Skip to main content
SpringerLink
Log in

Childhood and Adolescent Cancer Survivors

  • Chapter
  • First Online:
Care of Adults with Chronic Childhood Conditions

  • 771 Accesses

Abstract

The number of survivors of pediatric cancers in the US and worldwide has grown significantly over the last half century, largely due to the development of increasingly effective treatments. With the improved survival in this population has come a growing recognition of treatment-related late effects. These late effects confer an increased rate of mortality as well as morbidity in the form of chronic health conditions. This chapter summarizes common long-term and late effects from cancer therapy and important considerations any provider should be aware of when caring for survivors of childhood and adolescent cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Cleeland CS, Allen JD, Roberts SA, Brell JM, Giralt SA, Khakoo AY, et al. Reducing the toxicity of cancer therapy: recognizing needs, taking action. Nat Rev Clin Oncol. 2012;9(8):471–8.

    Article  CAS  PubMed  Google Scholar 

  2. Howlader NNA, Krapcho M, Garshell J, Miller D, Altekruse SF, Kosary CL, et al., editors. SEER cancer statistics review, 1975–2011. Bethesda, MD: National Cancer Institute; 2014.

    Google Scholar 

  3. Ward E, DeSantis C, Robbins A, Kohler B, Jemal A. Childhood and adolescent cancer statistics, 2014. CA Cancer J Clin. 2014;64(2):83–103.

    Article  PubMed  Google Scholar 

  4. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355(15):1572–82.

    Article  CAS  PubMed  Google Scholar 

  5. Hewitt M, Weiner SL, Simone JV, National Cancer Policy Board, Institute of Medicine, National Research Council, editors. Childhood cancer survivorship: improving care and quality of life. Washington, DC: National Academies Press; 2003.

    Google Scholar 

  6. Albini A, Pennesi G, Donatelli F, Cammarota R, De Flora S, Noonan DM. Cardiotoxicity of anticancer drugs: the need for cardio-oncology and cardio-oncological prevention. J Natl Cancer Inst. 2010;102(1):14–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Curigliano G, Mayer EL, Burstein HJ, Winer EP, Goldhirsch A. Cardiac toxicity from systemic cancer therapy: a comprehensive review. Prog Cardiovasc Dis. 2010;53(2):94–104.

    Article  CAS  PubMed  Google Scholar 

  8. Sonis ST. Regimen-related gastrointestinal toxicities in cancer patients. Curr Opin Support Palliat Care. 2010;4(1):26–30.

    Article  PubMed  Google Scholar 

  9. Sul JK, Deangelis LM. Neurologic complications of cancer chemotherapy. Semin Oncol. 2006;33(3):324–32.

    Article  CAS  PubMed  Google Scholar 

  10. Mohty B, El-Cheikh J, Yakoub-Agha I, Moreau P, Harousseau JL, Mohty M. Peripheral neuropathy and new treatments for multiple myeloma: background and practical recommendations. Haematologica. 2010;95(2):311–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Hagiwara H, Sunada Y. Mechanism of taxane neurotoxicity. Breast Cancer (Tokyo, Japan). 2004;11(1):82–5.

    Article  Google Scholar 

  12. Force T, Kerkela R. Cardiotoxicity of the new cancer therapeutics—mechanisms of, and approaches to, the problem. Drug Discov Today. 2008;13(17–18):778–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Robison LL, Mertens AC, Boice JD, Breslow NE, Donaldson SS, Green DM, et al. Study design and cohort characteristics of the Childhood Cancer Survivor Study: a multi-institutional collaborative project. Med Pediatr Oncol. 2002;38(4):229–39.

    Article  PubMed  Google Scholar 

  14. Hudson MM, Ness KK, Nolan VG, Armstrong GT, Green DM, Morris EB, et al. Prospective medical assessment of adults surviving childhood cancer: study design, cohort characteristics, and feasibility of the St. Jude Lifetime Cohort study. Pediatr Blood Cancer. 2011;56(5):825–36.

    Article  PubMed  Google Scholar 

  15. McBride ML, Rogers PC, Sheps SB, Glickman V, Broemeling AM, Goddard K, et al. Childhood, adolescent, and young adult cancer survivors research program of British Columbia: objectives, study design, and cohort characteristics. Pediatr Blood Cancer. 2010;55(2):324–30.

