Bron: the Lancet d.d. 5 april 2003:

'Zaterdag 5 april 2003 staat in de Lancet een artikel over de effecten van chemo en bestraling bij de ziekte van Hodgkin en non-Hodgkin. Deze behandeling veroorzaakt heel vaak nieuwe tumoren en ook nieuwe vormen van kanker. Behandelde vrouwen lopen bijvoorbeeld 136 keer zoveel kans als normaal om borstkanker te krijgen. De auteurs van de studie pleiten voor minder agressieve behandeling van Hodgkin. (JV)

Hieronder het abstract van het artikel in de Lancet en daaronder het abstract van een studie die bewijst dat vrouwen 136 keer meer kans op borstkanker hebben na een behandeling met chemo en bestraling van lymfklierkanker. Wat ik wel opvallend vind is dat als er een muis geneest met een nieuwe vorm van chemo dit op de voorpagina's van alle kranten breed wordt uitgemeten, zeker als de toonaangevende Lancet dit publiceert, nu is dit bericht bij mijn weten in nog geen enkele krant of medium genoemd. Over selectieve berichtgeving gesproken.

Bron: the Lancet d.d. 5 april 2003:

'The incidence of second malignant growths--including haematological cancers and solid tumours--has emerged as a serious long-term effect of therapy for Hodgkin's disease' 

Hodgkin's disease is a success story for cancer treatment. Use of intensive radiotherapy and chemotherapy regimens has ensured that more than 85% of patients are cured of their disease. However, development of secondary cancers is a serious long-term side-effect of treatment--women treated for Hodgkin's disease have a risk of developing breast cancer up to 136 times higher than that of the general population. In the April issue of The Lancet Oncology, Kenan Deniz and colleagues discuss a protocol for formal follow-up of patients treated for Hodgkin's disease. They describe treatment options that avoid the necessity for high-dose radiotherapy, and review the unique characteristics of treatment-induced breast cancers which should aid development of effective management strategies for these patients. 


Lancet Oncol 2003; 4: 207-14 


Breast cancer in women after treatment for Hodgkin's disease
Kenan Deniz a , Susan O'Mahony a , Gillian Ross b , and Anand Purushotham a 

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Summary
Although substantial progress has been made in the management of Hodgkin's lymphoma during the past 30 years, the development of secondary malignant diseases has emerged as a serious consequence of treatment. In particular, extended follow-up of patients with Hodgkin's disease has revealed an increased risk of breast cancer. We have systematically reviewed all published literature on breast cancer after treatment for Hodgkin's disease and show that high risk is particularly associated with treatment at a young age, mantle radiotherapy, and chemotherapy. Breast cancers in this context differ from sporadic disease because they develop in younger women, are associated with a high incidence of bilateral disease, and are generally located near the midline of the body. The risk of breast cancer is lower in patients who receive newer, combined modality treatments for Hodgkin's disease. In this review we discuss a protocol for formal follow-up and screening of patients who have recovered from Hodgkin's disease to aid early diagnosis and ensure the possibility of effective management.

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Affiliations:
a KD, SO'M, and AP are at the Cambridge Breast Unit, Addenbrookes Hospital, Cambridge, UK. b GR is at the Royal Marsden Hospital, London, UK. 

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