Spring 2018

Restoring health after cancer

with Karim Thomas Sadak, M.D., M.P.H., M.S.E.

Since the groundbreaking Childhood Cancer Survivor Study began at the University of Minnesota in 1994, the U has been an international leader in caring for pediatric cancer survivors and addressing the unique health issues they may face throughout their lives. 

Karim Thomas Sadak, M.D., M.P.H., M.S.E., directs the Masonic Cancer Center’s childhood cancer survivorship program, which has been supported for decades by Children’s Cancer Research Fund. 

Karim Thomas Sadak, M.D., M.P.H., M.S.E.

What’s changed since 1994? 

Today, greater than 80 percent of childhood cancer patients will become long-term survivors. This has created a huge, growing population of kids who need health care that’s a little bit different. 

We know that two-thirds of childhood cancer survivors will have some long-term complication or chronic condition, what we call a “late effect,” directly related to their treatments. A third will end up having a serious, life-threatening late effect. So there’s a lot of opportunity, across the lifespan of these survivors, to either prevent these complications or have the screening in place to catch them early. 

What types of complications do you see? 

All treatment options—chemo, radiation, bone marrow transplant, and surgery—can cause late effects. 

One chemotherapy mainstay, for example, if given at a higher dose, can cause heart failure at ages much younger than in the general population. So these kids, for the rest of their lives, need echocardiograms to make sure their hearts aren’t becoming weakened. 

Other types of late effects include second cancers; lung late effects; concerns for liver health, kidney health, bladder health, eye health, and even dental health. One of the most common late effects involves the endocrine system and can result in infertility. 

How have therapies been altered in response to these findings? 

The biggest change is less use of radiation. Kids with ALL [acute lymphoblastic leukemia] and Hodgkin lymphoma, for generations, all received extensive radiation. Now we can attain high cure rates with chemotherapy alone in many cases—different combinations and different cocktails. Less radiation translates to lessened risk for secondary cancers. 

What’s unique about the U’s program? 

Continuity. Our team sees these kids throughout their entire lives. 

Also, every patient at University of Minnesota Masonic Children’s Hospital gets the opportunity to participate in world-class research if they’re interested. Our database includes more than 700 survivors and allows us to make a difference for the next generation of survivors through research.

Find out how you can support childhood cancer survivorship research by contacting Jen Foss of the University of Minnesota Foundation at 612-626-5276 or foss@umn.edu.

New therapies, new late effects?

Unlike standard chemotherapy drugs, immunotherapies and targeted agents are designed to distinguish between cancer cells and normal cells and fight only the cancer—leaving the normal cells unharmed. These new therapies—some of which employ T cells (in orange), a type of white blood cell that’s part of a normal immune system—are revolutionizing cancer treatment and stand to improve survival rates. But their long-term effects are still unknown. Because of the University of Minnesota’s strong track record in childhood cancer survivorship research, Karim Thomas Sadak, M.D., M.P.H., M.S.E., and his team have received $150,000 to monitor the late effects of these immunotherapies. The study is among the first of its kind.