The overall cure rate for pediatric malignancies is significantly improved to over 75% with an estimated 270,000 survivors of childhood cancer in the United States currently. The achievement of high cure rates for most pediatric malignancies has been accompanied by a growing population of childhood cancer survivors who are at an increased risk for a myriad of health problems resulting from their cancer or its treatment. Some cancer-related complications do not become apparent until several years following cancer treatment. As the survivors of childhood cancers age, the effects of therapy may be exacerbated by effects of aging on organ function. Late effects encompass a variety of detrimental conditions including organ dysfunction, psychosocial complications, and subsequent malignancies that may negatively impact quality of life and may predispose them to early mortality. In contrast to the multitude of publications describing treatment-related sequelae in childhood cancer survivors, relatively few provide specific recommendations for health screening and risk-reduction counseling to guide healthcare providers in monitoring this vulnerable population. In this chapter, we will summarize the evaluation and management of childhood cancer survivors who may be encountered across a wide variety of healthcare settings, salient issues influencing healthcare for childhood cancer survivors, of which guidelines currently available and limitations in current practice.
Part of the book: Pediatric Cancer Survivors