Late effects of the treatment of childhood cancer

Abstract

Excellent progress has been made in the last few decades in the cure rates of pediatric malignancies, with more than 80% of children with cancer who have access to contemporary treatment being cured. However, the therapies responsible for this survival can also produce adverse physical and psychological long-term outcomes, referred to as late effects, which appear months to years after the completion of cancer treatment. Research has shown that 60% to 90% of childhood cancer survivors (CCSs) develop one or more chronic health conditions, and 20% to 80% of survivors experience severe or life-threatening complications during adulthood. Therefore, understanding the late side effects of such treatments is important to improve the health and quality of life of the growing population of CCSs.

Keywords: Survivorship; Cancer; Children; Treatment; Late effects

Core Tip: Childhood cancer and contemporary anticancer therapies responsible for excellent cure rates can produce adverse, long-term, health-related outcomes, referred to as late effects. Therapy-related long-term complications may affect multiple organs and organ systems, including cardiovascular, endocrine/metabolic, reproductive, neurologic, immune, pulmonary, gastrointestinal, urinary, musculoskeletal, auditory, ocular, dermatologic and oral/dental organs, as well as contribute to the risk of neurocognitive and psychosocial difficulties, and subsequent malignant neoplasms. Many of these late effects are life-altering or potentially life-threatening. Long-term multidisciplinary follow-up of childhood cancer survivors is recommended for the prevention, early detection, and treatment of late effects.