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Childhood Cancer: Health Risks Linger

Childhood Cancer Survivors May Benefit From Specialized Care, Researcher Says
By
WebMD Health News
Reviewed by Louise Chang, MD

June 26, 2007 -- Childhood cancer treatments have improved greatly in recent decades, but childhood cancer survivors may need specialized care for their adult health.

So say Dutch cancer specialists in The Journal of the American Medical Association.

They included pediatric oncologist Huib Caron, MD, PhD, of Emma Children's Hospital/Academic Medical Center in Amsterdam, Netherlands.

Caron and colleagues studied nearly 1,300 childhood cancer survivors. The survivors lived at least five years after cancer treatment at Caron's hospital from 1966 to 1996.

Most of the patients had been treated for cancer before age 15. Caron's team checked in with the survivors an average of 17 years later, when most survivors were about 24 years old.

The survivors got thorough medical checkups to check for other cancers, fertility problems, amputations, obesity, heart problems, psychological or emotional issues, and other conditions.

Late Effects of Childhood Cancer

Nearly a fifth of the survivors had no medical problems. But almost three-quarters of the group had at least one medical problem.

Most survivors -- nearly 60% -- had more than one medical problem, and almost a quarter had five or more medical problems.

A total of 121 patients died during the follow-up period, mainly due to their childhood cancer, the study shows.

Patients who got radiation therapy as children were two to three times more likely to have serious health problems than those who didn't get radiation treatment as children.

The study doesn't show whether the young adults' health problems stemmed from their childhood cancer or childhood cancer treatment.

Treating Childhood Cancer Survivors

"At 25 years of age, when life is beginning and you've got life ahead of you, many of our survivors are confronted with health problems," Caron says.

But he adds that in his practice, "the picture is less depressing than you would estimate from these data.

"Yes, they have health problems, but the majority of the people I see in our late-effects clinic are very happy to be around, are very optimistic, [and] cope very well with these kind of health problems," says Caron.

Specialized clinics are needed to treat childhood cancer survivors, who "run a high risk of a large spectrum of different health problems at a young age," says Caron.

He notes that many doctors aren't very familiar with childhood cancer survivors' health risks.

Caron's study is accompanied by an editorial calling for more research on the late effects of childhood cancer.

"What the future holds for survivors who have bravely won the battle with their childhood cancer is uncertain," states the editorial.

"It is critically important for physicians to recognize these risks, facilitate risk-based health care, and strive to improve therapy," write the editorialists, who included Kevin Oeffinger, MD, of the pediatrics department of New York's Memorial Sloan-Kettering Cancer Center.

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