    Article  PubMed  Google Scholar 

  16. Hudson MM, Mertens AC, Yasui Y, Hobbie W, Chen H, Gurney JG, et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA. 2003;290(12):1583–92.

    Article  CAS  PubMed  Google Scholar 

  17. Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, et al. Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA. 2013;309(22):2371–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Diller L, Chow EJ, Gurney JG, Hudson MM, Kadin-Lottick NS, Kawashima TI, et al. Chronic disease in the Childhood Cancer Survivor Study cohort: a review of published findings. J Clin Oncol. 2009;27(14):2339–55.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Hudson MM, Mulrooney DA, Bowers DC, Sklar CA, Green DM, Donaldson SS, et al. High-risk populations identified in Childhood Cancer Survivor Study investigations: implications for risk-based surveillance. J Clin Oncol. 2009;27(14):2405–14.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Lipshultz SE, Adams MJ, Colan SD, Constine LS, Herman EH, Hsu DT, et al. Long-term cardiovascular toxicity in children, adolescents, and young adults who receive cancer therapy: pathophysiology, course, monitoring, management, prevention, and research directions: a scientific statement from the American Heart Association. Circulation. 2013;128(17):1927–95.

    Article  PubMed  Google Scholar 

  21. Robison LL, Hudson MM. Survivors of childhood and adolescent cancer: life-long risks and responsibilities. Nat Rev Cancer. 2014;14(1):61–70.

    Article  CAS  PubMed  Google Scholar 

  22. Oeffinger KC, Mertens AC, Sklar CA, Yasui Y, Fears T, Stovall M, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2003;21(7):1359–65.

    Article  PubMed  Google Scholar 

  23. Yeh JM, Nekhlyudov L, Goldie SJ, Mertens AC, Diller L. A model-based estimate of cumulative excess mortality in survivors of childhood cancer. Ann Intern Med. 2010;152(7):409–17.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Armstrong GT, Liu Q, Yasui Y, Neglia JP, Leisenring W, Robison LL, et al. Late mortality among 5-year survivors of childhood cancer: a summary from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(14):2328–38.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Mertens AC, Liu Q, Neglia JP, Wasilewski K, Leisenring W, Armstrong GT, et al. Cause-specific late mortality among 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2008;100(19):1368–79.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Mertens AC, Yasui Y, Neglia JP, Potter JD, Nesbit ME, Ruccione K, et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol. 2001;19(13):3163–72.

    CAS  PubMed  Google Scholar 

  27. Armstrong GT, Kawashima T, Leisenring W, Stratton K, Stovall M, Hudson MM, et al. Aging and risk of severe, disabling, life-threatening, and fatal events in the Childhood Cancer Survivor Study. J Clin Oncol. 2014;32(12):1218–27.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Children’s Oncology Group. Long-term follow-up guidelines for survivors of childhood, adolescent, and young adult cancers, 2016. Available from: http://www.survivorshipguidelines.org/. Accessed 9 Jan 2016.

  29. Chemaitilly W, Sklar CA. Endocrine complications in long-term survivors of childhood cancers. Endocr Relat Cancer. 2010;17(3):R141–59.

    Article  CAS  PubMed  Google Scholar 

  30. Gurney JG, Kadan-Lottick NS, Packer RJ, Neglia JP, Sklar CA, Punyko JA, et al. Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors. Cancer. 2003;97(3):663–73.

    Article  PubMed  Google Scholar 

  31. Mulder RL, Kremer LCM, Santen HMv, Ket JL, Trotsenburg ASPv, Koning CCE, et al. Prevalence and risk factors of radiation-induced growth hormone deficiency in childhood cancer survivors: a systematic review. Cancer Treat Rev. 2009;35(7):616–32.

    Article  CAS  PubMed  Google Scholar 

  32. Tonorezos ES, Hudson MM, Edgar AB, Kremer LC, Sklar CA, Wallace WHB, et al. Screening and management of adverse endocrine outcomes in adult survivors of childhood and adolescent cancer. Lancet Diabetes Endocrinol. 2015;3(7):545–55.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Link K, Moëll C, Garwicz S, Cavallin-Ståhl E, Björk J, Thilén U, et al. Growth hormone deficiency predicts cardiovascular risk in young adults treated for acute lymphoblastic leukemia in childhood. J Clin Endocrinol Metab. 2004;89(10):5003–12.

