Pediatric Cancer Survivors

Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects-that is, complications, disabilities, or adverse outcomes-as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.

More than 325,000 children, teens, and adults in the United States are survivors of childhood cancer. The surgery, radiation, chemotherapy, and stem cell transplants used to cure children can affect growing bodies and developing minds. If survivors know of these potential problems, they can take steps to identify, cope with, or treat them early if they do develop. The third edition of Childhood Cancer Survivors charts the territory for survivors by providing state-of-the-art information about: " Medical late effects from treatment " Emotional aspects of surviving cancer " Schedules for follow-up care " Challenges in the heath-care system " Lifestyle choices to maximize health " Discrimination in employment or insurance Woven throughout the text are stories from more than 100 survivors and parents. Authors Keene, Hobbie, and Ruccione are experts in the field of childhood cancer. Keene is the mother of a survivor of childhood leukemia and the author of several books including Childhood Leukemia, Childhood Cancer, Educating the Child with Cancer, and Chemo, Craziness & Comfort. Hobbie is Associate Director of the Cancer Survivorship Program at Children's Hospital of Philadelphia. Ruccione is Co-Director of the HOPE (Hematology-Oncology Psychosocial and Education) Program in the Children's Center for Cancer and Blood Diseases at Children's Hospital Los Angeles.

Pediatric cancer develops in 1 to 500 children. Typically, the type of cancers that develop in children is different than those that develop in adults, in that they are often the result of a DNA mutation rather than environmental or lifestyle risk factors. Leukemia, brain and central nervous system tumors, and neuroblastomas are the most common cancer types in child populations. Children tend to respond better to anticancer treatments, including chemotherapy and radiation. However, long-term side effects are common in children, often requiring follow-up care and lifestyle intervention for the rest of their lives. The percentage of 5-year survivors was over 50% for the most common cancers. This suggests that a majority of cancers in this population are highly survivable. As such, research should focus on aspects of survivorship for these individuals. This book will explore issues related to pediatric cancer and their associated treatments.

The risk of cancer increases with age, and the number of older adults seeking treatment is increasing dramatically in line with the aging population. The care of older patients differs from that of younger adults because of differences in the biology of the tumor, age-related differences in host physiology, comorbidity burden and psychosocial issues, which might impact the efficacy and side effects of cancer therapy. Practical Geriatric Oncology is a comprehensive, evidence-based text that synthesizes the growing literature in this field and provides practical guidelines to the care of older adults with cancer. Coverage includes patient assessment, management of solid tumors and hematologic malignancies, the impact of age on the pharmacology of cancer therapy, surgical oncology and radiation oncology in the older adult, symptom management and supportive care. In addition to serving as core reading for oncologists and hematologists, the book will also be a useful work for other healthcare professionals who provide oncology care, including surgeons, radiation oncologists, palliative care doctors, primary care providers, geriatricians and nurses.

This authoritative reference examines in depth the myriad challenges facing pediatric cancer survivors and proposes a robust framework for structured follow-up of these patients through adulthood. Approaches to long-term follow-up include both established models of care and targeted models of lifelong surveillance of late effects by bodily systems and neurological outcomes. Sections devoted to quality of life and re-entry after treatment focus on key concerns such as health risk behaviors, school and career issues, psychological challenges, and care disparities. And a robust resources section adds extra usefulness to the expert coverage. Among the Handbook's topics: • Developmental considerations in the transition from child and adolescent to adult survivorship. • Long-term follow-up roadmaps by disease and treatment. • Neuropsychological effects of pediatric brain tumors and associated treatment. • Building resiliency in childhood cancer survivors: a clinician’s perspective. • School issues and educational strategies for survivors of childhood cancer. • Educating and preparing the childhood cancer survivor for long-term care: a curriculum model for cancer centers. A work of rare scope, scholarship, and clinical acumen, the Handbook of Long-Term Care of the Childhood Cancer Survivor is a rewarding, practice-building resource essential to a wide range of healing professionals, including primary care physicians, pediatricians, oncologists, nurses, psychologists, neuropsychologists, child psychologists, and licensed therapists.

It was not long ago that clinicians would say,“study ed at the 1975 meeting revealed. Among them was the late complications of cancer treatments we give to one based on data collected by the Late Effects Study children? You must be joking! We can start worrying Group, an international consortium that consisted about that when we start curing them! Meanwhile, initially of ?ve, then ten, pediatric centers. This was cure must be our only aim. ”These practitioners were the ?rst large scale, cooperative unit of its kind, - only partially correct in what seemed to be a glaring ganized speci?cally for the purpose of studying the truth, for, in fact, increasing numbers of children late effects of cancer therapy (the study of delayed were beginning to survive their malignancy,and the complications had been included as part of the or- long-term consequences of therapy would soon be- inal design in the National Wilms Tumor Study come critical. launched in 1969) [1]. These historical notes demon- It is well to remember that the delayed conse- strate that the epidemiologic,statistical and reco- quences of a cancer treatment delivered to develop- keeping mechanisms necessary for studying lo- ing organisms were ?rst studied long ago. It has been term survivors effectively were in the process of be- 100 years since Perthes reported in 1903 that growth ing established decades before the meeting in 1975.

This book is a comprehensive guide that will help medical professionals – pediatric oncologists, nurses, pediatricians, family practitioners, internists, radiation oncologists, surgeons – to understand and manage the long-term effects of treatment for childhood and adolescent cancer. The consequences of treatment are described for each organ system, with explanation of pathophysiology, clinical manifestations, detection and screening and management. Disease- and organ-based algorithms of care and tables designed to facilitate the assessment of late effects are highlights of the book and will assist in the provision of hands-on care that is up to date and geared to clinical need. Among the other topics addressed are stem cell transplantation, psychological care, legal issues, transition to adulthood and methodological issues in the study of survivorship care.