Medical and Psychosocial Issues in Childhood Cancer Survivors

  • Smita Bhatia
  • Wendy Landier
  • Jacqueline Casillas
  • Lonnie Zeltzer


More than 12,000 children and adolescents younger than 20 years are diagnosed with cancer each year in the United States.1 With the use of risk-based therapies, the overall 5-year survival rate is approaching 80%, resulting in a growing population of childhood cancer survivors.1 In 1997, there were an estimated 270,000 survivors of childhood cancer; over two-thirds of these were older than 20 years of age.2 This figure translates into 1 in 810 individuals under the age of 20 and 1 in 640 individuals between the ages of 20 and 39 years having successfully survived childhood cancer.


Acute Lymphoblastic Leukemia Clin Oncol Childhood Cancer Hematopoietic Cell Transplant Cranial Radiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Reis LAG, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1973–1998. Bethesda, MD: National Cancer Institute, MD, 2001.Google Scholar
  2. 2.
    Hewitt M, Weiner SL, Simone JV. Childhood Cancer Survivorship: Improving Care and Quality of Life. Washington, DC: National Academies Press, 2003.Google Scholar
  3. 3.
    Sklar CA. An overview of the effects of cancer therapies: the nature, scale, and breadth of the problem. Acta Paediatr Scand Suppl 1999;433:1–4.CrossRefGoogle Scholar
  4. 4.
    Garré ML, Gandus S, Cesana B, et al. Health status of long-term survivors after cancer in childhood. Am J Pediatr Hematol Oncol 1994;16:143–152.PubMedGoogle Scholar
  5. 5.
    Oeffinger KC, Eshelman DA, Tomlinson GE, et al. Grading of late effects in young adult survivors of childhood cancer followed in an ambulatory adult setting. Cancer (Phila) 2000;88:1687–1695.PubMedCrossRefGoogle Scholar
  6. 6.
    Stevens MCG, Mahler H, Parkes S. The health status of adult survivors of cancer in childhood. Eur J Cancer 1998;34:694–698.PubMedCrossRefGoogle Scholar
  7. 7.
    Vonderweid N, Beck D, Caflisch U, et al. Standardized assessment of late effects in long-term survivors of childhood cancer in Switzerland: results of a Swiss Pediatric Oncology Group (SPOG) pilot study. Int J Pediatr Hematol/Oncol 1996;3:483–490.Google Scholar
  8. 8.
    Brown RT, Sawyer MB, Antoniou G, et al. A 3-year follow-up of the intellectual and academic functioning of children receiving central nervous system prophylactic chemotherapy for leukemia. J Dev Behav Pediatr 196;17(6):392–398.Google Scholar
  9. 9.
    Kramer J, Moore IM. Late effects of cancer therapy on the central nervous system. Semin Oncol Nurs 1989;5:22–28.PubMedCrossRefGoogle Scholar
  10. 10.
    Moore IM, Packer RJ, Karl D, et al. Adverse effects of cancer treatment on the central nervous system. In: Schwartz CL H W, Constine LS, Ruccione KS (eds). Survivors of Childhood Cancer: Assessment and Management. St. Louis: Mosby, 1994:81–95.Google Scholar
  11. 11.
    Fochtman D. Follow-up care for survivors of childhood cancer. Nurse Pract Forum 1996;6:194–200.Google Scholar
  12. 12.
    Packer RJ, Sutton LN, Atkins TE, et al. A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results. J Neurosurg 1989; 70:707–713.PubMedGoogle Scholar
  13. 13.
    Mulhern RK, Reddick WE, Palmer SL, et al. Neurocognitive deficits in medulloblastoma survivors and white matter loss. Ann Neurol 1999;46:834–841.PubMedCrossRefGoogle Scholar
  14. 14.
    Shan K, Lincoff AM, Young JB. Anthracycline-induced cardiotoxicity. Ann Intern Med 1966;125:47–58.Google Scholar
  15. 15.
    Grenier MA, Lipshultz SE. Epidemiology of anthracycline cardiotoxicity in children and adults. Semin Oncol 1998;25:72–85.PubMedGoogle Scholar
  16. 16.
    Pai VB, Nahata MC. Cardiotoxicity of chemotherapeutic agents: incidence, treatment and prevention. Drug Saf 2000;22:263–302.PubMedCrossRefGoogle Scholar
  17. 17.
    Prout MN, Richards MJS, Chung KJ, et al. Adriamycin cardiotoxicity in children. Cancer (Phila) 1977;39:62.PubMedCrossRefGoogle Scholar
  18. 18.
