SAN ANTONIO, Texas – 22-year-old Brittany Galan has been seeing oncologists since she was six-weeks-old and diagnosed with leukemia.
"I had a 10% survival rate," said Galan.
Miraculously, after six months of chemotherapy, she was cured. Then two decades later during a routine exam – a shocking diagnosis.
"I was about 20 at the time and Dr. Shaw came back with the results and she says you need to go see a cardiologist," said Galan.
Physicians believe the chemotherapy that saved her life as a baby may be the cause her of cardiac problems nearly nineteen years later.
"The younger you are, the tissues are theoretically more sensitive to chemotherapy," explained Greg Aune, M.D., PhD, and Assistant Professor of Pediatrics at University of Texas Health Science Center at San Antonio.
Aune knows all too well what young cancer patients are going through. Cured of Hodgkin's disease in his teens, he developed heart problems at thirty-five.
"I had to get open heart surgery to basically save my life," Aune said.
Today, Aune collects and analyzes data from childhood cancer survivors.
"The purpose of this study is to really identify the types of people who after they're treated for chemotherapy, are more likely to develop heart problems," said Helen M. Parsons, PhD, MPH, Assistant Professor of Epidemiology and Biostatistics, and Health Services Researcher at UT San Antonio.
Research that can eventually help childhood cancer survivors like Brittany identify cardiac problems.
"If I didn't take the medication that I take now," said Galan, "I don't know where I'd be."
Aune says only 30 percent of cancer survivors are seen in survivorship programs and actively monitored for potential health problems. He encourages childhood cancer survivors to find a program, if possible.
Chemotherapy is a form of cancer treatment which uses drugs to kill cancerous cells. Only some types of cancer treatments are said to cause cardiac problems, such as weakening of the heart muscle and abnormal heart rhythm (arrhythmia). Anthracycline chemotherapy and radiation therapy are said to be two forms of cancer treatments linked to heart problems, which are considered "late effects", in that it takes several years for a cancer survivor to notice.
(Sources: http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/chemotherapy/chemotherapyprinciplesanin-depthdiscussionofthetechniquesanditsroleintreatment/chemotherapy-principles-what-is-chemo , http://www.survivorshipguidelines.org/pdf/heartHealth.pdf)
WARNING SIGNS: For those without a pre-existing heart condition, if faintness, shortness of breath (with minimal exertion), or chest pain occur during chemo, the patient should report it to their treatment team immediately.
(Source: http://www.mayoclinic.org/diseases-conditions/cancer/expert-answers/chemotherapy-side-effects/faq-20058319 )
TREATMENT: Childhood cancer survivors should have frequent check-ups, at least once a year, with their doctors to monitor heart function. Electrocardiograms (EKG's) and echocardiograms (heart ultrasound) are recommended to monitor the heart's rate/rhythm and heart muscle function, respectively. For those cancer patients with pre-existing heart conditions, a doctor may suggest an alternative type of chemotherapy. Maintaining a healthy heart before, during, and after cancer treatments by exercising, not smoking, and maintaining a healthy body weight with proper nutrition can greatly reduce the risk of cardiovascular issues.
(Sources: http://www.cancer.net/survivorship/long-term-side-effects-cancer-treatment, http://www.mayoclinic.org/diseases-conditions/cancer/expert-answers/chemotherapy-side-effects/faq-20058319, http://www.survivorshipguidelines.org/pdf/heartHealth.pdf)