July 3, 2012 | by Shawn Le
We’re all pretty familiar with the common side effects of chemotherapy and radiation therapy. If we don’t know someone who’s gone through cancer — or maybe gone through it ourselves — we’ve seen patients on TV, in the movies or in books losing their hair or feeling too nauseated to move.
Chemotherapy and radiation therapy are common, effective treatments for cancer. But they’re also untargeted. Both therapies throw a wrench into rapidly dividing cells to kill them; but neither therapy can tell the difference between healthy cells that divide rapidly (like those in hair follicles) and cancerous cells that are doing the same. That’s one reason cancer patients can lose their hair and have other side effects during treatment.
Physicians have to delicately balance the desire to kill cancer with the need to protect healthy cells. In some cases, cancer treatment has long-term side effects that may not reveal themselves until months or years later.
That’s what happened with “Good Morning America” co-anchor Robin Roberts, who recently shared her diagnosis of myelodysplastic syndrome (MDS), a condition in which the bone marrow gets damaged and produces too few healthy blood cells. Roberts previously was treated for breast cancer.
City of Hope isn’t involved in Roberts’ care, but Smita Bhatia, M.D., M.P.H., director of City of Hope’s Center for Cancer Survivorship, explains that MDS can be related to cancer treatment.
Some 2 to 10 percent of breast cancer patients may develop MDS as a side effect of their treatment with chemotherapy or radiation therapy. Breast cancer patients can develop other conditions, too.
“Certain chemotherapuetic agents, such as anthracyclines, can increase the risk of heart failure; alkylating agents and topoisomerase II inhibitors can increase the risk of MDS; radiation can cause coronary heart disease; and chemotherapy can cause ‘chemobrain,’” Bhatia says.
When treating MDS, says Bhatia, doctors need to take into account details about patients’ previous therapy for their first cancer, so they can understand how much exposure patients have had to certain therapies over their lifetime.
Ultimately, says Bhatia, “the most effective treatment for treatment-related MDS is allogeneic stem cell transplantation.”
Roberts will undergo a bone marrow transplant to treat the disease and was fortunate to find a perfectly matched donor — her sister. As growing numbers of patients survive their cancers, like Roberts, we can expect to see more people have similar long-term health issues to deal with in the years to come.