Cardiovascular and Pulmonary Challenges After Treatment of Childhood Cancer

Henk Visscher; Maria Otth; E A M Lieke Feijen; Paul C Nathan; Claudia E Kuehni

doi:10.1016/j.pcl.2020.07.007

Cardiovascular and Pulmonary Challenges After Treatment of Childhood Cancer

Pediatr Clin North Am. 2020 Dec;67(6):1155-1170. doi: 10.1016/j.pcl.2020.07.007.

Authors

Henk Visscher¹, Maria Otth², E A M Lieke Feijen³, Paul C Nathan⁴, Claudia E Kuehni⁵

Affiliations

¹ Division of Haematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada; Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, The Netherlands. Electronic address: [email protected].
² Childhood Cancer Research Platform, Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Division of Hematology-Oncology, Department of Pediatrics, Kantonsspital Aarau, Switzerland.
³ Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, Utrecht 3584 CS, The Netherlands.
⁴ AfterCare Program, Division of Haematology/Oncology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
⁵ Childhood Cancer Research Platform, Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland; Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Mittelstrasse 43, Bern 3012, Switzerland.

PMID: 33131539
DOI: 10.1016/j.pcl.2020.07.007

Abstract

Childhood cancer survivors are at risk for developing cardiovascular disease and pulmonary disease related to cancer treatment. This might not become apparent until many years after treatment and varies from subclinical to life-threatening disease. Important causes are anthracyclines and radiotherapy involving heart, head, or neck for cardiovascular disease, and bleomycin, busulfan, nitrosoureas, radiation to the chest, and lung or chest surgery for pulmonary disease. Most effects are dose dependent, but genetic risk factors have been discovered. Treatment options are limited. Prevention and regular screening are crucial. Survivors should be encouraged to adopt a healthy lifestyle, and modifiable risk factors should be addressed.

Keywords: Cardiovascular; Childhood cancer survivor; Late effects; Pulmonary.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Antineoplastic Agents / adverse effects
Cancer Survivors*
Cardiovascular Diseases / etiology*
Cardiovascular Diseases / mortality
Drug-Related Side Effects and Adverse Reactions
Humans
Lung Diseases / etiology*
Lung Diseases / mortality
Neoplasms / therapy*
Population Surveillance
Radiotherapy / adverse effects
Risk Factors

Substances

Antineoplastic Agents