- The Washington Times - Tuesday, August 26, 2003


Children’s chances of beating cancer have improved, but as many as two-thirds of survivors are likely to experience a delayed side effect from the disease or the treatment, said a report released yesterday.

About a quarter of survivors may experience severe or life-threatening side effects that do not show up immediately but could affect things such as growth, fertility, heart function, muscle movement or cognitive activity, said the study by the Institute of Medicine, an arm of the National Academy of Sciences.

Susceptibility to these late side effects depends on the child’s age at the time of diagnosis, how much chemotherapy and radiation were used as well as the severity and location of the cancer.

The late side effects can occur in follow-up treatment or they may develop in adulthood, complicating their identification and treatment, the report said. Also, because treatments for cancer have evolved in recent years, the delayed side effects are also changing.

In 1997, 270,000 Americans of all ages had survived childhood cancer — including about 1 in 640 adults aged 20 to 39. That was up from 1970, when children diagnosed with cancer had little chance of being cured.

The rising number of survivors has made the long-term care issues more apparent.

“We’re learning more as the first generation of childhood cancer survivors get older,” said Dr. Stuart Kaplan, a staff physician in a follow-up cancer care clinic at St. Jude Children’s Research Hospital in Memphis, Tenn.

Looking for known threats and treating side effects early can help to minimize the damage these side effects can cause, he said.

“Directed screening is very important, and it’s really the job of the primary care providers,” he said, adding that educating patients is also important “because the onus is often on them.”

The report recommends:

• Developing guidelines for the follow-up care of childhood cancer survivors.

• Creating links between primary physicians and specialists.

• Raising awareness of the late side effects that threaten cancer survivors.

• Stepping up research to prevent late side effects.



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