    Minow RA, Benjamin RS, Gottlieb JA. Adriamycin (NSC-123127) cardiotoxicity: a clinicopathologic correlation. Cancer Chemother Rep 1975;6:195.Google Scholar
  19. 19.
    Bossi G, Lanzarini L, Laudisa ML, et al. Echocardiographic evaluation of patients cured of childhood cancer: a single center study of 117 subjects who received anthracyclines. Med Pediatr Oncol 2001;36:593–600.PubMedCrossRefGoogle Scholar
  20. 20.
    Kremer LCM, van Dalen EC, Offringa M, et al. Anthracyclineinduced clinical heart failure in a cohort of 607 children: long-term follow-up study. J Clin Oncol 2001;19:191–196.PubMedGoogle Scholar
  21. 21.
    Fajardo L, Stewart J, Cohn K. Morphology of radiation-induced heart disease. Arch Pathol 1968;86:512–519.PubMedGoogle Scholar
  22. 22.
    Kushner JR, Hansen VL, Hammar SP. Cardiomyopathy after widely separated courses of Adriamycin exacerbated by actinomycin D and mithramycin. Cancer (Phila) 1975;36:1577.PubMedCrossRefGoogle Scholar
  23. 23.
    Smith PJ, Eckert H, Waters KD, et al. High incidence of cardiomyopathy in children treated with Adriamycin and DTIC in combination chemotherapy. Cancer Treat Rep 1977;61:1736.PubMedGoogle Scholar
  24. 24.
    Von Hoff D, Rozencweig M, Piccart M. The cardiotoxicity of anticancer agents. Semin Oncol 1982;9:23.Google Scholar
  25. 25.
    Lipshultz SE, Lipshultz SR, Mone SM, et al. Female sex and higher drug dose as risk factors for late cardiotoxic effects of doxorubicin therapy for childhood cancer. N Engl J Med 1995; 332:1738–1743.PubMedCrossRefGoogle Scholar
  26. 26.
    Pratt CB, Ransom JL, Evans WE. Age-related Adriamycin cardiotoxicity in children. Cancer Treat Rep 1978;62:1381.PubMedGoogle Scholar
  27. 27.
    Von Hoff DD, Rozencweig M, Layard M, et al. Daunomycin induced cardiotoxicity in children and adults. Am J Med 1977;62:200.CrossRefGoogle Scholar
  28. 28.
    Martin RG, Rukdeschel JC, Chang P, et al. Radiation-related pericarditis. Am J Cardiol 1975;35:216.PubMedCrossRefGoogle Scholar
  29. 29.
    Marks RDJ, Agarwal SK, Constable WC. Radiation induced pericarditis in Hodgkin’s disease. Acta Radiol Ther Phys Biol 1973;12:305.PubMedGoogle Scholar
  30. 30.
    Mill WB, Baglan RJ, Kurichetz P, et al. Symptomatic radiation induced pericarditis in Hodgkin’s disease. Int J Radiat Oncol Biol Phys 1984;10:2061.PubMedGoogle Scholar
  31. 31.
    Kadota RP, Burgert EO, Driscoll DJ, et al. Cardiopulmonary function in long-term survivors of childhood Hodgkin’s lymphoma: a pilot study. Mayo Clin Proc 1988;63:362.PubMedGoogle Scholar
  32. 32.
    Perraut DJ, Levy M, Herman JD, et al. Echocardiac abnormalities following cardiac radiation. J Clin Oncol 1985;3:546.Google Scholar
  33. 33.
    Scott DL, Thomas RD. Late onset constrictive pericarditis after thoracic radiotherapy. Br Med J 1978;1:341.PubMedGoogle Scholar
  34. 34.
    Haas JM. Symptomatic constrictive pericarditis developing 45 years after radiation therapy to the mediastinum: a review of radiation pericarditis. Am Heart J 1969;77:89.PubMedCrossRefGoogle Scholar
  35. 35.
    Boivin JF, Hutchinson GB, Lubin JH, et al. Coronary artery disease in patients treated for Hodgkin’s disease. Cancer (Phila) 1992;69:1241–1247.PubMedCrossRefGoogle Scholar
  36. 36.
    Bu’Lock FA, Gabriel HM, Oakhill A, et al. Cardioprotection by ICRF187 against high dose anthracycline toxicity in children with malignant disease. Br Heart J 1993;70:185–188.Google Scholar
  37. 37.
