Key Points for This Section

Childhood cancer survivors may have late effects that affect the heart. Certain factors may increase the risk that heart late effects will occur. Heart late effects may be caused by treatment for certain childhood cancers.

Childhood cancer survivors may have late effects that affect the heart.

Heart late effects may include the following:

• Abnormal heartbeat.
• Disease of the heart muscle.
• Congestive heart failure.
• Increased risk of stroke, blood clots, and chest pains.
• Tiring quickly during exercise.
• Coronary artery disease (hardening of the heart arteries).

Certain factors may increase the risk that heart late effects will occur.

The following may increase the risk of heart late effects:

• Being female.
• Being young at the time of treatment (the younger the child, the greater the risk).
• Having other risk factors for heart disease, such as a family history of heart disease, being overweight, smoking, or having high blood pressure, high cholesterol, or diabetes.
• Having received a stem cell transplant.

This risk may also increase as the amounts of anthracycline drugs and radiation used increase and as the time since treatment gets longer.

Heart late effects may be caused by treatment for certain childhood cancers.

Treatment for these and other childhood cancers may cause heart late effects:

• Acute lymphoblastic leukemia (ALL).
• Central nervous system (CNS) tumors.
• Hodgkin lymphoma.
• Wilms tumor.

Glossary Terms

Not normal. An abnormal lesion or growth may be cancer, premalignant (likely to become cancer), or benign (not cancer).

An aggressive (fast-growing) type of leukemia (blood cancer) in which too many lymphoblasts (immature white blood cells) are found in the blood and bone marrow. Also called acute lymphocytic leukemia and ALL.

A type of antibiotic that comes from certain types of Streptomyces bacteria. Anthracyclines are used to treat many types of cancer. Anthracyclines damage the DNA in cancer cells, causing them to die. Daunorubicin, doxorubicin, and epirubicin are anthracyclines.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

A waxy, fat-like substance made in the liver, and found in the blood and in all cells of the body. Cholesterol is important for good health and is needed for making cell walls, tissues, hormones, vitamin D, and bile acid. Cholesterol also comes from eating foods taken from animals such as egg yolks, meat, and whole-milk dairy products. Too much cholesterol in the blood may build up in blood vessel walls, block blood flow to tissues and organs, and increase the risk of developing heart disease and stroke.

A tumor of the central nervous system (CNS), including brain stem glioma, craniopharyngioma, medulloblastoma, and meningioma. Also called central nervous system tumor.

Weakness of the heart muscle that leads to a buildup of fluid in body tissues.

Any of several diseases in which the kidneys make a large amount of urine. Diabetes usually refers to diabetes mellitus in which there is also a high level of glucose (a type of sugar) in the blood because the body does not make enough insulin or use it the way it should.

A record of the relationships among family members along with their medical histories. This includes current and past illnesses. A family history may show a pattern of certain diseases in a family. Also called family medical history.

A cancer of the immune system that is marked by the presence of a type of cell called the Reed-Sternberg cell. The two major types of Hodgkin lymphoma are classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma. Symptoms include the painless enlargement of lymph nodes, spleen, or other immune tissue. Other symptoms include fever, weight loss, fatigue, or night sweats. Also called Hodgkin disease.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

Being too heavy for one’s height. Excess body weight can come from fat, muscle, bone, and/or water retention. Being overweight does not always mean being obese.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

Something that increases the chance of developing a disease. Some examples of risk factors for cancer are age, a family history of certain cancers, use of tobacco products, being exposed to radiation or certain chemicals, infection with certain viruses or bacteria, and certain genetic changes.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

A disease in which malignant (cancer) cells are found in the kidney, and may spread to the lungs, liver, or nearby lymph nodes. Wilms tumor usually occurs in children younger than 5 years old.