    Article  CAS  PubMed  Google Scholar 

  34. Murray RD, Shalet SM. Adult growth hormone replacement: lessons learned and future direction. J Clin Endocrinol Metab. 2002;87(10):4427–8.

    Article  CAS  PubMed  Google Scholar 

  35. Mukherjee A, Tolhurst-Cleaver S, Ryder WDJ, Smethurst L, Shalet SM. The characteristics of quality of life impairment in adult growth hormone (GH)-deficient survivors of cancer and their response to GH replacement therapy. J Clin Endocrinol Metab. 2005;90(3):1542–9.

    Article  CAS  PubMed  Google Scholar 

  36. Follin C, Thilén U, Ahrén B, Erfurth EM. Improvement in cardiac systolic function and reduced prevalence of metabolic syndrome after two years of growth hormone (GH) treatment in GH-deficient adult survivors of childhood-onset acute lymphoblastic leukemia. J Clin Endocrinol Metab. 2006;91(5):1872–5.

    Article  CAS  PubMed  Google Scholar 

  37. Sklar C, Whitton J, Mertens A, Stovall M, Green D, Marina N, et al. Abnormalities of the thyroid in survivors of Hodgkin’s Disease: data from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab. 2000;85(9):3227–32.

    CAS  PubMed  Google Scholar 

  38. Chow EJ, Friedman DL, Stovall M, Yasui Y, Whitton JA, Robison LL, et al. Risk of thyroid dysfunction and subsequent thyroid cancer among survivors of acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. Pediatr Blood Cancer. 2009;53(3):432–7.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Metzger ML, Howard SC, Hudson MM, Gow KW, Li C-S, Krasin MJ, et al. Natural history of thyroid nodules in survivors of pediatric Hodgkin lymphoma. Pediatr Blood Cancer. 2006;46(3):314–9.

    Article  PubMed  Google Scholar 

  40. Meacham LR, Sklar CA, Li S, Liu Q, Gimpel N, Yasui Y, et al. Diabetes mellitus in long-term survivors of childhood cancer. Increased risk associated with radiation therapy: a report for the Childhood Cancer Survivor Study. Arch Intern Med. 2009;169(15):1381–8.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Armstrong GT, Oeffinger KC, Chen Y, Kawashima T, Yasui Y, Leisenring W, et al. Modifiable risk factors and major cardiac events among adult survivors of childhood cancer. J Clin Oncol. 2013;31(29):3673–80.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Meacham LR, Chow EJ, Ness KK, Kamdar KY, Chen Y, Yasui Y, et al. Cardiovascular risk factors in adult survivors of pediatric cancer–a report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev. 2010;19(1):170–81.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Gurney JG, Ness KK, Sibley SD, O’Leary M, Dengel DR, Lee JM, et al. Metabolic syndrome and growth hormone deficiency in adult survivors of childhood acute lymphoblastic leukemia. Cancer. 2006;107(6):1303–12.

    Article  CAS  PubMed  Google Scholar 

  44. Hoffman KE, Derdak J, Bernstein D, Reynolds JC, Avila NA, Gerber L, et al. Metabolic syndrome traits in long-term survivors of pediatric sarcoma. Pediatr Blood Cancer. 2008;50(2):341–6.

    Article  PubMed  Google Scholar 

  45. van Waas M, Neggers SJCMM, Pieters R, van den Heuvel-Eibrink MM. Components of the metabolic syndrome in 500 adult long-term survivors of childhood cancer. Ann Oncol. 2010;21(5):1121–6.

    Article  PubMed  Google Scholar 

  46. de Ville de Goyet M, Moniotte S, Brichard B. Cardiotoxicity of childhood cancer treatment: update and current knowledge on long-term follow-up. Pediatr Hematol Oncol. 2012;29(5):395–414.

    Article  PubMed  Google Scholar 

  47. van der Pal HJH, van Dalen EC, Kremer LCM, Bakker PJM, van Leeuwen FE. Risk of morbidity and mortality from cardiovascular disease following radiotherapy for childhood cancer: a systematic review. Cancer Treat Rev. 2005;31(3):173–85.

    Article  PubMed  Google Scholar 

  48. Mulrooney DA, Yeazel MW, Kawashima T, Mertens AC, Mitby P, Stovall M, et al. Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort. BMJ. 2009;339:b4606.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Lipshultz SE, Alvarez JA, Scully RE. Anthracycline associated cardiotoxicity in survivors of childhood cancer. Heart. 2008;94(4):525–33.