    Wexler L. Ameliorating anthracycline cardiotoxicity in children with cancer: clinical trials with dexrazoxane. Semin Oncol 1998;25:86–92.PubMedGoogle Scholar
  38. 38.
    Iarussi D, Indolfi P, Coppolino P, et al. Recent advances in the prevention of anthracycline cardiotoxocity in childhood. Curr Med Chem 2001;8:1667–1678.Google Scholar
  39. 39.
    Littman P, Meadows AT, Polgar G, et al. Pulmonary function in survivors of Wilm’s tumor: patterns of impairment. Cancer (Phila) 1976;37:2773.PubMedCrossRefGoogle Scholar
  40. 40.
    Benoit MR, Lemerle J, Jean R, et al. Effects on pulmonary function of whole lung irradiation for Wilms’ tumor in children. Thorax 1982;37:175.Google Scholar
  41. 41.
    Miller RW, Fusner JE, Fink RJ, et al. Pulmonary function abnormalities in long-term survivors of childhood cancer. Med Pediatr Oncol 1986;14:202.PubMedCrossRefGoogle Scholar
  42. 42.
    Springmeyer SC, Flourney N, Sullivan KM, et al. Pulmonary function changes in long-term survivors of allogeneic marrow transplantation. In: Gale RP (ed). Recent Advances in Bone Marrow Transplantation. New York: Liss, 1983:343.Google Scholar
  43. 43.
    Robison LL, Mertens AC, Boice JD Jr, et al. Study design and cohort characteristics of the Childhood Cancer Survivor Study: a multi-institutional collaborative project. Med Pediatr Oncol 2002;38(4):229–339.PubMedCrossRefGoogle Scholar
  44. 44.
    Mertens AC, Yasui Y, Liu Y, et al. Pulmonary complications in survivors of childhood and adolescent cancer. A report from the Childhood Cancer Survivor Study. Cancer (Phila) 2002;95:2431–2441.PubMedCrossRefGoogle Scholar
  45. 45.
    Gisberg SJ, Comis RL. The pulmonary toxicity of antineoplastic agents. Semin Oncol 1982;9:34.Google Scholar
  46. 46.
    Bauer KA, Sskarin AT, Balikian JP, et al. Pulmonary complications associated with combination chemotherapy programs containing bleomycin. Am J Med 1983;74:557.PubMedCrossRefGoogle Scholar
  47. 47.
    Goldiner PL, Schweizer O. Hazards of anesthesia and surgery in bleomycin-treated patients. Semin Oncol 1979;6:121.PubMedGoogle Scholar
  48. 48.
    Samuels ML, Johnson DE, Holoye PY, et al. Large doses of bleomycin therapy and pulmonary toxicity: a possible role of prior radiotherapy. JAMA 1976;235:1117.PubMedCrossRefGoogle Scholar
  49. 49.
    Aronin PA, Mahaley MSJ, Rudnick SA, et al. Prediction of BCNU pulmonary toxicity in patients with malignant gliomas: an assessment of risk factors. N Engl J Med 1980;303:183.PubMedCrossRefGoogle Scholar
  50. 50.
    Hancock S, Cox R, McDougall I. Thyroid diseases after treatment of Hodgkin’s disease. N Engl J Med 1991;325:599.PubMedCrossRefGoogle Scholar
  51. 51.
    Glatstein E, McHardy-Young S, Brast N, et al. Alterations in serum thyrotropin (TSH) and thyroid function following radiotherapy in patients with malignant lymphoma. J Clin Endocrinol Metab 1971;32:833.PubMedCrossRefGoogle Scholar
  52. 52.
    Rosenthal MB, Goldfine ID. Primary and secondary hypothyroidism in nasophanryngeal carcinoma. JAMA 1976;236:1591.PubMedCrossRefGoogle Scholar
  53. 53.
    Gurney JG, Kadan-Lottick NS, Packer RJ, et al. Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors: Childhood Cancer Survivor Study. Cancer (Phila) 2003;97:663–673.PubMedCrossRefGoogle Scholar
  54. 54.
    Sklar C, Whitton J, Mertens A, et al. Abnormalities of the thyroid in survivors of Hodgkin’s disease: data from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab 2000;85:3227–3232.PubMedCrossRefGoogle Scholar
  55. 55.
    Chin D, Sklar C, Donahue B, et al. Thyroid dysfunction as a late effect in survivors of pediatric medulloblastoma/primitive neuroectodermal tumors: a comparison of hyperfractionated versus conventional radiotherapy. Cancer (Phila) 1997;80:798–804.PubMedCrossRefGoogle Scholar
  56. 56.
