Children are able to live a cancer free life after undergoing aggressive cancer therapy, these are childhood cancer survivors.
Since the second half of the 20th century, the cure rates of all cancers affecting children have increased significantly. Till 1958, there were not many children who could combat and survive cancer because of the lack of adequate treatment methods. Today, nearly 80% of all adolescents and children who have been diagnosed with some form of cancer can live up to five years with the help of effective medication and treatment once the diagnosis has been confirmed. Most of these children are considered completely cured.
According to statistics from over ten million of all survivors of cancer residing in the United States of American in the year 2005, almost 270,000 were completely treated before they reached the second decade of their life. However, in the majority of these cases, the treatment had various consequences related to the overall health of the patient. There are a number of known complications and side effects of surgical procedures, radiation therapies and chemotherapies associated with the cure of cancer which may manifest in the healthy organs and tissues once treatment has been completed.
Side effects of treatment:
The majority of these complications and side effects can be successfully resolved and are reversible after the completion of the treatment. The side effects that continue to manifest long after the completion of treatment are known as the late effects or the long term effects. Long term effects can manifest from several weeks to several decades after the treatment has been completed. It is possible for some survivors never to develop any late effects at all. The others report mild, moderate and in some cases, severe effects. The severity of the late effects varies from patient to patient and can be associated with the form, duration and intensity of the therapy used for the treatment. Another crucial factor is the age at which the child received the cancer treatment because according to research, younger children are at a greater risk of developing late effects than the rest.
Side effects that may affect children during adulthood:
Perhaps one of the greatest, most life changing long term effects of cancer treatment is the loss of fertility.
In children who have undergone some form of brain surgery followed by exposure to radiation to the head, or chemotherapy aimed directly to the spinal cord, the chances of neurological difficulties are quite common. Some of the most common neurological problems experienced by these children include mental retardation, learning disabilities and cognitive disabilities.
If a class of drugs known as the anthracyclines2 is used during chemotherapy, cardiac damage is common as this drug weakens the cardiac muscles, resulting in congestive heart failure. Radiation therapy aimed at the heart can also increase the chances of development of heart conditions and can also result in significant damage to the lungs. Some of the common long term effects in this case include retardation of the child’s overall growth, problems in hearing, damage to the thyroid glands, liver, kidneys and various other organs and systems of the body.
Another long term complication of radiation therapy and chemotherapy used for treating cancer in children may be the development of a secondary cancer once the treatment has been completed. Once again, this depends upon the duration, type and intensity of the treatment and therapy used for curing the initial cancer. The age at which the child received the first therapy is also a critical factor. However, the development of a secondary cancer in survivors is a rare possibility and may not occur in the majority of children who have undergone cancer treatment.
Child’s mental health:
It is possible for the mental health of the children who survived cancer to be affected in later ages. Some of the most common long term mental health effects experienced by survivors include depression and anxiety, which are associated with physical appearance and the constant fear of developing cancer again. These mental health symptoms can cause problems in developing normal and healthy personal relationships, in phases of education and in consistent employment.
What can help?
It is critical to schedule regular follow ups for the survivors of childhood cancer, in order to detect and identify any long term problems that may be affecting the well being of the individual. It is better to detect these problems at the earliest stage so that proper measures can be taken to help the patients before they start hindering normal, every-day activities.
What can doctors do?
Doctors can help patients who have suffered from childhood cancers. They inform the survivors about all the possible long term effects. It is possible that survivors may be facing a number of occupational and educational problems because of the long term effects. It is important to make them realize that, as cancer survivors, these individuals are entitled to special educational services to make their access to education easier and more convenient. For parents the first step in ensuring that the child receives education is acquiring the special education services from his/her school. Education is the right of every child and must not be denied based on any medical problem or disability.
Counselors are available to provide help to parents who face such a challenge.
CureSearch. Access at: www.curesearch.org
The Children’s Oncology Group and the National Childhood Cancer Foundation provide this comprehensive site about childhood cancer. It has separate sections for parents/families and for patients in different age groups: preschool, ages 5-10, 10-14, and 14-22. The site is divided into four major sections: newly diagnosed, in treatment, end of treatment, and after treatment. Topics covered include childhood cancer types, diagnostic tests, treatment methods, school and friends, and the family. The site also includes a clinica -trials matching service, discussion boards, and a resource directory for national and local support groups and services.
Keene, Nancy 2003. Educating the Child with Cancer: A Guide for Parents and Teachers. Kensington, MD: Candlelighters Childhood Cancer Foundation. This book was developed with the intent of promoting understanding and communication between parents, educators, and medical professionals, so that together they can provide an appropriate education for children who have been treated for cancer. Topics include gaining access to special education services, helping siblings in the classroom, physical activity in school, cognitive late effects, and grief in the classroom.
Carroll, William L., and Jessica B. Reisman. 2005. 100 Questions and An swers about Your Childs Cancer. Sudbury, MA: Jones and Bartlett.
This book presents practical answers to questions about childhood cancer, treatment options, and post-treatment quality-of-life and coping strategies for both patients and parents. Two childhood cancer experts authored this book and incorporated comments from parents of children with cancer.
National Children’s Cancer Society. The Mountain You’ve Climbed.’ A Parent’s Guide to Childhood Cancer Survivorship
This guide is designed to answer parents’ questions regarding childhood cancer and offer suggestions on how to integrate the cancer experience into all areas of the family’s life. It addresses issues beginning from the time of diagnosis through the completion of treatment and beyond. Order at: www.thenccs.org/aboutNCCS
Ball, Edward D., and Gregory A. Lelek. 2003. / 100 Questions and Answers about Leukemia. Sudbury, MA: Jones and Bartlett.
This article was originally published on 7/12/2014 and last revision and update of it was 9/14/2015.