Dr. Paul C. Nathan and colleagues of the Hospital for Sick Children in Toronto did a survey involving 8,522 adult survivors of childhood cancer. The purpose of the survey was to determine if the survivors had received the recommended cancer follow-up health care. The average age of the survivors was 31.4 years at the time of the survey and 6.8 years at the time of their cancer diagnosis.

It is so important for cancer survivors to be diligent in scheduling recommended follow-up health care on a consistent basis because they have a significant risk of developing late side effects from their cancer therapy including secondary cancers and heart disease. Another study completed in 2004 by Dr. Huib N. Caron and colleagues from Emma Children's Hospital in Amsterdam of 1,362 patients indicates that pediatric cancer survivors will have at least one severe health problem in life after cancer. The most common severe events are orthopedic complications, followed by second tumors and obesity.

Surprisingly, the majority of long-term survivors of childhood cancer do not follow through on their recommended follow-up care, despite knowing the risk involved. Only 32 percent of the 8,522 adult survivors of childhood cancer reported seeing a doctor or nurse involved in cancer care in the previous two years. The survivors who hadn’t seen a doctor or a nurse for any reason in the preceding two years accounted for 12 percent.

Only 28 percent of those at high risk for developing heart disease reported having an echocardiogram. Only 49 percent at high risk for developing breast cancer reported having a mammogram, according to Nathan.

The study of 1,362 patients by Dr. Huib N. Caron and colleagues was to determine the total burden of poor health outcomes for survivors of childhood cancers. They followed the survivors from 1966 to1996 for an average of 17 years each after their childhood cancer diagnoses until they reached an average of 24.4 years old. They were able to follow-up completely on 94.3 percent of the patients.

Almost 75 percent of the survivors had at least one adverse health event and 24.6 percent had at least five adverse health events. Tragically, forty percent of the childhood cancer survivors had at least one severe, life-threatening, or disabling health event.
Not surprisingly, those with the highest risk for not following up on routine cancer screenings were the uninsured, the men, and those with low household incomes.

Those who had childhood bone tumors had a 64 percent occurrence of high or severe burden of adverse health events. Childhood survivors of leukemia or Wilms tumors had the least prevalence, which was 12 percent each.

Physicians must recognize these long-term risks, and use the information gathered in these research studies to facilitate risk-based healthcare, and then work to reduce the risk of developing long-term illnesses.

SOURCE: Journal of the American Medical Association June 26, 2007

Related blogs
Lasting Effects of Chemo Can be Debilitating
Chemotherapy Uses Chemicals to Destroy Cancer Cells
Bone Cancer Treatment

Photo Credit