Health Status of Adult Long-term Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

Abstract

HE DEVELOPMENT OF CURAtive therapy for most pediatric malignancies provides the opportunity to investigate the impact of cancer treatment on health status of large numbers of long-term survivors. Numerous studies have established that cancer and its treatment predispose to late morbidity and increase the risk of early mortality in longterm childhood cancer survivors. 1-8 In general, children with aggressive tumor histologies have required more intensive treatment, which predispose them to heightened risks of physical morbidity. Treatment-related late sequelae with significant potential impact on physical functioning include neurocognitive dysfunction, cardiopulmonary toxicity, endocrinopathy, and second malignancy. The frequency and severity of many of the common sequelae have been correlated with sex, age at diagnosis, and cumulative dose-exposures of specific treatment modalities. 9-12

Long-term Functional Outcome in Young Adult Survivors of Childhood Brain Tumor

“…This result can be explained by the location of the posterior fossa near the brainstem and cerebellum, which is the part of the brain responsible for movement, balance, and coordination. Finally, consistent with the results of other studies on health status and medical late effects of cancer survivors, 32,33 female gender is another significant factor for a poor outcome in motor skills in our study. However, as our cohort is predominantly female (61.1%), which is not representative of the BT patients' population, there might be a bias in the recruitment that could have impacted the results.…”

Adaptation of an Obesity Intervention Program for Pediatric Cancer Survivors (NOURISH-T)

“…Findings from medical record review (phase one) showed that a large proportion of PCS are overweight/obese, and that this trend continues over time when PCS are off active cancer treatment. These results are consistent with published reports (Garmey et al, 2008;Oeffinger et al, 2003) but suggest even higher rates of overweight/obesity than in the general U.S. population (Ogden et al, 2012). A large number of PCS were overweight or obese at diagnosis (34.6% of 5-12 year-olds; 44% of 13-17 yearolds).…”

Physical functioning in pediatric survivors of childhood posterior fossa brain tumors

“…Although these specific activities may not be regularly performed in isolation on a daily basis, they are essential for successful performance of activities such as putting on boots (from a standing position), kicking a ball, or maneuvering in small spaces. These results are consistent with the findings by Hudson et al (2003), who reported that 31.7% of adult survivors of all childhood CNS tumors (not just PFBTs) reported physical performance limitations and participation restrictions in activities such as bathing, dressing, shopping, and going to school. 30 Although balance rehabilitation may be more difficult than improving strength or speed, these data suggest that PFBT survivors should be supported to engage in ongoing activities to challenge and improve their balance abilities.…”