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Late effects of childhood cancer

Steven G Waguespack
The hypothalamic-pituitary-thyroid axis is a common site of unintended, acquired disease either during or after the treatment of cancer. Children treated with external radiation therapy are at the highest risk for developing a thyroid-related late effect, but thyroid dysfunction and second primary thyroid neoplasms can also occur after treatment with radiopharmaceutical agents such as 131I-metaiodobenzylguanidine. Increasingly recognized is the development of early thyroid dysfunction as an off-target consequence of the more novel cancer therapeutics such as the tyrosine kinase inhibitors and immune checkpoint inhibitors...
December 12, 2018: Hormone Research in Pædiatrics
Surya P Rednam
PURPOSE OF REVIEW: A significant proportion of pediatric cancer occurs in children with hereditary cancer predisposition syndromes. Their survival may be significantly improved and/or late effects diminished through screening for their greatly elevated cancer risks. Here, an overview of new developments in the field of pediatric cancer surveillance is provided. RECENT FINDINGS: Consensus-based screening guidelines have been developed for most syndromes associated with childhood cancer risks...
December 10, 2018: Current Opinion in Pediatrics
Karen E Effinger, Kayla L Stratton, Paul Graham Fisher, Kirsten K Ness, Kevin R Krull, Kevin C Oeffinger, Gregory T Armstrong, Leslie L Robison, Melissa M Hudson, Wendy M Leisenring, Paul C Nathan
BACKGROUND: Although paediatric astrocytoma has an excellent 5-year survival rate, survivors remain at risk for morbidity and late mortality. This study aimed to estimate the risk of late mortality, chronic conditions, poor health status and social impairment in ageing paediatric astrocytoma survivors. METHODS: We longitudinally evaluated 1182 5-year astrocytoma survivors diagnosed between 1970 and 1986 and 4023 siblings enrolled in a retrospective cohort study...
December 4, 2018: European Journal of Cancer
K Scott Baker, Karen L Syrjala
Adolescents and young adults (AYAs) with cancer, defined by the National Cancer Institute as having been diagnosed between the ages of 15 and 39 years old, have not benefited from the same improvements in quality of outcomes and survival that have been seen for individuals diagnosed in childhood or as older adults. Although is leukemia composed of a diverse group of diagnoses, leukemia AYA survivors share unique vulnerabilities with other AYA diagnostic groups. They will spend the majority of their lives as survivors, with clear evidence of adverse medical conditions, health care requirements, and social and psychological needs that differ not only from their peers but also, from the needs of other cancer survivor populations...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Judith Gebauer, Claire Higham, Thorsten Langer, Christian Denzer, Georg Brabant
The number of patients surviving five or more years after initial cancer diagnosis has significantly increased over the last decades due to considerable improvements in the treatment of many cancer entities. A negative consequence of this is the emergence of long-term sequelae and endocrine disorders account for a high proportion of these. These late effects can occur decades after cancer treatment and affect up to 50% of childhood cancer survivors. Multiple predisposing factors for endocrine late effects have been identified; including radiation, gender and age at the time of diagnosis...
November 23, 2018: Endocrine Reviews
Amilie Boonstra, Marieke Gielissen, Eline van Dulmen-den Broeder, Nicole Blijlevens, Hans Knoop, Jacqueline Loonen
OBJECTIVES: Fatigue is a common and disabling late effect in childhood cancer survivors (CCS). In this pilot study, the effectiveness of cognitive behavior therapy (CBT) in CCS with persistent and severe fatigue was retrospectively evaluated. MATERIALS AND METHODS: In total, 33 consecutively referred CCS with persistent severe fatigue were offered CBT. The primary outcome was fatigue severity (Checklist Individual Strength, Fatigue Severity Subscale). Secondary outcomes were functional impairment, psychological distress, and quality of life (QoL)...
November 20, 2018: Journal of Pediatric Hematology/oncology
Brigitte Gerstl, Elizabeth Sullivan, Serena Chong, Debbie Chia, Handan Wand, Antoinette Anazodo
Improvements in cancer therapy for childhood and adolescent and young adult (AYA) survivors have increased in excess of 80% among pediatric patients and in excess of 85% among AYA cancer patients. Our research group explored the late effects consequences of cancer treatment on pregnancy and birth outcomes subsequent to a childhood (0-14 years) or AYA (15-25 years) diagnosis of cancer in female cancer survivors. Embase and Medline databases were searched. There were 17 review (n = 10 matched and n = 7 unmatched) studies that met the inclusion criteria...