    Sklar CA. Growth and neuroendocrine dysfunction following therapy for childhood cancer. Pediatr Clin N Am 1997;44:489–503.CrossRefGoogle Scholar
  57. 57.
    Danoff BF, Cowchock FS, Marquette C, et al. Assessment of the long-term effects of primary radiation therapy for brain tumors in children. Cancer (Phila) 1982;49:1580.PubMedCrossRefGoogle Scholar
  58. 58.
    Onoyama Y, Mitsuyuki A, Takahashi M, et al. Radiation therapy of brain tumors in children. Radiology 1977;115:687.Google Scholar
  59. 59.
    Oberfield SE, Allen JC, Pollack J, et al. Long-term endocrine sequelae after treatment of medulloblastoma: prospective study of growth and thyroid function. J Pediatr 1986;108:219.PubMedCrossRefGoogle Scholar
  60. 60.
    Oliff A, Bode U, Bercu BB, et al. Hypothalamic-pituitary dysfunction following CNS prophylaxis in acute lymphocytic leukemia: correlation with CT scan abnormalities. Med Pediatr Oncol 1979;7:141.PubMedCrossRefGoogle Scholar
  61. 61.
    Robison LL, Nesbit ME, Sather HN, et al. Height of children successfully treated for acute lymphoblastic leukemia: a report from the late effects study committee of Children’s Cancer Study Group. Med Pediatr Oncol 1985;13:14.PubMedCrossRefGoogle Scholar
  62. 62.
    Berry DH, Elders MJ, Crist W, et al. Growth in children with acute lymphocytic leukemia: a Pediatric Oncology Group study. Med Pediatr Oncol 1983;11:39.PubMedCrossRefGoogle Scholar
  63. 63.
    Papadakis V, Tan C, Heller G, et al. Growth and final height after treatment for childhood Hodgkin’s disease. J Pediatr Hematol Oncol 1996;18:272–276.PubMedCrossRefGoogle Scholar
  64. 64.
    Sklar C, Mertens A, Walter A, et al. Final height after treatment for childhood acute lymphoblastic leukemia: comparison of no cranial irradiation with 1800 and 2400 centigrays of cranial irradiation. J Pediatr 1993;123:59–64.PubMedCrossRefGoogle Scholar
  65. 65.
    Blatt J, Bercu BB, Gillin JC, et al. Reduced pulsatile growth hormone secretion in children after therapy for acute lymphocytic leukemia. J Pediatr 1984;104:182.PubMedCrossRefGoogle Scholar
  66. 66.
    Sklar CA, Mertens AC, Walter A, et al. Changes in body mass index and prevalence of overweight in survivors of childhood acute lymphoblastic leukemia: role of cranial irradiation. Med Pediatr Oncol 2000;35:91–95.PubMedCrossRefGoogle Scholar
  67. 67.
    Oeffinger KC, Mertens AC, Sklar CA, et al. Obesity in adult survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2003;21:1359–1365.PubMedCrossRefGoogle Scholar
  68. 68.
    Cifton DK, Bremmer WJ. The effect of testicular x-irradiation on spermatogenesis in man. J Androl 1983;4:387.Google Scholar
  69. 69.
    Rowley MM, Leach DR, Warner GA, et al. Effect of graded doses of ionizing radiation on the human testes. Radiat Res 1974; 59:665.PubMedCrossRefGoogle Scholar
  70. 70.
    Blatt J, Sherins RJ, Niebrugge D, et al. Leydig cell function in boys following treatment for testicular relapse of acute lymphoblastic leukemia. J Clin Oncol 1985;3:1227.PubMedGoogle Scholar
  71. 71.
    Sherins RJ, DeVita VT. Effects of drug treatment for lymphoma on male reproductive capacity. Ann Intern Med 1973;79:216.PubMedGoogle Scholar
  72. 72.
    da Cunha MF, Meisrich ML, Fuller LM, et al. Recovery of spermatogenesis after treatment for Hodgkin’s disease with limiting dose of MOPP chemotherapy. J Clin Oncol 1984;2:571.PubMedGoogle Scholar
  73. 73.
    Santaro A, Bonadonna G, Valagussa P, et al. Long-term results of combined chemotherapy-radiotherapy approach in Hodgkin’s disease: superiority of ABVD plus radiotherapy versus MOPP plus radiotherapy. J Clin Oncol 1987;5:27.Google Scholar
  74. 74.
