Late Effects and Long-Term Follow-Up after Cancer in Childhood

Abstract

Today, 80% of children and adolescents with cancer survive their disease. From the results of aftercare research arises the question: Are the survivors also healthy? Many late effects depend on the type of cancer and its treatment. Patients with brain tumors and with malignant sarcomas are very often affected by secondary diseases. Data from the USA report that around 2/3 of all patients still living 30 years after their cancer treatment in childhood suffer from late complications. Equivalent figures for Germany were previously unavailable. In accordance with the guidelines, regular follow-ups to diagnose a relapse or possible late effects have mostly been carried out in the primary children's hospitals. In adolescence and in young adulthood, this regimen does no longer serve the patientsʼ mental and physical needs. To ensure appropriate care for this maturing patient group, interdisciplinary approaches (e.g., aftercare consultations) are required in which pediatric oncologists collaborate with colleagues from the field of internal medicine and other disciplines. Individual, risk-adapted (depending on the cancer treatment) aftercare plans based on pre-existing aftercare recommendations must be drawn up for every patient and to secure the early diagnosis of possible late effects. The conservation of health and quality of life after cancer treatment (in all age groups) will in the future not only represent a social but also an economic consideration.

Long-term medical imaging use in children with central nervous system tumors

“…remain still or with contraindications for sedation, or children with claustrophobia or intolerance for noise) and of limited diagnostic value in some CNS tumors [19]. As follow-up time increases, it will be increasingly important to understand the best practices for childhood cancer survivors [8]. Regardless of the imaging modality, patients and families may experience anxiety associated with waiting for results of a surveillance imaging test.…”

“…In contrast to children with solid tumors [6][7][8][9][10], no clear outcome data support a particular imaging regimen for children with CNS tumors during long-term follow-up. A recent review of studies of children with brain tumors showed that the median time to relapse across all tumor types was 13.7 months [11].…”

Adverse Events During Supervised Exercise Interventions in Pediatric Oncology—A Nationwide Survey

“…Survival rates in children and adolescents with cancer have increased over the last decades and researchers and health care providers attempt to improve the quality of survival and reduction of negative side effects during treatment and survivorship ( 1 ). In this context, exercise program, are one possible supportive approach to increase health-related quality of life and counteract the disease and treatment related negative effects ( 2 ).…”

Secondary CNS tumours in children initially treated from ALL according to the treatment protocols of chemotherapy and radiotherapy

“…У США та європейських країнах створено спеціальну групу з вивчення пізніх усклад нень протипухлинного лікування (Late Effects Study Group) [11,26,28,29,30]. За даними ряду публікацій, співвідношення між статтю та частотою вторинного канцерогенезу неодноз начні.…”