Challenges after curative treatment for childhood cancer and long-term follow up of survivors.
Childhood cancer survivors are at increased risk of serious morbidity, premature mortality, and diminished health status. Proactive and anticipatory risk-based health care of survivors and healthy lifestyles can reduce these risks. In this article, the authors first briefly discuss four common problems of survivors: neurocognitive dysfunction, cardiovascular disease, infertility and gonadal dysfunction, and psychosocial problems. Second, the authors discuss the concept of risk-based care, promote the use of recently developed evidence-based guidelines, describe current care in the United States, Canada, and the Netherlands, and articulate a model for shared survivor care that aims to optimize life long health of survivors and improve two-way communication between the cancer center and the primary care physician.
Oeffinger
Kevin C
KC
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. oeffingk@mskcc.org
Nathan
Paul C
PC
Kremer
Leontien C M
LC
D000293:Adolescent; D000359:Aftercare; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D011320:Primary Health Care; D012307:Risk Factors; D017741:Survivors
D000970:Antineoplastic Agents