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    The Human Cost of Child Cancer Survival

    Survival Rates Up, so Are Life-Threatening Side Effects

    WebMD Health News

    Aug. 26, 2003 -- Child cancer survival rates have skyrocketed in the last 30 years. But a new study shows these medical advancements have come at an unexpected price: Life-threatening side effects from treatment are creeping up later in life.

    Patterns of late side effects of cancer treatment are popping up in the form of complications, disabilities, or adverse outcomes, giving credence to the notion that child cancer is a chronic problem that requires ongoing care, researchers write. The findings appear in a report published by the Institute of Medicine.

    25% of Kids Have Life-Threatening Side Effects

    Most children with cancer are treated with some combination of chemotherapy, radiation therapy, and surgery -- and about 44% receive all three, researchers write. The study shows that as many as two-thirds of child cancer survivors are likely to experience at least one side effect after they reach adulthood, and possibly 25% experience a late side effect that is severe or life-threatening.

    When researchers analyzed childhood cancer death statistics, they found an interesting pattern. There was a tenfold increase in death rates among cancer survivors from 1970 to 1986 and most of these deaths were attributed to the return of the primary cancer. But a range of treatment-related side effects -- including secondary cancers, heart problems related to chemotherapy, and lung complications -- caused 21% of them.

    Children with cancers involving the brain and spinal cord suffered learning impairments, social difficulties, behavioral adjustment problems, and long-term education and vocational handicaps.

    Young kids or those who receive intense or prolonged treatment are most at risk for late side effects, researchers write.

    Because of the risks child cancer survivors face, researchers strongly recommend these patients should be systematically followed-up by:

    • Developing guidelines for the care of childhood cancer survivors
    • Defining a minimum set of standard for systems that link specialty and primary care doctors
    • Improve professional education and training regarding late side effects
    • Improve awareness of late side effects and their implications for long-term health

    Creating that system should be a top priority, they write.

    SOURCE: Childhood Cancer Survivorship: Improving Care and Quality of Life, Institute of Medicine of the National Academies, Aug. 24, 2003.

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