Exploring the Long-term Impact of Radiation Therapy

Radiation therapy for cancer can save a young person’s life. But it can affect the body later on, and even reduce the chances of surviving another cancer.

For children, adolescents, and young adults who have cancer, radiation treatment can be a lifesaver. But research is showing that radiation therapy may have long-term impacts, affecting cardiovascular health and metabolism, and even reducing a woman’s chance of surviving breast cancer if it occurs later in life.

Researchers explored the topic in two different studies published in the American Association for Cancer Research’s journal Cancer Epidemiology, Biomarkers and Prevention. 

In one study, researchers analyzed data on breast cancer among premenopausal women, and focused on those who had been previously treated with radiation for their childhood, adolescent, or young adult cancer. The researchers found that those patients previously treated with radiation had significantly reduced breast cancer-specific survival compared with women who had not previously received radiation treatment. 

“Our results suggest that breast cancer-related survival is significantly decreased among all survivors of childhood, adolescent, and young adult cancer who were treated with radiation therapy and then develop breast cancer, even in the setting of early-stage breast cancer and other characteristics that are considered good prognostic factors,” said Candice A. Sauder, MD, surgical oncologist at the University of California (UC) Davis Comprehensive Cancer Center. “As such, we may need to tailor our treatment strategy for women with a second primary breast cancer.”

In the second study, researchers assessed the health status of 431 adults who survived childhood cancers of the abdomen or pelvic area after treatment with radiation. The researchers found that the survivors were significantly more likely to have insulin resistance, high levels of triglycerides, and low levels of high-density lipoproteins (“good cholesterol”) than their peers in the general population. 

They also had lower lean body mass, which causes a person to burn fewer calories while resting than someone with higher lean body mass.

“Body composition abnormalities and cardiometabolic impairments are of concern among survivors given that in the general population, these conditions increase the risk of developing life-threatening diseases including cardiovascular disease and type 2 diabetes,” said Carmen Wilson, PhD, corresponding author of the study and assistant member in the Epidemiology and Cancer Control department at St. Jude Children’s Research Hospital in Memphis, Tennessee. 

While it may not be possible to avoid radiation therapy as a treatment, changes in lifestyle behavior or the addition of resistance training could help reduce some of the long-term effects in survivors, suggested Wilson, adding that additional research on such intervention is needed.