title: The truly healthy adult survivor of childhood cancer: inside feelings and behaviors.
abstract: People cured from a cancer are not only the previous patients out from the dark tunnel of the disease, in particular if we speak of youngsters. In order for a person to be considered completely cured of childhood cancer, his/her physical conditions, as well as the many associated psychological and social issues must be evaluated. Nowadays, the majority of sick children can expect to be cured, and the number of adult survivors is rapidly becoming a new population requiring special care. Most of them appear to lead normal adult lives. They have obtained high school degrees, good jobs, and several have families and children. Nevertheless, a small percentage show some psychological or social problems, such as anxiety, depression, fear of the future or of relapse, fear of a second primary, or sterility. The most vulnerable among them include females, people in poor financial conditions, the unemployed, and those with low education. There are still some open questions. What will their old age be like? Are they really cured? The most important data in the literature are reported herein. Post-traumatic stress disorder is also discussed. We believe that, in the future, survivors will have two possible outcomes which will be related to the risk of disease and treatment. Those who suffered from low and standard risk disease will reach and enjoy a normal life, while those who underwent very aggressive treatment, with or without stem cell transplantation, might have to cope with a more vulnerable life. We mainly stress the need to avoid all types of psychological and social distress. We recommend providing patients and their families with the information they need and strengthening their coping ability starting from the time of diagnosis and carrying on throughout the whole treatment period.
authors.affiliation: Department of Pediatric Hematology and Oncology, G. Gaslini Children's Research Hospital, Genoa, Italy. luisamassimo@ospedale-gaslini.ge.it
authors.forename: L M
authors.initials: LM
authors.lastname: Massimo
authors.forename: D
authors.initials: D
authors.lastname: Caprino
mesh_terms: D000328:Adult; D000339:Affect; D002648:Child; D003142:Communication; D015438:Health Behavior; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D007558:Italy / Q000453:epidemiology; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D010817:Physician-Patient Relations; D017741:Survivors / Q000706:statistics & numerical data*