Adult Survivors of Childhood Cancers

An estimated 8.9 million Americans with a history of cancer other than non-melanoma skin cancer or in situ diseases were alive in 1997. Of these, an estimated 270,000 were survivors of childhood cancers. Survival rates from childhood cancers have increased dramatically over the past few decades, due in large part to the fact that nearly 80 percent of children with cancer are treated in clinical trials by multi-specialty medical teams.

For an increasing number of patients of all ages, cancer is a chronic disease, not a fatal one. Over many years of survival, patients may find their cancer journey marked by a series of successes and failures that may include the management of recurrences, physical and cognitive side effects, or even second cancers. As treatments and supportive care have improved, however, it has become possible to reduce recurrences and minimize or eliminate some of the delayed or long-term side effects commonly experienced by patients treated with less advanced therapies.

As I've gotten older, I've needed to keep that positive attitude. I've had some side effects from my treatment - I'm diabetic and my heart and lung functions are reduced somewhat. But I take my medicine, and pay attention to my diet, my stress level, and things like that. I think that taking good care of myself will help keep me cancer free and help me have the fullest possible life.

We recognize more and more that surviving cancer involves factors related to the way our bodies and minds respond to the changes brought on by the disease. We need to better understand these changes and how they influence cancer progression, treatment, and life after treatment. For example, evidence is emerging that psychosocial factors that influence immune or endocrine processes may influence the development or progression of certain cancers.

NCI supports research on the relationship of particular treatments to specific short-and long-term side effects. We also need to understand, for example, the biological basis of these side effects, why some patients are able to be more optimistic than others about treatment success (even in the face of a difficult prognosis), and what contributes to people's ability to overcome side effects that impact their mobility, physical comfort, or psychological well being.

I still check in from time to time with the doctors who treated me, but since I became an adult most of my health care is provided by my primary care physician.

Because the large and growing number of long-term survivors is a relatively recent phenomenon, no clearly defined system exists for monitoring and managing long-term and delayed side effects or second cancers. Research is needed to determine the most appropriate roles of oncology specialists, primary care providers,and survivors themselves in their lifelong follow-up care.

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