    Stillman RJ, Schilfeld JS, Schiff I, et al. Ovarian failure in long-term survivors of childhood malignancy. Am J Obstet Gynecol 1981;139:62.PubMedGoogle Scholar
  75. 75.
    Sarafoglou K, Boulad F, Gillio A, et al. Gonadal function after bone marrow transplantation for acute leukemia during childhood. J Pediatr 1997;130:210–216.PubMedCrossRefGoogle Scholar
  76. 76.
    Sklar C. Reproductive physiology and treatment-related loss of sex hormone production. Med Pediatr Oncol 1999;33:2–8.PubMedCrossRefGoogle Scholar
  77. 77.
    Green D, Whitton J, S M, et al. Pregnancy outcomes of partners of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol 2003;21:716–721.PubMedCrossRefGoogle Scholar
  78. 78.
    Green D, Whitton JA, Stovall M, et al. Pregnancy outcome of female survivors of childhood cancer: A report from the childhood cancer survivor study. Am J Obstet Gynecol 2002;187:1070–1080.PubMedCrossRefGoogle Scholar
  79. 79.
    Neglia JP, Friedman DL, Yutaka Y, et al. Second malignant neoplasms in five-year survivors of childhood cancer: childhood cancer survivor study. J Natl Cancer Inst 2001;93:618–629.PubMedCrossRefGoogle Scholar
  80. 80.
    Olsen JH, Garwicz S, Hertz H, et al. Second malignant neoplasms after cancer in childhood or adolescence. Nordic Society of Paediatric Haematology and Oncology Association of the Nordic Cancer Registries. BMJ 1993;307:1030–1036.PubMedGoogle Scholar
  81. 81.
    Bhatia S, Yasui Y, Robison LL, et al. High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the Late Effects Study Group. J Clin Oncol 2003;21:4386–4394.PubMedCrossRefGoogle Scholar
  82. 82.
    Bhatia S, Ramsay NKC, Steinbuch M, et al. Malignant neoplasms following bone marrow transplantation. Blood 1996;87:3633–3639.PubMedGoogle Scholar
  83. 83.
    Darrington DL, Vose JM, Anderson JR, et al. Incidence and characterization of secondary myelodysplastic syndrome and acute myelogenous leukemia following high-dose chemoradiotherapy and autologous stem cell transplantation for lymphoid malignancies. J Clin Oncol 1994;12:2527–2534.PubMedGoogle Scholar
  84. 84.
    Mertens AC, Yasui Y, Neglia JP, et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the childhood cancer survivors study. J Clin Oncol 2001;19:3163–3172.PubMedGoogle Scholar
  85. 85.
    Moller TR, Garwicz S, Barlow L, et al. Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: a population-based study in the Nordic countries. J Clin Oncol 2001;19:3173–3181.PubMedGoogle Scholar
  86. 86.
    Teta MJ, Del Po MC, Kasl SV, et al. Psychosocial consequences of childhood and adolescent cancer survival. J Chronic Dis 1986;39:751–759.PubMedCrossRefGoogle Scholar
  87. 87.
    Elkin T, Phipps S, Mulhern R. Psychological functioning of adolescent and young adult survivors of pediatric malignancy. Med Pediatr Oncol 1997;29:582–588.PubMedCrossRefGoogle Scholar
  88. 88.
    Zebrack BL, Zeltzer LK, Whitton J, et al. Psychological outcomes in long-term survivors of childhood leukemia, Hodgkin’s disease, and non-Hodgkin’s lymphoma: a report from the Childhood Survivor Study. Pediatrics 2002;110:42–52.PubMedCrossRefGoogle Scholar
  89. 89.
    Eiser C, Hill J, Vance YH. Examining the psychological consequences of surviving childhood cancer: systematic review as a research method in pediatric psychology. J Pediatr Psychol 2000; 25:449–460.PubMedCrossRefGoogle Scholar
  90. 90.
    Zeltzer LK. Cancer in adolescents and young adults psychosocial aspects. Long term survivors. Cancer (Phila) 1993;15:3463–3468.CrossRefGoogle Scholar
  91. 91.
    Chang PN. Psychosocial needs of long-term childhood cancer survivors: a review of the literature. Pediatrician 1991;18:20–24.PubMedGoogle Scholar
  92. 92.
    Fritz GK, Williams JR, Amylon MD. After treatment ends: psychosocial sequelae in pediatric cancer survivors. Am J Orthopsychiatry 1988;58:552–561.PubMedCrossRefGoogle Scholar
  93. 93.