    Article  CAS  PubMed  Google Scholar 

  50. Landier W, Bhatia S, Eshelman DA, Forte KJ, Sweeney T, Hester AL, et al. Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group Long-Term Follow-Up Guidelines From the Children’s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol. 2004;22(24):4979–90.

    Article  PubMed  Google Scholar 

  51. Landier W, Armenian SH, Lee J, Thomas O, Wong FL, Francisco L, et al. Yield of screening for long-term complications using the children’s oncology group long-term follow-up guidelines. J Clin Oncol. 2012;30(35):4401–8.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Edelstein K, D’Agostino N, Bernstein LJ, Nathan PC, Greenberg ML, Hodgson DC, et al. Long-term neurocognitive outcomes in young adult survivors of childhood acute lymphoblastic leukemia. J Pediatr Hematol Oncol. 2011;33(6):450–8.

    Article  PubMed  Google Scholar 

  53. Krull KR, Brinkman TM, Li C, Armstrong GT, Ness KK, Srivastava DK, et al. Neurocognitive outcomes decades after treatment for childhood acute lymphoblastic leukemia: a report from the St Jude lifetime cohort study. J Clin Oncol. 2013;31(35):4407–15.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Schaapveld M, Aleman BMP, van Eggermond AM, Janus CPM, Krol ADG, van der Maazen RWM, et al. Second cancer risk up to 40 years after treatment for Hodgkin’s Lymphoma. N Engl J Med. 2015;373(26):2499–511.

    Article  CAS  PubMed  Google Scholar 

  55. Hawkins MM. Is there evidence of a therapy-related increase in germ cell mutation among childhood cancer survivors? J Natl Cancer Inst. 1991;83(22):1643–50.

    Article  CAS  PubMed  Google Scholar 

  56. Madanat-Harjuoja LM, Malila N, Lahteenmaki P, Pukkala E, Mulvihill JJ, Boice JD Jr, et al. Risk of cancer among children of cancer patients—a nationwide study in Finland. Int J Cancer. 2010;126(5):1196–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  57. McBride KA, Ballinger ML, Killick E, Kirk J, Tattersall MH, Eeles RA, et al. Li–Fraumeni syndrome: cancer risk assessment and clinical management. Nat Rev Clin Oncol. 2014;11(5):260–71.

    Article  CAS  PubMed  Google Scholar 

  58. Kadan-Lottick NS, Robison LL, Gurney JG, Neglia JP, Yasui Y, Hayashi R, et al. Childhood cancer survivors’ knowledge about their past diagnosis and treatment: Childhood Cancer Survivor Study. JAMA. 2002;287(14):1832–9.

    Article  PubMed  Google Scholar 

  59. Oeffinger KC, Wallace WH. Barriers to follow-up care of survivors in the United States and the United Kingdom. Pediatr Blood Cancer. 2006;46(2):135–42.

    Article  PubMed  Google Scholar 

  60. Nathan PC, Greenberg ML, Ness KK, Hudson MM, Mertens AC, Mahoney MC, et al. Medical care in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2008;26(27):4401–9.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Hewitt M, Greenfield S, Stovall E, editors. From cancer patient to cancer survivor: lost in transition. Washington, DC: Institute of Medicine and National Research Council; 2005.

    Google Scholar 

  62. ASCO Survivorship Guidelines [cited 9 Jan 2016]. Available from: http://www.instituteforquality.org/practice-guidelines.

  63. Green DM, Kawashima T, Stovall M, Leisenring W, Sklar CA, Mertens AC, et al. Fertility of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(16):2677–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Green DM, Sklar CA, Boice JD, Mulvihill JJ, Whitton JA, Stovall M, et al. Ovarian failure and reproductive outcomes after childhood cancer treatment: results from the Childhood Cancer Survivor Study. J Clin Oncol. 2009;27(14):2374–81.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Bath LE, Wallace WHB, Critchley HOD. Late effects of the treatment of childhood cancer on the female reproductive system and the potential for fertility preservation. BJOG Int J Obstetr Gynaecol. 2002;109(2):107–14.

    Article  Google Scholar 

  66. Sklar C. Maintenance of ovarian function and risk of premature menopause related to cancer treatment. JNCI Monogr. 2005;2005(34):25–7.

