As if having cancer at a young age isn't bad enough, it looks as though these kids could get hit with a double whammy. They're six times more likely to suffer from cancer again over the next two decades than the average person is to come down with the disease. That's according to the largest retrospective study on recurring cancer in young victims to date, covering 13,581 people. Presented by University of Minnesota physicians on Mar. 27 at the American Cancer Assn.'s meeting in New Orleans, the study notes that in some cases, initial cancer treatments may be causing the secondary outbreaks.
For example, girls with cancer who were treated with chest radiation were 16 times more likely than the overall population to develop breast cancer later in life. "The take-home message here is that patients need to know how they were treated as children and discuss with their doctors how they should be treated and monitored in light of that knowledge," says Joseph Neglia, the pediatrician who led the study.
SOUNDING THE ALARM.
But a new experimental treatment from the University of Michigan Health Systems (UMHS) holds significant promise for combating late-stage cancer in children and preventing secondary outbreaks. The treatment is a cancer vaccine made from dendritic cells, the specialized white blood cells that alert the immune system to outside invaders such as bacteria, viruses, or cancer cells. It combines dendritic cells with a patient's own tumor cells and, when injected, ignites the recipient's immune system. In initial clinical trials, the vaccine caused the disease to stabilize or regress in 13 of 17 children.
All of the kids, ranging in age from 3 to 17, had end-stage cancers that did not respond to other treatments. The vaccine was injected into the patient once every two weeks, for a total of three times, with the goal of getting the dendritic cells to attack the tumors. No significant side effects were recorded. "This study is certainly not a home run, but it does give us a lot of encouragement," says UMHS physician James Geiger.
The group plans to next treat the spread of cancer cells by injecting patients who have successfully finished standard treatments and hence have minimal disease. Theoretically, the injections would help the body's immune system wipe out remaining cancer cells floating free in the bloodstream and elsewhere. Approval of the treatment could be years off. But the vaccine is one of the more promising developments in recent years and could become a key tool in the arsenal to fight the 8,000 to 10,000 cancers diagnosed in U.S. children each year.
By Cathy Arnst in New Orleans
Edited by Alex Salkever