse effects in the patient. Researchers developed these treatment modalities in order to kill the cancer cells, but found that the procedures cannot avoid damaging normal tissues as well.

The newly emerging therapies promise to focus in on the cancer cells while not affecting normal tissues. Unfortunately, most clinical trials to date using such technologies as vaccines, gene therapy, angiogenesis inhibitors, have been disappointing. Some of the new therapies have found roles as adjuvants that enhance the effect of radiation or chemotherapy. However, physicians will continue to use these traditional therapies for quite some time.

The National Cancer Institute has taken a leading role in the understanding the significance of the late effects of cancer treatments. I will not attempt to summarize their extensive review 1 in this brief article, but will just present a few key points.

The NCI article focuses on survivors of childhood cancer, and it appears that the majority of detrimental effects are due to radiation treatments. As I mentioned in a previous article on radiation treatments, improvements in technology have permitted more focused targets for the radiation beams.

Since radiation is focused on tumors in specific sites, the article arranges effects by body system: · Treatments to the central nervous system (brain and spinal cord) can cause inflammation of these organs, loss of vision, hearing, and sense of balance, as well as cognitive deficits (difficulties in learning). · Treatments to the head and neck can cause dysfunction of the endocrine glands, causing deficiencies in thyroid hormone, growth hormone, adenocorticotropic hormone, thyrotropin-releasing hormone and sex hormones. · Chemotherapy can be particularly damaging to the liver, causing both fibrosis and cirrhosis. · The use of radiation or anthracyclines to treat tumors in the breast cavity can cause damage to both the heart and lungs. · Radiation or cisplatin treatments directed to the kidneys can result in many types of kidney dysfunctions, while treatments directed to the bladder can result in bladder fibrosis and loss in bladder capacity. · Radiation can cause reductions in bone mineral density and bone growth. · Radiation and chemotherapy can affect the male and female gonads resulting in reduced reproductive function. · Reports indicate that survivors of childhood cancer are more likely to suffer premature mortality compared with the general population. The most common causes are relapse of the primary cancer, second malignancy, and cardiac toxicity.

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