“As of January 2010, there were an estimated 379,112 survivors of childhood and adolescent cancers, of whom 35,253 (9.3%) had been treated for Hodgkin lymphoma,” according the American Cancer Society—as summarized in “Cardiotoxicity and Breast Cancer as Late Effects of Pediatric Hodgkin Lympoma (HL) Treatment,” a CE feature in the April issue of AJN.
Author Joanne Lee Candela, an adult NP in the survivorship program at the Memorial Sloan Kettering Cancer Center in New York City, hopes to raise awareness among all nurses of “residual risks associated with the various HL treatments, thereby promoting appropriate screening and, as needed, referral for specialty care.” The below table, from the article, depicts selected potential late effects of Hodgkin lymphoma treatment. Click to enlarge.
The article points out that “two of the most prevalent and life-threatening late effects are female breast cancer, secondary to chest radiation as well as to any underlying genetic tendencies, and cardiotoxicity and its sequelae, which are related to chest radiation that encompasses the heart and to the anthracycline component of chemotherapy.”
Why is this important to nurses in all settings? These late effects of HL treatment can show up decades after treatment. It’s crucial to know what to look for, and, if possible, as much as possible about a patient’s treatment history:
“When caring for a patient with a history of cancer, it is important to ask whether she or he has a treatment summary—particularly when the treatments may have late effects. The treatment summary and care plan should be provided to patients as they finish cancer treatment to alert them and their future health care providers to potential risks and late adverse effects associated with the treatments they received and the need for appropriate screening.”
But read the entire article, which gives a comprehensive overview of the evolution of HL treatment modalities, the etiology and presentation of HL, and the clinical presentation and management (as well as prevention strategies, where relevant) of the most significant and common late effects of childhood and adolescent treatment.—Jacob Molyneux, senior editor