November 16, 2018: Journal of Adolescent and Young Adult Oncology
Hee Young Ju, Eun-Kyeong Moon, Jiwon Lim, Byung Kiu Park, Hee Young Shin, Young-Joo Won, Hyeon Jin Park
BACKGROUND: Second malignant neoplasm is one of the most devastating late effects of childhood cancers. This study aimed to evaluate the incidence and survival outcomes of patients developing second malignant neoplasms (SMNs) after surviving childhood cancer in Korea. METHODS: Medical data of childhood cancer patients diagnosed between 1993 and 2012 were obtained from the Korea Central Cancer Registry. The risk of developing SMNs was calculated using standardized incidence ratio (SIR), excess absolute risk (EAR), and cumulative risk...
2018: PloS One
Wassim Chemaitilly, Charles A Sklar
Endocrine complications are frequently observed in childhood cancer survivors (CCS); in many instances, these complications develop months to years after the completion of cancer therapy. The estimated prevalence of endocrine late effects is 50% among CCS; the main risk factors are external beam radiation that includes key endocrine organs (the hypothalamus/pituitary, thyroid and gonads) and/or alkylating agents. Novel agents targeting tumor growth have increased the options available to a small number of patients albeit with the need for treatment over long periods of time...
November 7, 2018: Hormone Research in Pædiatrics
Rachel S Fisher, Joseph R Rausch, Amanda C Ferrante, Kemar V Prussien, Randal S Olshefski, Kathryn A Vannatta, Bruce E Compas, Cynthia A Gerhardt
OBJECTIVE: The majority of childhood cancer survivors develop at least one late effect subsequent to treatment (eg, cardiovascular disease and obesity). Consistent engagement in recommended health behaviors may mitigate some of these conditions. Researchers have identified early survivorship as a teachable moment, yet few studies have examined positive health behaviors during this period. METHODS: Families of children with cancer (ages 5-17) were initially recruited following a diagnosis or relapse of cancer...
November 6, 2018: Psycho-oncology
Thorsten Langer, Desiree Grabow, Peter Kaatsch, Ursula Creutzig, Angelika Eggert, Gabriele Escherich, Gabriele Calaminus
Nowadays, childhood cancer patients survive much more often than they did 40 years ago. Therefore, the cure rates rise over 80%. Approximately 33,000 cured childhood cancer patients are documented by the German Childhood Cancer Registry (GCCR) for long-term follow-up in Germany. But does that mean, they are healthy, too? When compared to the normal population, it can be seen that morbidity and mortality are significantly higher among former childhood cancer patients. In two out of three survivors, the cancer and its treatments can lead to treatment-related late complications 30 years later; in about one-third, these late complications are classified as severe...
October 2018: Klinische Pädiatrie
Ritva Ahomäki, Andreina Kero, Mari Koivisto, Laura Madanat-Harjuoja, Nea Malila, Päivi M Lähteenmäki
According to previous studies, childhood cancer survivors have an elevated risk for late mental health effects. However, only few studies exist on young adulthood (YA) cancer survivors' mental health outcomes. In our study, we examined first time antidepressant (AD) medication purchases of childhood and YA cancer patients compared to siblings. The first time AD medication purchases of 7,093 cancer patients aged 0-34 years at diagnosis and a sibling cohort (N = 26,882) were retrieved from the Social Insurance Institution of Finland (Kela) since 1...
October 25, 2018: International Journal of Cancer. Journal International du Cancer
Myxuan Huynh, Loredana Gabriela Marcu, Eileen Giles, Michala Short, Donna Matthews, Eva Bezak
INTRODUCTION: The most common solid tumours that develop in children are cancers of the central nervous system. Due to the increased rate of survival over the past decades, greater focus has been placed on the minimisation of long term side effects. In childhood cancer survivors, over 60% report one or more radiation-related late toxicities while half of these adverse events are graded as life-threatening or severe. Proton therapy enables high conformity with the planning target volume and a reduction in dose to areas beyond the target...
November 2018: Cancer Treatment Reviews
Julienne E Bower, Joshua Wiley, Laura Petersen, Michael R Irwin, Steve W Cole, Patricia A Ganz
OBJECTIVE: Fatigue is a common side effect of cancer treatment, but there is considerable variability in fatigue severity and persistence among survivors. This study aimed to characterize longitudinal trajectories of fatigue after breast cancer treatment and to identify predictors of varying fatigue trajectories. METHODS: Women (N = 191) from the Mind-Body Study completed assessments after primary treatment for early stage breast cancer and at regular follow-ups that occurred up to 6 years after treatment (M = 4...
