Long-term effects of childhood cancer Increased risk of cardiovascular disease

Children with cancer are at higher risk for cardiovascular disease as adults

More and more people are surviving cancer. If the illness is over, however, long-term consequences can still threaten years later. For example, a new study found that people with childhood cancer were more at risk for cardiovascular disease as adults.

More and more younger people are getting cancer

Although older people in particular are diagnosed with cancer, scientific studies have shown that more and more teenagers are also suffering from cancer. And even cancer-related new cases in children are increasing dramatically, according to researchers. Thanks to medical advances, more and more patients are surviving their illness. Nevertheless, they have to reckon with after-effects in the further life. This is also shown by the results of a German long-term study recently published in the European Heart Journal.

People who have childhood cancer have, according to a long-term study as adults, an increased risk of cardiovascular disease. (Image: Frantab / fotolia.com)

Two times the risk of cardiovascular disease

People who have had cancer as a child or adolescent are at an increased risk of developing high blood pressure and a lipid metabolism disorder as adults. In addition, they have an almost two-fold increased risk of cardiovascular disease.

This is the result of the first long-term study, which has systematically examined the health and in particular the cardiovascular long-term consequences of childhood and adolescent cancer in comparison with the German general population, reports the University Medical Center of Johannes Gutenberg University Mainz.

Thus, on average, hypertension and lipid metabolism disorders occurred more frequently and earlier (six or eight years) than in the general population.

Cardiovascular disease was found in 4.5 percent of long-term survivors - most of whom are already in their 40s. This is almost eight years earlier than in the rest of the population.

Nearly 1000 subjects who had cancer early

In order to arrive at these results, scientists from the Mainz University Medical Center examined a total of 951 adults as children or adolescents between October 2013 and February 2016 as part of the CVSS study ("Cardiac and vascular late sequelae in long-term survivors of childhood cancer") had cancer.

The experts conducted clinical investigations, collected information about the cancer treatment of the time and asked the subjects if they smoke and if there were already cardiovascular diseases in the family.

Study participants were between 23 and 48 years old at the time of the study. Their study results were compared with those of 15,000 people from the rest of the population.

Hypertension and lipid metabolism disorders

Univ. Dr. Jörg Faber, head of the pediatric oncology center at the University Center for Tumor Diseases (UCT Mainz), one of three study leaders emphasizes:

"Our results show that early cancer patients have a substantially higher risk of developing classical risk factors for cardiovascular diseases such as high blood pressure and lipid metabolism early in life, ie in adulthood."

Univ. Dr. Philipp Wild, Head of the Department of Preventive Cardiology and Medical Prevention, also CVSS study leader and senior author of the work adds:

"In addition, in nearly 80 percent of those affected - 207 out of 269 - elevated lipid levels were first identified in the clinical trials associated with the study and had previously gone undetected." A similar picture emerged in hypertension.

Avoid late effects as far as possible

On the basis of the knowledge gained, it is now important to avoid these late effects as far as possible. "And that is possible," Professor Faber is convinced:

"Early screening programs that focus on high blood pressure and elevated levels of fat should become an integral part of structured cancer follow-up, regardless of the type of cancer."

The development of a cardiovascular disease from high blood pressure could be prevented at an early stage, for example, by changing the lifestyle with a healthy diet and coping with stress or using blood pressure medication.

Cancer treatment could damage heart cells and blood vessels

The previous follow-up is only for five to ten years - and aims mainly to avoid the recurrence of cancer. In addition, current guidelines recommend regular cardiovascular examinations only for specific types of tumors.

"In order to develop an optimal aftercare strategy, however, further studies are needed", emphasizes Univ.-Prof. Dr. Maria Blettner, Director of the Institute for Medical Biometry, Epidemiology and Informatics (IMBEI), also study leader of the CVSS study and author of this work.

The researchers also want to focus increasingly on the exact mechanisms by which cardiovascular symptoms develop in former cancer patients.

It is known, for example, that chemotherapy or radiation in the context of a cancer treatment can damage heart cells as well as blood vessels temporarily or even permanently. The assumption is that certain genetic factors also play a role here.

"This now needs to be further clarified by means of detailed further studies at the molecular level," the study authors say. (Ad)