There was a time, not too long ago, when most children with cancer died. There was a time when children with cancer were not even told of their cancer diagnosis, because it instilled such fear. Fortunately, both of those historical tidbits have changed in recent decades. With better treatments, survival rates for pediatric cancer are now roughly 80%. Most children with cancer grow up, but they may not remember much about the cancer they overcame as a child or the types of treatments they received.
Knowing those details is important. Many pediatric cancer survivors develop medical problems later on, and the type of cancer and the type of treatment they received can affect how physicians respond. These numbers jumped out at me when I wrote a feature story on long-term care of pediatric cancer survivors: One of every 640 young adults in the United States survived cancer as a child, and approximately two-thirds of them have at least one chronic health problem. Later problems include secondary cancers, cardiovascular and lung diseases, learning disabilities and memory difficulties, vision and hearing problems, infertility, and more.
Pediatric oncologists are working to create systems so childhood cancer survivors will have their medical histories easily available to them and to the physicians who treat them later in life. Long-term follow-up programs for childhood cancer survivors have sprung up at many centers in the past 5 years. And guidelines exist for physicians who are not familiar with the nuances of care for adults who survived childhood cancer.
In the words of Dr. Anna T. Meadows, medical director of the cancer survivorship and living well after cancer program at The Children’s Hospital of Philadelphia: “People are not really thinking that the kids grow up, yet the average age of our survivors is now in the 40s.” As a first step, she said, physicians should ask their adult patients if they had cancer as a child.