BACKGROUNDSurvivors of childhood cancer are at increased risk for osteoporosis, cardiovascular disease, and second malignancies—conditions for which modifiable risk factors are recognized and lifestyle interventions have shown benefit. Although some data regarding health behaviors of this population exist, receptivity to health promotion is largely unknown.METHODSA survey was mailed to 380 survivors (age range, 11–33 years) of childhood leukemia, lymphoma, or central nervous system carcinomas (and guardians of survivors < 18 years old) to elicit data on exercise, dietary intake of calcium, fat, and fruits and vegetables, smoking status, readiness to pursue lifestyle change, quality of life, and interest in various health interventions.RESULTSResponses from 209 survivors (a 55% response rate) suggested that most did not meet guidelines for fruit and vegetable consumption (79%), calcium intake (68%), or exercise (52%), 42% were overweight/obese, and 84% consumed > 30% of calories from fat. Older (> 18 years) compared with younger (< 18 years) survivors were more likely to smoke (17% vs. 1%), to be obese (21.6% vs. 14.6%), and to have suboptimal calcium intakes (75.6% vs. 57.6%). No differences in lifestyle behaviors were observed between cancer groups. Compared with interventions aimed at weight control, improving self‐esteem, or smoking cessation, the highest levels of interest were found consistently for interventions aimed at getting in shape and eating healthy. Survivors preferred mailed interventions to those delivered in‐person, by telephone counselors, or via computers.CONCLUSIONSSurvivors of childhood cancer practiced several suboptimal health behaviors. Health promotion interventions aimed at areas of interest and delivered through acceptable channels have the potential to improve long‐term health and function of this vulnerable population. Cancer 2005. © 2005 American Cancer Society.

No abstract

This study's findings may be helpful to nurses, health educators, and allied health professionals in developing effective interventions that promote healthful lifestyle change among childhood cancer survivors.

No abstract

Objective Survivors of childhood cancer are at an increased risk for reduced quality of life (QOL), yet few studies have explored factors associated with improving health-related QOL (HRQOL) in this population. We thus explored the relationship between physical activity (PA) and HRQOL among survivors of childhood cancer. Methods A total of 215 survivors of childhood lymphoma, leukemia, and central nervous system (CNS) cancers completed mailed surveys that elicited information regarding leisure-time PA (LTPA) measured in metabolic equivalents, HRQOL, and diagnostic and demographic factors. Correlations and adjusted regression models were use to explore the relationship between LTPA and HRQOL. Results In the total sample, modest yet significant linear associations were observed between LTPA and overall HRQOL (β = 0.17, p < 0.01) as well as each of the respective subscales (β = 0.11–0.23 and p < 0.05 to < 0.001). Among adolescent survivors of childhood cancer, LTPA was significantly associated with overall HRQOL (β = 0.27), cancer worry (β = 0.36), cognitive function (β = 0.32), body appearance (β = 0.29), and social function (β = 0.27) (all p < 0.05). Among adult survivors of childhood cancer, LTPA was only significantly associated with physical function (β = 0.28, p < 0.001). Conclusions Significant associations exist between LTPA and HRQOL; however, the association was stronger and observed in more domains for adolescent survivors of childhood cancer. More research is needed to determine the antecedents and consequences of physical activity in this population.

The nature and scope of mature adolescents' legal authority to consent to general medical treatment without parental involvement is often misrepresented by commentators. This state of affairs is further complicated by the law itself, which has developed a broad "mature minor exception" to the general requirement of parental consent in abortion cases and which has additionally carved out numerous specific status-based and condition-based exceptions to that requirement. In these circumstances, it is not always a simple matter for physicians and other medical professionals who treat adolescents to ascertain the applicable law. In this article, we discuss the underlying differences between medical ethics and law, which have caused some of the confusion in this area, and we set out the most current legal rules governing adolescent decision-making authority in general medical settings. A comprehensive analysis of both statutory and common law demonstrates that in such settings, parental consent continues to be required by most jurisdictions, even when the minor can be considered cognitively "mature."

Background Children who undergo treatment for childhood acute lymphoblastic leukemia (ALL) and lymphoma are at risk for several long-term health problems. Obesity, for which survivors of ALL and lymphoma are also at risk, may further exacerbate these problems. This pilot study evaluates changes in physical activity and body composition among children being treated for ALL and lymphoma and their parents. Procedures Recently diagnosed adolescent ALL and lymphoma patients were recruited from two pediatric hematology and oncology clinics, and matched on age, race, and gender to healthy individuals in the community. Changes in diet, physical activity and body composition were collected at baseline, 6, and 12 months. Results All children (n = 15) were, on average, 10.3 years of age at enrollment, and were fairly evenly distributed with regard to gender. Analyses revealed a significant difference between cases and controls with respect to the change in BMI from baseline to 12 months (p = 0.01). Additionally, controls demonstrated a significantly greater increase in moderate-vigorous physical activity (MVPA) than the cases (229.8 Metabolic equivalent of tasks [METs] vs. 23.5 METs); indicating cases remained fairly inactive over the course of treatment. Conclusion Our data corroborate previous findings that, following treatment for ALL and lymphoma, childhood cancer survivors tend to be less active and at greater risk for obesity than their healthy peers. The present study, which assessed cases prospectively over a 12 month period during the early phases of treatment, extends prior reports by demonstrating that these outcomes are evident at an early stage in treatment.

Heightened awareness of the genitourinary complications of sickle cell disease may prevent end stage disease, including renal failure and impotence. New forms of therapy for sickle cell disease, such as hydroxyurea, may prevent these complications in the future.