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Life After Cancer A Roadmap for Cancer Survivors

Challenges for Childhood Cancer Survivors
Ernest H. Rosenbaum, MD

The childhood cancer remission rate is now between 75-80%. Although the treatments for childhood cancers have dramatically improved, it is estimated that within a period of five to twenty years following treatment, approximately three-quarters of childhood cancer survivors will have at least one if not more chronic health conditions related to either the cancer and/or its treatments.

Childhood survivors are at least eight times more likely than their cancer-free siblings to develop severe and life-threatening chronic health conditions such as heart attacks, congestive heart failure, gonadal (ovaries/testes) failure, second cancers and thought-process problems. This fragile health status may cause survivors of pediatric cancers to die prematurely from the side effects of the cancer and/or its treatment. Recent studies of survivors of childhood cancer reported an extraordinarily high incidence of late and often permanent complications following treatment with combination chemotherapy and ionizing radiation. Two-thirds of these pediatric cancer survivors had at least one chronic health problem, and 25% had three or more chronic health problems. A recent study found that survivors of childhood cancer are not generally receiving the follow-up care needed to identify and control these chronic conditions. Survivors without a survivorship care plan need to contact their oncologist. The impact of some of these health problems can be reduced with scheduled surveillance, screening, appropriate treatment, and lifestyle changes.

Additionally, healthy lifestyle changes can help improve survival, reduce the risk of comorbidities, a recurrence or a new cancer, and reduce the short- and long-term side effects of therapy. Scientific evidence has shown the therapeutic value of the healthy prudent diet. exercise programs, emotional support, weight control, tobacco abstinence and various lifestyle interventions for control and possible reduction of side effects.

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