    Barakat LP, Kazak AE, Meadows AT, et al. Families surviving childhood cancer: a comparison of posttraumatic stress symptoms with familes of healthy children. J Pediatr Psychol 1997;22:843–859.PubMedCrossRefGoogle Scholar
  94. 94.
    Kazak AE, Barakat LP, Meeske K, et al. Post traumatic stress, family functioning and social support in survivors of childhood leukemia and their mothers and fathers. J Consult Clin Psychol 1997;65:120–129.PubMedCrossRefGoogle Scholar
  95. 95.
    Hudson MM, Mertens AC, Yasui Y, et al. Health status of adult long-term survivors of childhood cancer. A report from the childhood cancer survivor study. JAMA 2003;290:1583–1592.PubMedCrossRefGoogle Scholar
  96. 96.
    Zeltzer LK, Chen E, Weiss R, et al. Comparison of psychologic outcome in adult survivors of childhood acute lymphoblastic leukemia versus sibling controls: a cooperative Children’s Cancer Group and National Institutes of Health study. J Clin Oncol 1997;15:547–556.PubMedGoogle Scholar
  97. 97.
    Mulhern RK, Wasserman AL, Friedman AG, et al. Social competence and behavioral adjustment of children who are long-term survivors of cancer. Pediatrics 1989;83:18–25.PubMedGoogle Scholar
  98. 98.
    Glover DA, Byrne J, Mills JL, et al. Impact of CNS treatment on mood in adult survivors of childhood leukemia: a report from the Children’s Cancer Group. J Clin Oncol 2003;21:4395–4401.PubMedCrossRefGoogle Scholar
  99. 99.
    Stuber ML, Christakis DA, Houskamp B, et al. Posttrauma symptoms in childhood leukemia survivors and their parents. Psychosomatics 1996;37:254–261.PubMedGoogle Scholar
  100. 100.
    Stuber ML, Kazak AE, Meeske K, et al. Predictors of posttraumatic stress symptoms in childhood cancer survivors. Pediatrics 1997;100:958–964.PubMedCrossRefGoogle Scholar
  101. 101.
    Hobbie WL, Stuber M, Meeske K, et al. Symptoms of posttraumatic stress in young adult survivors of childhood cancer. J Clin Oncol 2000;18:4060–4066.PubMedGoogle Scholar
  102. 102.
    Meeske KA, Ruccione K, Globe DR, et al. Posttraumatic stress, quality of life, and psychological distress in young adult survivors of childhood cancer. Oncol Nurs Forum 2001;28:481–489.PubMedGoogle Scholar
  103. 103.
    Reiter-Purtill J, Vannatta K, Gerhardt CA, et al. A controlled longitudinal study of the social functioning of children who completed treatment of cancer. J Pediatr Hematol/Oncol 2003; 25:467–473.CrossRefGoogle Scholar
  104. 104.
    Spirito A, Stark LJ, Cobiella C, et al. Social adjustment of children successfully treated for cancer. J Pediatr Psychol 1990; 15:359–371.PubMedCrossRefGoogle Scholar
  105. 105.
    Mulhern R, Wasserman A, Friedman A, et al. Social competence and behavioral adjustment of children who are long-term survivors of cancer. Pediatrics 1989;83:18–25.PubMedGoogle Scholar
  106. 106.
    Pendley JS, Dahlquist LM, Dreyer ZA. Body image and psychosocial adjustment in adolescent cancer survivors. J Pediatr Psychol 1997;22:29–43.PubMedCrossRefGoogle Scholar
  107. 107.
    Haupt R, Fears TR, Robison LL, et al. Educational attainment in long-term survivors of childhood acute lymphoblastic leukemia. JAMA 1994;272:1134–1135.CrossRefGoogle Scholar
  108. 108.
    Mitby PA, Robison LL, Whitton JA, et al. Utilization of special education services and educational attainment among long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. Cancer (Phila) 2003;97:1115–1126.PubMedCrossRefGoogle Scholar
  109. 109.
    Nagarajan R, Neglia JP, Clohisy DR, et al. Education, employment, insurance, and marital status among 694 survivors of pediatric lower extremity bone tumors: a report from the childhood cancer survivor study. Cancer (Phila) 2003;97:2554–2564.PubMedCrossRefGoogle Scholar
  110. 110.
    Meadows AT, McKee L, Kazak AE. Psychosocial status of young adult survivors of childhood cancer: a survey. Med Pediatr Oncol 1989;17:466–470.PubMedGoogle Scholar
  111. 111.