    Article  Google Scholar 

  67. Green DM, Liu W, Kutteh WH, Ke RW, Shelton KC, Sklar CA, et al. Cumulative alkylating agent exposure and semen parameters in adult survivors of childhood cancer: a report from the St Jude Lifetime Cohort Study. Lancet Oncol. 2014;15(11):1215–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Green DM, Nolan VG, Goodman PJ, Whitton JA, Srivastava D, Leisenring WM, et al. The cyclophosphamide equivalent dose as an approach for quantifying alkylating agent exposure: a report from the Childhood Cancer Survivor Study. Pediatr Blood Cancer. 2014;61(1):53–67.

    Article  CAS  PubMed  Google Scholar 

  69. Thomson AB, Critchley HOD, Kelnar CJH, Wallace WHB. Late reproductive sequelae following treatment of childhood cancer andoptions for fertility preservation. Best Pract Res Clin Endocrinol Metab. 2002;16(2):311–34.

    Article  PubMed  Google Scholar 

  70. Chemaitilly W, Mertens AC, Mitby P, Whitton J, Stovall M, Yasui Y, et al. Acute ovarian failure in the Childhood Cancer Survivor Study. J Clin Endocrinol Metab. 2006;91(5):1723–8.

    Article  CAS  PubMed  Google Scholar 

  71. Metzger ML, Meacham LR, Patterson B, Casillas JS, Constine LS, Hijiya N, et al. Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications. J Clin Oncol. 2013;31(9):1239–47.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Sankila R, Olsen JH, Anderson H, Garwicz S, Glattre E, Hertz H, et al. Risk of cancer among offspring of childhood-cancer survivors. Association of the Nordic Cancer Registries and the Nordic Society of Paediatric Haematology and Oncology. N Engl J Med. 1998;338(19):1339–44.

    Article  CAS  PubMed  Google Scholar 

  73. Signorello LB, Mulvihill JJ, Green DM, Munro HM, Stovall M, Weathers RE, et al. Congenital anomalies in the children of cancer survivors: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2012;30(3):239–45.

    Article  PubMed  Google Scholar 

  74. Zebrack BJ, Zeltzer LK, Whitton J, Mertens AC, Odom L, Berkow R, et al. Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin’s disease, and non-Hodgkin’s lymphoma: a report from the Childhood Cancer Survivor Study. Pediatrics. 2002;110(1 Pt 1):42–52.

    Article  PubMed  Google Scholar 

  75. Hobbie WL, Stuber M, Meeske K, Wissler K, Rourke MT, Ruccione K, et al. Symptoms of posttraumatic stress in young adult survivors of childhood cancer. J Clin Oncol. 2000;18(24):4060–6.

    CAS  PubMed  Google Scholar 

  76. Recklitis CJ, Diller LR, Li X, Najita J, Robison LL, Zeltzer L. Suicide ideation in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2010;28(4):655–61.

    Article  PubMed  Google Scholar 

  77. Langeveld NE, Grootenhuis MA, Voûte PA, de Haan RJ. Posttraumatic stress symptoms in adult survivors of childhood cancer. Pediatr Blood Cancer. 2004;42(7):604–10.

    Article  CAS  PubMed  Google Scholar 

  78. Ozono S, Saeki T, Mantani T, Ogata A, Okamura H, S-i Nakagawa, et al. Psychological distress related to patterns of family functioning among Japanese childhood cancer survivors and their parents. Psycho-Oncology. 2010;19(5):545–52.

    Article  PubMed  Google Scholar 

  79. Alderfer MA, Navsaria N, Kazak AE. Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer. J Fam Psychol. 2009;23(5):717–25.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Barakat LP, Alderfer MA, Kazak AE. Posttraumatic growth in adolescent survivors of cancer and their mothers and fathers. J Pediatr Psychol. 2006;31(4):413–9.

    Article  PubMed  Google Scholar 

  81. Zebrack BJ, Stuber ML, Meeske KA, Phipps S, Krull KR, Liu Q, et al. Perceived positive impact of cancer among long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Psycho-Oncology. 2012;21(6):630–9.

    Article  PubMed  Google Scholar 

  82. Michel G, Taylor N, Absolom K, Eiser C. Benefit finding in survivors of childhood cancer and their parents: further empirical support for the Benefit Finding Scale for Children. Child Care Health Dev. 2010;36(1):123–9.

