The Long and Winding Cancer Road

Hodgkin lymphoma survivors may have increased risk of stomach cancer

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Treatments for cancers afflicting young people have improved vastly over the years. For example, survival rates have never been higher for Hodgkin lymphoma, one of the most common cancers in young adults.

New research has discovered that some Hodgkin lymphoma treatment regimens may result in higher risks for stomach cancer.

Developing this second cancer was extremely rare, however, occurring in less than 1 percent of survivors.

The authors of this study still suggested that both clinicians and survivors should be aware that gastrointestinal symptoms, such as stomach or abdominal pain, need to be evaluated promptly.

"Don’t ignore abdominal pain."

Lindsay M. Morton, PhD, a researcher with the National Cancer Institute (NCI) Division of Cancer Epidemiology and Genetics, and colleagues examined data from the Netherlands, Denmark, Finland, Norway, Sweden, the United States and Canada.

The aim of the study was to learn more about the relationship between Hodgkin lymphoma treatment and stomach cancer risk.

Hodgkin lymphoma is a cancer of the immune system that can appear during the teen and young adult years. Thanks to improved treatments, five-year survival rates for Hodgkin’s increased from 72 percent in the mid 1970s to 88 percent nearly 30 years later.

Today, some 175,000 Hodgkin lymphoma survivors live in the US.

Despite these dramatic improvements, the blood disease is known to increase a survivor's risk for second cancers, including those of the breast, lung and stomach.

For this study, the research team looked at data on 17,477 cases of Hodgkin lymphoma and discovered that 89 individuals developed stomach or gastric cancer.

This means that roughly one half of 1 percent (0.50 percent) of the participants had the second malignancy.

The investigators compared the treatments of Hodgkin’s survivors with and without stomach cancer.

Stomach cancer risks were highest among those who received higher doses of radiation to the stomach and higher doses of the chemotherapy medication procarbazine, an alkylating agent sold under the brand name Matulane.

Patients who received the highest radiation doses had a risk of stomach cancer nearly three times greater than that of patients who received the lowest doses.

Another alkylating agent, the chemotherapy medication dacarbazine (brand names Dabaz, Dacarex, Dacarin, Dacazine, Daczin), may also increase stomach cancer risks, the study uncovered. However, more research is needed to confirm this association.

Dr. Morton said in a prepared statement, “Because Hodgkin lymphoma patients commonly receive treatment in their 20s and 30s, many of the stomach cancers arise before age 50, nearly 20 years earlier than is typical for newly diagnosed patients who have never had cancer. Clinicians who follow these survivors should be alert to patient complaints related to the gastrointestinal tract.”

This research was published August 24 in the Journal of Clinical Oncology.

This work was supported by the Intramural Research Program of NCI as well as through NCI-issued contracts. No conflicts of interest were reported.

Review Date: 
August 29, 2013
Last Updated:
August 29, 2013