This year alone, 215,000 women will be diagnosed with breast cancer. And sadly, not all of them will be treated equally.

Researchers reported last Tuesday that breast cancer patients who are either obese or poor are more likely to receive lower doses of chemotherapy. This might be why some women relapse and others do not, according to the researchers whose findings appear in the Journal of Clinical Oncology.

This treatment discrepancy seems to stem from doctors who mean well and want to save certain women from severe side effects of chemotherapy. Doctors may be under-dosing obese patients, for example, because a larger dose based on weight could lead to worse side effects. There is no evidence this is true, however.

As for socioeconomic status, researchers report doctors are assuming less-educated patients won't stick with a tough course of treatment -- and so they prescribe less, in hopes patients will complete the regimen.

Researchers found that severely obese women were four times more likely to get less chemotherapy than they need. Women with less than a high school education were three times more likely to receive low doses of chemotherapy. And women living in the South were almost six times more likely to come up short on the drugs they need to save their lives.

"We have new therapies and cures out there for many forms of cancer and sadly, sometimes we're not curing people because they are not getting the full doses that should be standard," says Dr. Gary Lyman who led the study at the University of Rochester Medical Center in New York.

The overall cure rate for the 20,000 children diagnosed with cancer in the United States each year is more than 75 percent. Sounds good -- especially when 50 years ago, most children diagnosed with cancer died. But considering that only one in three childhood cancer survivors remain healthy, perhaps this is not such good news.

Thirty years after diagnosis, about 40 percent of survivors have a serious health problem and one-third have multiple problems. Strokes, heart disease, and kidney failure are just a few of the major health concerns that plague many survivors who have entered adulthood.

Doctors have long known that cancer treatments can cause new cancers later in life. But the Childhood Cancer Survivor Study -- the largest ever childhood study of its kind -- shows there are other long-term health problems. Researchers studied 10,000 survivors -- past studies examined 200-300 survivors -- and found these survivors were eight times as likely as their siblings to develop severe and life-threatening conditions. They found survivors of bone tumors, nerve and brain cancer, and Hodgkin's disease faced the highest risk.

The source of these later-in-life health problems vary. Kidney failure may result from damage caused by chemotherapy or radiation or the infections children suffer when their immune systems are weakened. Drugs used to treat infections may also be to blame. Strokes may result from head and chest radiation.

Cancer treatment for people of all ages comes with a price. We buy time, we buy life in exchange for the unknown. But for children -- who stand to live longer than adults -- there is a greater unknown. Sadly, there is a dark side to surviving cancer.

In the past year, I have had three severe skin reactions characterized by red, itchy, burning bumps that start on my chest and without fail climb over my shoulders and onto my back. They last for a few weeks, are irritated by the Florida heat, and have had no known cause -- until today when I visited my dermatologist for a skin cancer screening and briefed her on this bizarre condition that has kept me away from sunscreen and out of the swimming pool and in hiding from the sun. I have suspected that sunscreen, chlorine, the sun -- or some combination of the three -- have been my potential irritants. So I've been avoiding them altogether. But I learned today that the sunscreen and the chlorine are not to blame. That leaves the sun, which is the most likely culprit -- and only because I have received chemotherapy with one very toxic drug. Adriamycin.

My dermatologist told me about a phenomenon called UV Recall that is associated with Adriamycin. Apparently the toxicity of this drug, even though administered long ago, can be recalled, causing a reaction when the UV rays of the sun soak into my skin. Sunscreen may help, my doctor told me, but she cautioned me that it is just a screen -- it does not offer full protection. And she said the best suncreen option would include zinc oxide. I think for me, though, staying out of the sun is my best bet. It's not ideal -- it means I will remain on the fringe of the swimming pool, hiding in the shade, while my boys swim their little hearts out. And tropical vacations will be off my wish list. And I will seek outdoor fun mostly after the sun goes down. But this is okay -- I knew there were long-term side effects of chemotherapy drugs. I am just thankful for now that my heart has not been compromised -- a side effect of both Adriamycin and the drug Herceptin that I have also received. And it's also not a bad thing that the steps I must now take to prevent skin reactions are also the steps that protect me from skin cancer. So in some sort of round-about way, my inconvenient skin issues may just help me stay healthy. And that's just fine with me.