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Survivors of childhood cancer have a significantly increased risk for developing heart disease as young adults, a new study finds.

The finding came from an analysis of data on 14,358 five-year cancer survivors who were diagnosed before age 21 and 3,899 siblings of cancer survivors. The cancers were leukemia, brain cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, kidney cancer, neuroblastoma, soft tissue carcinoma or bone cancer.

The study found that young adult survivors of these childhood cancers are much more likely than others in their age group to have cardiovascular problems, including heart failure, heart attack, heart inflammation and heart valve abnormalities, for up to 30 years after being treated for cancer.

They also found that the risk was associated with lower exposure to chemotherapy and radiation treatment than previously thought.

“Young adults who survive childhood or adolescent cancer are clearly at risk for early cardiac morbidity and mortality not typically recognized within this age group,” wrote the study’s lead author, Dr. Daniel Mulrooney, a pediatric hematology oncologist at the University of Minnesota, and his research colleagues. “Such individuals require ongoing clinical monitoring, particularly as they approach ages in which cardiovascular disease becomes more prevalent.”

Health-care providers need to be aware of this increased risk for heart disease when caring for patients who survived childhood cancer, the researchers said.

The incidence of breast cancer in the United States declined 7 percent between 2002 and 2003, but only part of that decrease can be attributed to reduced use of hormone replacement therapy (HRT) by menopausal women, researchers say.

HRT use declined after the 2002 release of The Women’s Health Initiative study, which concluded that hormone therapy increases the risk of breast cancer. Other studies have confirmed the link.

“We found that the change in hormone therapy use only accounted for a decline (in breast cancer) of about 3 percent, so there’s another 4 percent that is being caused by something we do not yet know,” study leader Brian Sprague said in a news release.

He and his colleagues reviewed studies that looked at the decline of HRT use and the decline in breast cancer incidence. Based on the available literature, Sprague and colleagues estimated that reduced use of HRT accounted for 42 percent of the decline in breast cancer incidence.

Further research is needed to identify the other reasons for the decrease in breast cancer cases, Sprague said.

“This does not mean that women should start taking hormones again, but there appear to be additional factors that have contributed to the decline in breast cancer,” he noted.

People who have asthma and who also smoke could reverse some of the damage to their lungs by saying no to cigarettes, new Dutch research suggests.

“We found that exposure to cigarette smoke appears to increase the thickness of the epithelium, or lining, of the airways in the lung,” Martine Broekema, lead author of the study and a researcher at the University of Groningen in the Netherlands, said in a news release from the American Thoracic Society. “This may be the underlying cause of the fact that smoking asthma patients experience more asthma symptoms, such as shortness of breath and phlegm production, compared to nonsmoking asthma patients.”

The researchers looked at 147 people with asthma symptoms, including 35 smokers, 46 ex-smokers and 66 people who had never smoked.

People who currently smoked had more cells that produce mucous than did those who never smoked, the researchers found. “These pathological findings were associated with the severity of phlegm production reported by the asthma patients, suggesting a causal relationship between the two,” Broekema said. “Smoking asthmatics also showed a distinct inflammatory profile in their lungs compared to never-smoking asthmatics.”

“Furthermore, our data suggest that smoking cessation can reverse the thickening of the lining of the airways,” she said.
In the big picture, “this study shows again how important smoking cessation is for pulmonary health, and this appears to be especially true for asthmatic patients,” Broekema said. “The good news is that quitting appears to have a measurable benefit in these individuals.”