THE LONG-TERM SURVIVORS

Recent research indicates that approximately 60% of children diagnosed with cancer in Britain are cured and as a result, about 1 in a 1000 o f the general population will soon be survivors of childhood cancer. U nfortunately some elements of the therapies which ore responsible for this remarkable success are associated with serious complications, som etimes decades after their administration. Therefore, a comprehensive knowledge of the risks and benefits of different therapies will only b e obtained by monitoring the health of survivors indefinitely. With su ch therapeutic success, increasingly the composition of future treatme nt protocols will be influenced by knowledge of the risks of long term morbidity and mortality associated with past therapies. An awareness of the long term risks of complications of treatment is also important For estimating the future demand on the health services of this incre asing proportion of the general population who together represent many life years of care. This chapter reviews what is known concerning the long term risks Of complications of different treatments. Appropriate strategies For future clinical and epidemiological follow-up of the s urvivor population are discussed and the need for indefinite follow-up of the survivor population is emphasised.