Children's Hospital oncology researchers continue to find answers through research. Here is some information about recent studies completed at The Children's Hospital of Philadelphia.
This study examined the medical records of 57 males treated for Wilms’ tumor between 1985 and 2000. The purpose was to determine if these males, whose kidneys were removed as part of their treatment, were now at risk for developing a hydrocele (a collection of watery fluid around the testicle). We also wanted to know if radiation influenced the risk for this late effect. This study did indeed show that there is an increased prevalence of hydrocele in males who had kidney surgery, but neither radiation nor chemotherapy increased this risk. This study finding confirmed the non-serious nature of testicular enlargement by fluid in boys who had kidney surgery.
More than 80 percent of children and adolescents diagnosed with Hodgkin’s disease (HD) will survive long term. For the past decade, a modified chemotherapy regimen consisting of cyclophosphamide, vincristine, procarbazine and prednisone (COPP), together with adriamycin, bleomycin and vinblastine (ABV) has been used to treat patients with HD. This modified regimen contained less cyclophosphamide and procarbazine, agents known to impair fertility. This study reported on 11 male patients treated with COPP-ABV hybrid. Nine out of 11 subjects were categorized as infertile by semen analysis. There was no association between fertility status and prepubertal status at diagnosis or gonadotropin status. This information is vital in counseling newly-diagnosed patients and their families.
This study was the first reported large randomized clinical trial of treatment related to family adjustment to a serious pediatric illness. In studying a group of 150 families, researchers at Children's Hospital found that participants had significantly fewer symptoms of post-traumatic stress after a one-day treatment program, compared with a control group who did not receive the treatment. Post-traumatic stress symptoms (PTSS) include things like intrusive, unwanted thoughts; avoidance of stress-inducing settings and situations; and heightened arousal, such as nausea or increased heart rate triggered by reminders of the original experience. Researchers found the strongest effects of the treatment in the adolescent survivors, who had decreased arousal symptoms, and among the survivors' fathers, who had fewer intrusive thoughts. Mothers of survivors did not show a significant effect from the treatment in this study.
Building on the results of this research, there is now another study underway to investigate the effectiveness of a two-session group workshop specifically designed to address the survivorship issues of young adults.