Childhood Cancer Survivors Need Risk-Based Follow-Up

April 4, 2008

Survivors of childhood cancer often experience late effects of their treatment, but not all patients need to be recalled to a cancer clinic for follow-up, according to an editorial published in the April 5 issue of BMJ.

FRIDAY, April 4 (HealthDay News) -- Survivors of childhood cancer often experience late effects of their treatment, but not all patients need to be recalled to a cancer clinic for follow-up, according to an editorial published in the April 5 issue of BMJ.

Meriel Jenney, M.D., of the Children's Hospital for Wales in Cardiff, U.K., and Gill Levitt, of Great Ormond Street Hospital in London, U.K., write that over 75 percent of children with cancer survive into adulthood, but that at least 60 percent have to contend with substantial morbidities as a consequence of their treatment. They cite a study of 10,000 patients in the United States, which found that 27 percent of survivors have severe or life-threatening conditions.

However, patient follow-up could be more effective if it was based on risk stratification, so that low-risk patients could be monitored by their primary care physician with access to specialist back-up, medium-risk patients could have ongoing contact with a specialist nurse, and only high-risk patients would have regular clinic visits, the authors write.

"Although many patients will benefit from ongoing follow-up others must be allowed to move on -- to leave the clinical setting and put the experience of cancer behind them. If we keep calling patients back to the clinic some may never believe they have been cured," the authors conclude.

Editorial

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