Reduction in Radiation Has Reduced Second Tumors in Pediatric Cancer Patients Interview with:

Lucie Turcotte, MD, MPH University of Minnesota Masonic Children's Hospital Division of Pediatric Hematology-Oncology Assistant Professor Minneapolis, MN 55455

Dr. Lucie Turcotte

Lucie Turcotte, MD, MPH
University of Minnesota Masonic Children’s Hospital
Division of Pediatric Hematology-Oncology
Assistant Professor
Minneapolis, MN 55455 What is the background for this study? What are the main findings?

Response: We have observed dramatic improvements in the number of survivors of childhood cancer over the last 60 years. As more children are surviving, we have identified many important late health consequences of cancer therapy. One of the most devastating of these late health consequences is the diagnosis of a second cancer. As we have identified late effects, such as second cancers, we have modified therapy in an effort to prevent long-term sequelae of therapy, while still maintaining superior survival rates.

For this study, we utilized data from the Childhood Cancer Survivor Study (CCSS), which is a cohort of more than 23,000 survivors of childhood cancer from multiple centers in North America, who were initially diagnosed between 1970 and 1999. Our analysis focused on elucidating whether survivors diagnosed more recently were experiencing fewer second cancers, and determining whether a reduction in second cancers could be associated with treatment modifications.

The most important finding from this study is that the reductions in therapeutic radiation exposure that occurred between 1970-1999 resulted in a significant reduction in the second cancers experienced by survivors of childhood cancer. What should readers take away from your report?

Response: I hope readers take away and appreciate that important progress has been made in the way we are treating children with cancer. The goal of childhood cancer therapy has historically been cure at all costs, but that resulted in many health complications and inferior quality of life for long-term survivors. We are obligated to consider the potential late effects at the time of treatment decisions, and I hope people recognize that the changes in therapeutic radiation exposure have positively impacted children in the long term. What recommendations do you have for future research as a result of this study?

Response: Next important steps will be building on our current understanding of treatment-related subsequent cancers to better understand what other factors are putting children at risk. Examples include looking at specific genetic modifications that may increase second cancer risk, and also looking at specific chemotherapy and immune therapy exposures to understand their roles in the development of second cancers. There remains a great deal of work and study to be done, but our recent progress is encouraging.

No disclosures. Thank you for your contribution to the community.


Turcotte LM, Liu Q, Yasui Y, Arnold MA, Hammond S, Howell RM, Smith SA, Weathers RE, Henderson TO, Gibson TM, Leisenring W, Armstrong GT, Robison LL, Neglia JP. Temporal Trends in Treatment and Subsequent Neoplasm Risk Among 5-Year Survivors of Childhood Cancer, 1970-2015. JAMA. 2017;317(8):814-824. doi:10.1001/jama.2017.0693

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 1, 2017 by Marie Benz MD FAAD