Doctors are trying to stop the 'cure' from becoming a cause of cancer

The number of childhood cancer survivors is growing each day, and while there is much to celebrate, in some cases the treatments have caused life-long health issues and even more cancers.

Statistics show that of the 18,000 survivors of childhood cancers in Australia today, two-thirds are living with side effects, of which half are afflicted with major impacts such as heart disease, infertility and secondary cancers.

"At the moment, curing these children involves quite a cocktail of nasty chemicals - highly toxic drugs - even though they do work," said Professor Murray Norris of the Children's Cancer Institute.

"Curing is not enough; we need to develop newer, safer, more effective treatments that are going to give us the same results but without the side effects."

One such technique is minimal residual disease (MRD) testing, developed by the institute a few years ago, where researchers can pick up very small numbers of leukaemia cells in a patient in remission whose scans appear clear.

Now doctors can predict a relapse in a child who has seemingly beaten acute lymphoblastic leukaemia before it occurs, allowing them to personalise the treatment and therefore limit the side effects.

MRD testing has become routine for children with leukaemia, with researchers conducting tests for more than 100 young patients a year.

"We can now follow these children and see which of them are responding or not responding to the therapy they've been given," said Professor Norris.

"As a result, the survival rate for these children has climbed up to over 70 per cent, a virtual doubling [for patients with high-risk types of acute lymphoblastic leukaemia]."

MRD testing is one of the latest examples of translational cancer research, which involves taking laboratory-based research and moving it into the clinic and to the bedside.

The increase in five-year survival rates for children diagnosed with blood cancer in NSW, from 48 per cent in the 1970s and 87 per cent in the 2000s, has been attributed to the growing collaboration between researchers and clinicians.

This bridge between the clinic and the laboratory - between making an invention and having it applied to patient care - is making a difference, says Professor Glenn Marshall, head of translational research at the Children's Cancer Institute.

Maddy was just five years old when she hurt her leg while jumping on her friend's trampoline. In the GP's office, her mother Kristy mentioned that her daughter looked quite pale.

The doctor ordered a blood test which showed leukaemia. Maddy underwent intense chemotherapy for nine months.

"Maddy's MRD testing showed her treatment didn't need to be intensified, which meant that the chances of her having late side effects was greatly reduced," said Kristy.

"She's now a happy, healthy, very active 10-year-old and we owe that to the MRD testing and the personalised treatment plan they came up with for her."

Professor David Currow, chief executive of the Cancer Institute NSW, said translational research was "absolutely crucial" to improving cancer outcomes.

He said translational cancer research centres, funded by the Cancer Institute NSW, were bringing more than 800 clinicians and researchers together to ensure they were speaking daily.

"We are investing heavily in translational cancer research centres," he said.

"So we've invested on an annual basis about $9 million in translational cancer research and another $3 million on translational program grants."

It is estimated that 670 children aged up to 14 will be diagnosed with cancer in Australia this year, according to Cancer Institute NSW.

In NSW, on average 218 children were diagnosed with cancer each year between 2010 and 2012.

Fairfax Media is a proud supporter of the Kids Cancer Project, which is running Childhood Cancer Awareness Month this September.

The story Doctors are trying to stop the 'cure' from becoming a cause of cancer first appeared on The Sydney Morning Herald.

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