Brain cancer takes longterm toll on children-study

By Maggie Fox, Health and Science Correspondent

WASHINGTON (Reuters) – Nearly a third of children who
survive brain tumors need special education services later and
many suffer from chronic discomfort such as headaches and
nausea, U.S. researchers reported on Friday.

Children given radiation to cure their cancers fared worse
than those who had only surgery, but chemotherapy did not seem
to worsen their fates, they found.

The report, published in the Journal of Clinical Oncology,
adds to research showing that, while childhood cancer is
usually curable, its effects can linger for decades and even a
lifetime.

“We’ve been very focused on curing brain cancer, which we
now do in about 68 percent of the kids,” said pediatric
neurologist Dr. Paul Fisher of Stanford University School of
Medicine in California and Lucile Packard Children’s Hospital,
who led the study.

“Now we’re asking, ‘OK, but what are the kids like? We’re
curing them, but at what cost?”‘

Fisher and colleagues surveyed 134 former patients
returning to Packard Children’s Hospital for routine follow-up
visits.

They asked the children and their parents about whether
they had problems with common activities such as running or
bathing, if they worried about the future, whether they were
teased or had trouble in school.

The patients had a median age of about 11 and for most it
had been three years since they were diagnosed.

SYMPTOMS AFTER THERAPY

“Brain tumor patients tend to suffer a lot of cancer
symptoms even after therapy,” Fisher said.

“They often still have headaches, pain and nausea. Even
though they may have a normal lifespan, their symptoms don’t
get better. But most people think, ‘OK, they’re fine now.
Everything should be back to normal.”‘

Children who had more aggressive or larger tumors were more
impaired, and the use of radiation seemed to worsen the later
problems — not surprising, as radiation must pass through
healthy cells to reach a tumor.

The children know something is wrong.

“The longer it’s been since their diagnosis, the more
reluctant the kids are to talk about it,” Fisher said in a
statement. “They know they’re not the same person they were
before, and it’s very upsetting for them.”

Dr. Brannon Morris, who follows up with cancer patients
treated at St. Jude Children’s Research Hospital in Memphis,
Tennessee, said doctors have been aware there were long-term
effects and are working to develop less-toxic treatments.

“There is a tension every day of balancing treatment and
then concern for late effects,” Morris, who was not involved in
the research, said in a telephone interview.

“Some brain tumors really do need radiation, but if you can
minimize that dose by doing conformal radiation or targeted
radiation, then presumably you are preventing many of the side
effects,” Morris added.

“I think the biggest thing is to have the parents just
upfront inquire about the potential risks of treatment because
there are many.”

Fisher said the study will continue as the children age.

“Parents often come into the clinic and ask us, ‘What’s my
child going to be like five and 10 years from now?”‘ he said.

“Do the older children have a checkbook? Can they manage
money? We don’t know.”