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 patients' 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.

Keywords: Aftercare and transition; Cancer in children; Late effects; Long-term survival; Survivors’ quality of life.