    Nicholson HS, Mulvihill JJ, Byrne J. Late effects of therapy in adult survivors of osteosarcoma and Ewing’s sarcoma. Med Pediatr Oncol 1992;20:6–12.PubMedCrossRefGoogle Scholar
  112. 112.
    Hays DM, Landsverk J, Sallan SE, et al. Educational, occupational, and insurance status of childhood cancer survivors in their fourth and fifth decades of life. J Clin Oncol 1992;10:1397–1406.PubMedGoogle Scholar
  113. 113.
    Novakovic B, Fears TR, Horowitz ME, et al. Late effects of therapy in survivors of Ewing’s sarcoma family of tumors. J Pediatr Hematol Oncol 1997;19:220–225.PubMedCrossRefGoogle Scholar
  114. 114.
    Evans SE, Radford M. Current lifestyle of young adults treated for cancer in childhood. Arch Dis Child 1995;72:423–426.PubMedGoogle Scholar
  115. 115.
    Makipernaa A. Long-term quality of life and psychosocial coping after treatment of solid tumours in childhood. A populationbased study of 94 patients 11–28 years after their diagnosis. Acta Paediatr Scand Suppl 1989;78:728–735.Google Scholar
  116. 116.
    Green DM, Zevon MA, Hall B. Achievement of life goals by adult survivors of modern treatment for childhood cancer. Cancer (Phila) 1991;67:206–213.PubMedCrossRefGoogle Scholar
  117. 117.
    Byrne J, Fears TR, Steinhorn SC, et al. Marriage and divorce after childhood and adolescent cancer. JAMA 1989;262:2693–2699.PubMedCrossRefGoogle Scholar
  118. 118.
    Rauck AM, Green DM, Yasui Y, et al. Marriage in the survivors of childhood cancer: a preliminary description from the Childhood Cancer Survivor Study. Med Pediatr Oncol 1999;33:60–63.PubMedCrossRefGoogle Scholar
  119. 119.
    Felder-Puig R, Formann AK, Mildner A, et al. Quality of life and psychosocial adjustment of young patients after treatment of bone cancer. Cancer (Phila) 1998;83:69–75.PubMedCrossRefGoogle Scholar
  120. 120.
    Gray RE, Doan BD, Shermer P, et al. Psychologic adaptation of survivors of childhood cancer. Cancer (Phila) 1992;70:2713–2721.PubMedCrossRefGoogle Scholar
  121. 121.
    Brown RT, Madan-Swain A, Pais R, et al. Cognitive status of children treated with central nervous system prophylactic chemotherapy for acute lymphocytic leukemia. Arch Clin Neuropsychol 1992;7:481–497.PubMedCrossRefGoogle Scholar
  122. 122.
    Cetingul N, Aydinok Y, Kantar M, et al. Neuropsychologic sequelae in the long-term survivors of childhood acute lymphoblastic leukemia. Pediatr Hematol Oncol 1999;16:213–220.PubMedCrossRefGoogle Scholar
  123. 123.
    Kingma A, Rammeloo LAJ, van der Does-van den Berg A, et al. Academic career after treatment for acute lymphoblastic leukemia. Arch Dis Child 2000;82:353–357.PubMedCrossRefGoogle Scholar
  124. 124.
    Robison LL, Nesbit MEJ, Sather HN, et al. Factors associated with IQ scores in long-term survivors of childhood acute lymphoblastic leukemia. Am J Pediatr Hematol Oncol 1984;6:115–121.PubMedGoogle Scholar
  125. 125.
    Moss HA, Nannis ED, Poplack DG. The effects of prophylactic treatment of the central nervous system on the intellectual functioning of children with acute lymphocytic leukemia. Am J Med 1981;71:47–52.PubMedCrossRefGoogle Scholar
  126. 126.
    Roman DD, Sperduto PW. Neuropsychological effects of cranial radiation: current knowledge and future directions. Int J Radiat Oncol Biol Phys 1995;31:983–998.PubMedCrossRefGoogle Scholar
  127. 127.
    Anderson DM, Rennie KM, Ziegler RS, et al. Medical and neurocognitive late effects among survivors of childhood central nervous system tumors. Cancer (Phila) 2001;92:2709–2719.PubMedCrossRefGoogle Scholar
  128. 128.
    Johnson DL, McCabe MA, Nicholson HS, et al. Quality of long-term survival in young children with Medulloblastoma. J Neurosurg 1994;80:1004–1010.PubMedCrossRefGoogle Scholar
  129. 129.
