CARE AND TREATMENT OF LONG-TERM SURVIVORS OF CHILDHOOD-CANCER

With the advances in the therapy of childhood cancers over the past 30 years, many children who are now cured of their cancer are moving int o adulthood. These patients have, in many cases, been exposed to multi ple therapeutic modalities (chemotherapy, radiation, and/or surgery), and in recent years have experienced more and more intensive therapies . Potential late sequelae can involve almost any organ system, but can be predicted, in part, by the chemotherapy or radiation that individu als may have received. These complications may be categorized by their timing relative to the discontinuation of therapy: early (under 5 yea rs), intermediate (5-20 years), or very late (over 20 years). Four pot ential late sequelae are reviewed (thyroid, cataracts, renal, and oste oporosis), and recommendations are made for screening of at risk indiv iduals for these long-term complications. The need for long-term follo w-up of this unique group of individuals is critical as we attempt to completely define the risks and benefits of our therapeutic efforts.