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 cancerous, premalignant (likely to become cancer), or benign.

ALL. A 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 ALL and acute lymphocytic leukemia.

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.

Central nervous system tumor. 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.

A disease in which the body does not properly control the amount of sugar in the blood. As a result, the level of sugar in the blood is too high. This disease occurs when the body does not produce enough insulin or does not use it properly.

A record of a person's current and past illnesses, and those of his or her parents, brothers, sisters, children, and other family members. A family history shows the pattern of certain diseases in a family, and helps to determine risk factors for those and other diseases.

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 may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, 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.