    Glaser AW, Abdul Rashid NF, Walker DA. School behavior and health status after central nervous system tumours in childhood. Br J Cancer 1997;76:643–650.PubMedGoogle Scholar
  130. 130.
    Arceci RJ, Reaman GH, Cohen AR, et al. Position statement for the need to define pediatric hematology/oncology programs: a model of subspecialty care for chronic childhood diseases. Health Care Policy and Public Issues Committee of the American Society of Pediatric Hematology/Oncology. J Pediatr Hematol Oncol 1998;20:98–103.PubMedCrossRefGoogle Scholar
  131. 131.
    Bleyer WA, Smith RA, Green DM, et al. American Cancer Society Workshop on Adolescents and Young Adults with Cancer. Workgroup #1: Long-term care and lifetime follow-up. Cancer (Phila) 1993;71:2413.PubMedCrossRefGoogle Scholar
  132. 132.
    Masera G, Chesler M, Jankovic M, et al. SIOP Working Committee on psychosocial issues in pediatric oncology: guidelines for care of long-term survivors. Med Pediatr Oncol 1996; 27:1–2.PubMedCrossRefGoogle Scholar
  133. 133.
    Wallace WH, Blacklay A, Eiser C, et al. Developing strategies for long term follow up of survivors of childhood cancer. BMJ 2001;323:271–274.PubMedCrossRefGoogle Scholar
  134. 134.
    Hollen PJ, Hobbie WL. Establishing comprehensive specialty follow-up clinics for long-term survivors of cancer. Providing systematic physiological and psychosocial support. Support Care Cancer 1995;3:40–44.PubMedCrossRefGoogle Scholar
  135. 135.
    American Academy of Pediatrics Section on Hematology/Oncology. Guidelines for the pediatric cancer center and role of such centers in diagnosis and treatment. Pediatrics 1997;99:139–141.CrossRefGoogle Scholar
  136. 136.
    Ross JA, Severson RK, Robison LL, et al. Pediatric cancer in the United States. A preliminary report of a collaborative study of the Childrens Cancer Group and the Pediatric Oncology Group. Cancer (Phila) 1993;71:3415–3421.PubMedCrossRefGoogle Scholar
  137. 137.
    Children’s Oncology Group. Requirements for Institutional Membership. Arcadia: COG, 2001.Google Scholar
  138. 138.
    Hobbie WL, Ogle S. Transitional care for young adult survivors of childhood cancer. Semin Oncol Nurs 2001;17:268–273.PubMedCrossRefGoogle Scholar
  139. 139.
    Konsler GK, Jones GR. Transition issues for survivors of childhood cancer and their healthcare providers. Cancer Pract 1993; 1:319–324.PubMedGoogle Scholar
  140. 140.
    Oeffinger KC, Eshelman DA, Tomlinson GE, et al. Programs for adult survivors of childhood cancer. J Clin Oncol 1998;16:2864–2867.PubMedGoogle Scholar
  141. 141.
    Richardson RC, Nelson MB, Meeske K. Young adult survivors of childhood cancer: attending to emerging medical and psychosocial needs. J Pediatr Oncol Nurs 1999;16:136–144.PubMedCrossRefGoogle Scholar
  142. 142.
    Rigon H, Lopes LF, do Rosario Latorre M, et al. The GEPETTO program for surveillance of long-term survivors of childhood cancer: preliminary report from a single institution in Brazil. Med Pediatr Oncol 2003;40:405–406.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Smita Bhatia
    • 1
  • Wendy Landier
    • 2
  • Jacqueline Casillas
    • 3
  • Lonnie Zeltzer
    • 4
    • 5
    • 6
    • 7
  1. 1.Epidemiology and Outcomes Research, Department of Pediatric OncologyCity of Hope Cancer CenterDuarteUSA
  2. 2.Division of PediatricsCity of Hope Comprehensive Cancer CenterDuarteUSA
  3. 3.Department of Pediatrics, Division of Hematology/OncologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  4. 4.Departments of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral SciencesLos AngelesUSA
  5. 5.Pediatric Pain ProgramDavid Geffen School of Medicine at UCLALos AngelesUSA
  6. 6.Patients and Survivors ProgramDivision of Cancer Prevention and Control ResearchLos AngelesUSA
  7. 7.UCLA Jonsson Comprehensive Cancer CenterLos AngelesUSA

Personalised recommendations