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Advancements in cancer treatment over the last half century mean that more than 85% of children survive cancer. But many common treatments, including radiation and certain chemotherapy drugs, can damage the heart over time. This damage can lead to cardiomyopathy, a condition where the heart becomes weaker and less able to pump blood efficiently.
It’s a known complication from pediatric cancer treatment, which is why survivors receive regular echocardiograms (ultrasounds of the heart) every few years. While these scans are widely available, safe and lower in cost than other screening methods, they can be imprecise and often only show problems after heart damage has occurred.
That’s where Eric J. Chow, MD, MPH, a pediatric oncologist and epidemiologist at Fred Hutch Cancer Center, sees an opportunity to improve the survivorship experience for patients who were treated for cancer in childhood.
Chow, who holds the Jennifer Lynn Kranz, Unravel Pediatric Cancer Endowed Chair, has spent the last decade studying heart function in survivors and exploring how the ongoing screening process can be more efficient and more accurate.
“Both during and after treatment, and for most patients, it’s a lifelong heart screening, based on our current guidelines,” Chow said. “Having to do an echocardiogram every two years, on a repeat, lifelong basis could mean more than 30 echocardiograms over a lifetime. The work we’re trying to do is to help refine the technology so that we can identify those people who might benefit from more frequent screening, as well as those who might need less frequent screening.”
Rally Foundation for Childhood Cancer Research was an early supporter of Chow’s work a decade ago, and its renewed support via a Rally 20/20: Alumni Visionary Grant of $200,000 allows him to explore technologies that weren’t readily available when his research started.
“When we started 10 years ago, we weren’t using machine learning,” said Chow, a Rally 20/20: Alumni Visionary Grantee. “Today, there is the potential for AI tools to become helpful in flagging echocardiogram images where a closer look might be required. Our hypothesis is that we can improve the quality of the prediction that we can get from echocardiogram images by extracting more information than the human eye can readily see.”
‘It’s not always about what’s the latest and greatest treatment for a specific type of cancer, but for people who have been treated in the past using conventional methods, how can we minimize the damage over years to come.’
― Fred Hutch pediatric oncologist and epidemiologist Dr. Eric Chow
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Chow’s newest phase of research is collaborative in nature, working with Lindsay Edwards, MD, a pediatric cardiologist at Duke Health, and Patrick Boyle, PhD, an associate professor of Bioengineering the University of Washington. Both Edwards and Boyle serve as technology partners who help Chow leverage a large dataset of over 4,800 heart scans from pediatric cancer survivors as well as other clinical data, such as details around the cancer diagnosis and treatment.
Leveraging AI and machine learning, Chow hopes to develop a model that helps identify hidden indicators of early heart damage and slow decline sooner, unlocking a more accurate risk prediction on a patient-by-patient basis.
“We really appreciate the Rally Foundation’s investment in us and their long-standing interest in not only new treatments, but also addressing survivorship issues that people have to face long term,” Chow said. “It’s not always about what’s the latest and greatest treatment for a specific type of cancer, but for people who have been treated in the past using conventional methods, how can we minimize the damage over years to come.”