November 2018: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
Annette Weiss, Grit Sommer, Christina Schindera, Laura Wengenroth, Axel Karow, Manuel Diezi, Gisela Michel, Claudia E Kuehni
PURPOSE: Hearing loss, a complication of cancer treatment, may reduce health-related quality of life (HRQoL), especially in childhood cancer survivors of central nervous system (CNS) tumours who often have multiple late effects. We examined the effect of hearing loss on HRQoL in young survivors of CNS and other childhood cancers. METHODS: Within the Swiss Childhood Cancer Survivor Study, we sent questionnaires about hearing loss and HRQoL (KIDSCREEN-27) to parents of survivors aged 8-15 years...
October 10, 2018: Quality of Life Research
Despoina-Rafailia Benetou, Evangelos Stergianos, Maria Geropeppa, Erato Ntinopoulou, Marina Tzanni, Apostolos Pourtsidis, Andreas C Petropoulos, Marios K Georgakis, Dimitrios Tousoulis, Eleni Th Petridou
PURPOSE: Medical advances in pediatric oncology have led to increases in survival but the long-term adverse effects of treatment in childhood cancer survivors have not yet been examined in depth. In this systematic review, we aimed to study the prevalence and risk factors of late-onset cardiomyopathy (LOCM) among survivors of childhood lymphoma treated with anthracyclines. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines we searched Pubmed/Medline, abstracted data and rated studies on quality regarding late-onset (>1 year following treatment) cardiotoxicity of anthracyclines in survivors of childhood lymphoma...
September 28, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Anne-Lotte L F van der Kooi, Eva Clemens, Linda Broer, Oliver Zolk, Julianne Byrne, Helen Campbell, Marleen van den Berg, Claire Berger, Gabriele Calaminus, Uta Dirksen, Jeanette Falck Winther, Sophie D Fosså, Desiree Grabow, Riccardo Haupt, Melanie Kaiser, Tomas Kepak, Leontien Kremer, Jarmila Kruseova, Dalit Modan-Moses, Andreas Ranft, Claudia Spix, Peter Kaatsch, Joop S E Laven, Eline van Dulmen-den Broeder, André G Uitterlinden, Marry M van den Heuvel-Eibrink
BACKGROUND: Improved risk stratification, more effective therapy and better supportive care have resulted in survival rates after childhood cancer of around 80% in developed countries. Treatment however can be harsh, and three in every four childhood cancer survivors (CCS) develop at least one late effect, such as gonadal impairment. Gonadal impairment can cause involuntary childlessness, with serious consequences for the well-being of CCS. In addition, early menopause increases the risk of comorbidities such as cardiovascular disease and osteoporosis...
September 26, 2018: BMC Cancer
J Gebauer, H Lehnert, S M Schmid, C Spix, A Stein, T Langer
BACKGROUND: Childhood cancer survivors are at risk of cancer- and treatment-related chronic health conditions. Since these sequelae may occur years after the end of treatment, many patients are already adults and have completed pediatric oncological care. Thus, successful transition is essential in order to ensure long-term surveillance. OBJECTIVES: The present review outlines the most frequent late effects of childhood cancer treatment. Moreover, difficulties in transition of these patients are discussed and interdisciplinary models of care are presented...
November 2018: Der Internist
Thomas Wiebe, Lars Hjorth, Mercedes Marotta Kelly, Helena M Linge, Stanislaw Garwicz
A population based registry, with the acronym BORISS, was established. It contains all individuals (0-18 years of age at diagnosis) diagnosed with cancer from 1970-01-01 until 2016-12-31 in Southern Sweden. The treatment data has been entered into the registry after confirmation of the diagnosis by the Swedish national cancer registry and updates on vital status from the Swedish population registry. The number of individuals with a pediatric cancer diagnosed during these 46 years are 2928. Of these, 2065 are currently alive and 1882 individuals are 5-year survivors...
November 2018: European Journal of Epidemiology
Catherine A Brown, Danny R Youlden, Joanne F Aitken, Andrew S Moore
BACKGROUND: Therapy-related acute myeloid leukemia (t-AML) is defined as AML that develops after exposure to cytotoxic chemotherapy and/or radiation therapy. There is a paucity of available literature, particularly in regard to t-AML following childhood cancer. Our aim was to describe the risk of t-AML among children treated for other cancers and their subsequent survival. PROCEDURE: We utilized data from the population-based Australian Childhood Cancer Registry to examine all childhood patients (<15 years at diagnosis) treated with chemotherapy and/or radiotherapy for cancers other than AML who received a subsequent diagnosis of AML between 1983 and 2014...
September 5, 2018: Pediatric Blood & Cancer
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