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Long-term Complications Following Childhood and Adolescent Cancer: Foundations for Providing Risk-based Health Care for Survivors

Dr. Oeffinger is Professor, Family Practice and Pediatrics, and Director, After the Cancer Experience Young Adult Program, Department of Family Practice and Community Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX.
Dr. Hudson is Director, After Completion of Therapy Clinic, Departments of Hematology Oncology and Behavioral Medicine, St. Jude Children’s Research Hospital, Memphis, TN.

Survivors of childhood and adolescent cancer are one of the higher risk populations seen by health care professionals. The curative therapy administered for the cancer also affects growing and developing tissues. Following chemotherapy, radiation therapy, and surgery, many survivors will experience chronic or late-occurring health problems, often not becoming clinically apparent until decades after therapy. Survivors face an increased risk of morbidity, mortality, and diminished quality of life associated with their previous cancer therapy. Risk is further modified by the survivor’s genetics, lifestyle habits, and comorbid health conditions. Over their lifetime, survivors will see health care professionals from an array of specialties and disciplines. The aim of this review is threefold: (1) to convey a sense of the risk faced by survivors to clinicians unfamiliar with the population; (2) to provide an up-to-date tool for clinicians, regardless of specialty or discipline, when providing care for a survivor; and (3) to complement the recently completed recommendations for screening, prevention, and management of childhood cancer survivors.

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