Breast cancer following childhood cancer—more to the story than we thought

Advances in cancer biology, tested in clinical trials, and improvements in supportive care have contributed to an increasing number of individuals living many years following a cancer diagnosis. While this success has been realized across the age spectrum, it has been particularly evident in pediatric oncology, where overall survival rates approach, and in some cases exceed, 80% (1,2). As pediatric cancer survivors age, the health implications of prior cancer therapies become evident, elucidating a need for specialized long-term surveillance. The majority of childhood cancer survivors have at least one chronic health condition, many have multiple conditions, and these can be severe or disabling, affecting quality of life and contributing to pre-mature death (3,4). In fact, a recent report among a large cohort of Hodgkin lymphoma (HL) survivors uniquely outlined the multiplicity of cardiovascular conditions and the overall health burden experienced by these survivors (5). Many of the health issues identified among childhood cancer survivors might be expected in an older population, leading some investigators to suggest a potential mechanism for accelerated aging in this population (6).