What's new in the childhood cancer registry?

05.10.2017 09:37

Long-term pulmonary disease among Swiss childhood cancer survivors

Our research question 

  1. Do childhood cancer survivors have more often lung diseases like pneumonia, lung fibrosis and emphysema or chest wall problems than their siblings?
  2. How many years after cancer diagnosis can lung disease develop?
  3. Are recent childhood cancer treatments less toxic for the lung than treatments in previous decades?

Why is this important?

Lung diseases are severe late complications of childhood cancer treatment. Childhood cancer survivors visit the hospital three times more often for a lung disease than the general population. If clinicians detect lung disease at an early stage, they can help to mitigate adverse effects and to improve quality of life. Studies on lung diseases in the daily life of childhood cancer survivors are scarce, especially in Europe.

What did we do?

We invited all childhood cancer survivors from Switzerland to participate in a questionnaire survey. They had been treated for cancer between 1976 and 2005. We also invited their siblings to fill in the questionnaire as a control group. We asked whether the participants had ever had pneumonia, chest wall problems, lung fibrosis or emphysema.

What did we find?

We found that childhood cancer survivors had more pneumonias and chest wall problems than siblings, but lung fibrosis and emphysema were rare in both survivors and siblings. Childhood cancer survivors who had received busulfan chemotherapy were more likely to develop pneumonias, and those with thorax surgery more often had chest wall problems and lung fibrosis. Survivors developed lung diseases up to 35 years after the cancer. Survivors treated more recently had equally often lung problems than survivors treated many years ago, except for lung fibrosis, which became less common in survivors treated more recently.

What does this mean?

Lung diseases after childhood cancer treatment can develop during the whole life of survivors. This should be considered for follow-up care, and highlights that we need standardized lung monitoring in Switzerland. Pneumonia was the most common lung disease and it remained frequent in recently diagnosed survivors. Future research should investigate mechanisms leading to pneumonia in survivors.

More information:

Rahel Kasteler, Email : rahel.kasteler[at]ispm.unibe.ch

Claudia Kuehni, Email : claudia.kuehni[at]ispm.unibe.ch

Kasteler et al., Pediatric Blood and Cancer, 2017; doi.org/10.1002/pbc.26749


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