Adult Survivorship of Pediatric Cancers

  • Joann L. Ater
Part of the MD Anderson Cancer Care Series book series (MDCCS)


Advances in therapies over the past four decades have improved overall survival for children and adolescents with cancer. Currently, 80 % of patients diagnosed with cancer before the age of 20 years will survive beyond 5 years from diagnosis. Improved outcomes have resulted in a growing population of adult survivors of childhood cancer. Survival of childhood cancer comes at the price of lifelong chronic health issues in at least 62 % of survivors. Radiation therapy, especially at a young age, carries the highest risk of late adverse outcomes. Radiation therapy has been associated with an increased risk for late premature mortality, subsequent neoplasms, obesity, and pulmonary, cardiac, and thyroid dysfunction, as well as an increased overall risk for chronic health conditions. Surgery and chemotherapy also increase the risk for chronic health conditions such as cardiomyopathy, osteoporosis, renal dysfunction, hearing loss, pulmonary dysfunction, and liver dysfunction. Although many survivors are satisfied with their quality of life, long-term follow-up for all adult survivors of childhood cancer is recommended to screen for second malignancies and late effects of therapy, make appropriate referrals for care of treatment-related health conditions, and provide psychosocial support and advice. This chapter will discuss the practices and recommendations for care of adult survivors in the Childhood Cancer Survivor Clinic at MD Anderson.


Hodgkin Lymphoma Childhood Cancer Adult Survivor Cardiac Adverse Effect Central Nervous System Tumor 
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Suggested Readings

  1. Armstrong GT, Liu Q, Yasui Y, et al. Long-term outcomes among adult survivors of childhood central nervous system malignancies in the Childhood Cancer Survivor Study. J Natl Cancer Inst 2009;101:946–958.PubMedCrossRefPubMedCentralGoogle Scholar
  2. Armstrong GT, Stovall M, Robison LL. Long-term effects of radiation exposure among adult survivors of childhood cancer: results from the childhood cancer survivor study. J Radiat Res 2010;174:840–850.CrossRefGoogle Scholar
  3. Bhatia S, Constine LS. Late morbidity after successful treatment of children with cancer. Cancer J 2009;15(3):174–180.PubMedCrossRefGoogle Scholar
  4. Bhatia S, Sklar C. Second cancers in survivors of childhood cancer. Nat Rev Cancer 2002;2:124–132.PubMedCrossRefGoogle Scholar
  5. Dickerman JD. The late effects of childhood cancer therapy. Pediatrics 2007;119(3):554–568.PubMedCrossRefGoogle Scholar
  6. Diller L, Chow EJ, Gurney JG, et al. Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol 2009;27:2339–2355.PubMedCrossRefPubMedCentralGoogle Scholar
  7. Gianni L, Herman E, Lipshultz S, Minotti G, Sarvazyan N, Sawyer D. Anthracycline cardiotoxicity: from bench to bedside. J Clin Oncol 2008;26:3777–3784.PubMedCrossRefPubMedCentralGoogle Scholar
  8. Horowitz ME, Fordis M, Krause S, McKellar J, Poplack DG. Passport for care: implementing the survivorship care plan. J Oncol Practice 2009:5:110–112.CrossRefGoogle Scholar
  9. Hudson MM. Reproductive outcomes for survivors of childhood cancer. Obstet Gynecol 2010;116:1171–1183.PubMedCrossRefGoogle Scholar
  10. Krull KR, Huang S, Gurney JG, et al. Adolescent behavior and adult health status in childhood cancer survivors. J Cancer Survivorship 2010;4(3):210–217.CrossRefGoogle Scholar
  11. Mariotto AB, Rowland JH, Yabroff KR, et al. Long-term survivors of childhood cancers in the United States. Cancer Epidemiol Biomarkers Prev 2009;18:1033–1040.PubMedCrossRefGoogle Scholar
  12. Nandagopal R, Laverdiere C, Mulrooney D, Hudson MM, Meacham L. Endocrine late effects of childhood cancer therapy: a report from the Children’s Oncology Group. Horm Res 2008;69(2):65–74.PubMedCrossRefGoogle Scholar
  13. Oeffinger KC, Mertens AC, Sklar CA, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med 2006;355:1572–1582.PubMedCrossRefGoogle Scholar
  14. Shankar SM, Marina N, Hudson MM, et al. Monitoring for cardiovascular disease in survivors of childhood cancer: report from the Cardiovascular Disease Task Force of the Children’s Oncology Group. Pediatrics 2008;121:e387–e396.PubMedCrossRefGoogle Scholar
  15. Zeltzer LK, Recklitis C, Buchbinder D, et al. Psychological status in childhood cancer survivors: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2009;27(14):2396–2404.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© The University of Texas M. D. Anderson Cancer Center 2015

Authors and Affiliations

  • Joann L. Ater
    • 1
  1. 1.Department of PediatricsThe University of Texas MD Anderson Cancer CenterHoustonUSA

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