    Article  CAS  PubMed  Google Scholar 

  83. Zeltzer LK, Lu Q, Leisenring W, Tsao JCI, Recklitis C, Armstrong G, et al. Psychosocial outcomes and health-related quality of life in adult childhood cancer survivors: a report from the Childhood Cancer Survivor Study. Cancer Epidemiol Biomark Prev. 2008;17(2):435–46.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave, 2nd Floor, New York City, NY, 10017, USA

    Nirupa Jaya Raghunathan

  2. Harvard Medical School, Brigham and Women’s Hospital, 800 Huntington Avenue, 3rd Floor, Boston, MA, 02115, USA

    Larissa Nekhlyudov

  3. Department of General Internal Medicine, University of Colorado Denver/University of Colorado Health, 12631 E 17th Avenue, Mail Stop B180, 8th Floor, Aurora, CO, 80045, USA

    Linda S. Overholser

Authors
  1. Nirupa Jaya Raghunathan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Larissa Nekhlyudov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Linda S. Overholser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nirupa Jaya Raghunathan .

Editor information

Editors and Affiliations

  1. School of Medicine, Hofstra North Shore-LIJ School of Medicine, LAKE SUCCESS, New York, USA

    Mariecel Pilapil

  2. Mount Sinai School of Medicine , NEW YORK, New York, USA

    David E. DeLaet

  3. University of California Los Angeles , SANTA MONICA, California, USA

    Alice A. Kuo

  4. Baylor Clinic , HOUSTON, Texas, USA

    Cynthia Peacock

  5. Brigham and Women's Hospital , BOSTON, Massachusetts, USA

    Niraj Sharma

Appendix

Appendix

Childhood cancer survivor fact sheet

Definitions

A childhood cancer survivor is defined as a someone diagnosed and treated for cancer before the age of 20 years with at least 5 years of being cancer-free

Survivors are at risk for cancer therapy related chronic medical conditions (long-term and late effects):

• Long-term effects are adverse effects as a result of therapy that develop during treatment and persist for several years

• Late effects are adverse effects related to cancer therapy that may only develop many years later

Epidemiology

• If diagnosed with cancer before age 20 years, now have a 5-year survival of more than 80 % [2]

• Improved survival has translated into more than 380,000 childhood and adolescent cancer survivors living in the US [3]

• During a 2-year study period, only 31 % of CCS had received any survivor-focused care and 11 % had received no medical care at all [60]

Common chronic conditions (pathophysiology)

Survivors are at risk for complications related to underlying organ damage from cancer therapy; these therapies include chemotherapy, radiation therapy, surgery, bone marrow transplant, targeted therapies, and transfusions

Survivors are particularly at increased risk for the following conditions:

• Diabetes/insulin resistance

• Radiation-induced endocrinopathies (e.g., growth hormone, thyroid)

• Cardiovascular disease including cardiomyopathy and atherosclerotic disease

• Restrictive and/or obstructing pulmonary disease

• Neurocognitive issues including memory, concentration

• Secondary malignancies, particularly in the radiation field

• Hypogonadism and reduced fertility

Challenges in transition

• Population is mobile and may have inconsistent follow-up

• Changing insurance status can make care for chronic conditions difficult

• Psychological needs that may require specialized counseling

Resources

Provider resources

• COG Guidelines: http://www.survivorshipguidelines.org/

• ASCO Practice Guidelines: http://www.instituteforquality.org/practice-guidelines

• National Cancer Institute: http://www.cancer.gov/cancertopics/aya/survivorship

• SurvivorLink CME modules: http://www.cancersurvivorlink.org/CME/Index.aspx?v=HCP

Patient resources:

• Cancer.Net: http://www.cancer.net/survivorship

• Stupid Cancer: http://stupidcancer.org/

• Planet Cancer: http://myplanet.planetcancer.org/

• Cancer and Careers: http://www.cancerandcareers.org/en

• Fertility Resources: http://www.myoncofertility.org/

• First Descents: https://firstdescents.org/

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Raghunathan, N.J., Nekhlyudov, L., Overholser, L.S. (2016). Childhood and Adolescent Cancer Survivors. In: Pilapil, M., DeLaet, D., Kuo, A., Peacock, C., Sharma, N. (eds) Care of Adults with Chronic Childhood Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-43827-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43827-6_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43825-2

  • Online ISBN: 978-3-319-43827-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation