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CONTACT THE HERALD
Melanie Munk, Features Editor
munk@heraldnet.com
 
Published: Tuesday, September 9, 2008

Risks kids face after treatment for cancer

Jordan developed leukemia as a young child. At age 5, his treatment for the blood cancer consisted of radiation to his head and chemotherapy. But now that Jordan is 12 years old, and about to enter adolescence as a cancer survivor, he still isn't home free. Some side effects of cancer therapy may not appear until 10 to 30 years after treatment.

To avoid these problems, here's what young adults, teenagers, children and the people who care for them after cancer treatment need to know.

Progress against cancer

Improved treatment for childhood cancer is one of the greatest successes of modern medicine. The average cure rate for all childhood cancers combined has reached nearly 80 percent. With the overall death rate for the cancers steadily falling, the number of long-term survivors of childhood cancer has increased to more than 270,000 in the United States.

But the cure has a cost. Many cancer survivors suffer from health problems related to radiation, chemotherapy or surgery that they underwent as a child.

Late effects

A study in the New England Journal of Medicine found that, among children treated from the 1970s through the 1990s, about 75 percent had developed a chronic disease before age 40 years. A serious health problem arose in about 40 percent of the participants within the same period.

Some of the most common types of problems include:

Growth: Cancer treatment during childhood may sometimes slow or stunt growth. The difficulty most frequently occurs after radiation to the brain or spine.

Heart: Chest radiation or chemotherapy using anthracycline drugs can cause heart problems. People who received high treatment doses before their heart finished growing are at increased risk.

Fertility: Certain anticancer drugs or radiation to the pelvis can affect the reproductive organs. This may result in delayed puberty, impaired ability to have children or early menopause.

Thyroid: Head or neck radiation can impair normal function of the thyroid gland. Thyroid hormones that are too high or too low can influence your weight and your metabolism -- the rate at which every part of your body works.

Second cancers: After receiving chemotherapy or radiation, the chance goes up of developing another cancer different from the original. Additional factors such as smoking, exposure to sun or chemicals or family history can place cancer survivors at increased risk for certain tumors.

Mental and emotional: Difficulty with school or work may sometimes occur after cancer treatment. Depression, anxiety or fear of cancer relapse is also common.

Necessary follow-up

On the positive side, greater resilience and appreciation of life may result from going through the cancer experience. Two prevention steps draw upon these strengths.

Get a treatment summary: It should include your diagnosis, cancer location and stage, dates and specific types of treatments received, information about any relapses and record of complications. Bring this record with you when you move, or change providers or insurance plans.

Screen for problems: Many cancer treatment centers offer screening as part of a long-term follow-up program. Or go in for regular follow-up visits with a doctor close to your home, preferably one who works in partnership with your treatment center.

For more information: www.survivorshipguidelines.org. The Children's Oncology Group publishes updated guidelines for children, teenagers and young adults who have received treatment for cancer.



Contact Dr. Elizabeth Smoots, at doctor@practicalprevention.com.

© 2008 Elizabeth S. Smoots

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