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
Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. oeffingk@mskcc.org
Nathan
Paul C
PC
Kremer
Leontien C M
LC
D002318:Cardiovascular Diseases / Q000209:etiology; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000628:therapy*; D017741:Survivors; D016896:Treatment Outcome