Some survivors of childhood cancers that affect vision may face increased risk for long-term health and economic problems, two new studies suggest.
Various types of health problems
The studies, published online in the journal Cancer, provide new insight that could help improve patient care and follow-up, the researchers say.
One study included 470 adult survivors of retinoblastoma who were followed for an average of 42 years. Retinoblastoma, the most common eye tumour of young children, can occur in one or both eyes. Most patients live for many years after treatment.
Compared to a control group of adults who never had the cancer, retinoblastoma survivors were more likely to have various types of health problems, including second cancers, the study found.
This increased risk was highest among those who had retinoblastoma in both eyes. These patients are known to have a genetic risk for new cancers.
But some good news emerged, too: When the researchers excluded vision problems and new cancers, survivors who had retinoblastoma in one eye were not at higher risk for chronic health problems than the control group.
Significantly, most retinoblastoma survivors rated their health as good to excellent, suggesting these patients "maintain comparatively normal health many years after completing therapy", Dr Danielle Novetsky Friedman, of Memorial Sloan Kettering Cancer Centre in New York City, and colleagues said in a journal news release.
Unemployed, unmarried and living with a caregiver
Lifelong screening of these patients will enable timely treatment of any health problems they may experience, the researchers added.
The other study included 1,233 adult survivors of childhood brain tumours. Of those patients, more than 22 percent suffered vision loss.
There was no link detected between vision loss and mental health, but survivors who were blind in both eyes were at increased risk of being unemployed, unmarried and living with a caregiver.
However, the researchers saw no clear connection between less severe vision loss such as blindness in one eye and increased risk of such situations, Dr Peter de Blank, of Case Western Reserve University School of Medicine in Cleveland, and colleagues said in the news release.
They noted that chemotherapy improves vision in about one-third of children with brain tumours involving visual pathways, and stabilises vision in another third. However, they said vision will deteriorate in another third of patients despite intense treatment.