Dr. Ketan Kulkarni
As treatment for pediatric cancer continues to advance, so too does the five-year survival rate which currently exceeds 84 per cent at five years.
But with this progress comes a downside: the occurrence of second malignant neoplasm (SMN) or second cancers in some of the survivors.
Previous studies focus mainly on the incidence and risk of SMN in long-term childhood cancer survivors, however new research sheds light on SMN in children within five years of diagnosis of their initial cancer.
“It’s national Canadian data on second malignant neoplasm, which hasn’t been done before using CYP-C,” says Dr. Ketan Kulkarni, IWK hematologist, oncologist and principal investigator for the study.
CYP-C is the Cancer in Young People in Canada program, a national pediatric cancer surveillance database. It was the primary data source for the SMN study – providing a large sample size of more than 20,000 patients all across Canada.
“We used the CYP-C database in its entirety and clearly saw how powerful large datasets can be,” says Dr. Kulkarni. “The work was truly collaborative over the years and at a national level.”
Along with Dr. Kulkarni, IWK Clinical Pharmacy Specialist Dr. Tamara MacDonald and Dalhousie University medical student Kate Lim were part of the study team. Researchers from across the country also took part and the Public Health Agency of Canada supported all the statistical analysis.
Dr. Tamara MacDonald
The effort behind the research was widespread and Dr. Kulkarni believes the impact will be, too.
“We will be freely able to share the findings of the study with families as it’s open access. This is first conclusive dataset that will tell families what the accurate incidence and risk factors for SMN in Canada within first five years of diagnosis are,” he says. “Among the scariest things for families to hear is that treatment of cancer will increase risk of second cancer. This will help us establish further monitoring guidelines and establish standard recommendations. It will help us monitor closely those patients at highest risk of a second cancer and hopefully detect them very early and develop a high degree of awareness across all clinics.”
The hope is that as clinics Canada-wide integrate this new data into their practices, it will better inform primary cancer treatment with future SMN development in mind.