More than 325,000 children, teens, and adults in the United States are survivors of childhood cancer. The surgery, radiation, chemotherapy, and stem cell transplants used to cure children can affect growing bodies and developing minds. If survivors know of these potential problems, they can take steps to identify, cope with, or treat them early if they do develop. The third edition of Childhood Cancer Survivors charts the territory for survivors by providing state-of-the-art information about: " Medical late effects from treatment " Emotional aspects of surviving cancer " Schedules for follow-up care " Challenges in the heath-care system " Lifestyle choices to maximize health " Discrimination in employment or insurance Woven throughout the text are stories from more than 100 survivors and parents. Authors Keene, Hobbie, and Ruccione are experts in the field of childhood cancer. Keene is the mother of a survivor of childhood leukemia and the author of several books including Childhood Leukemia, Childhood Cancer, Educating the Child with Cancer, and Chemo, Craziness & Comfort. Hobbie is Associate Director of the Cancer Survivorship Program at Children's Hospital of Philadelphia. Ruccione is Co-Director of the HOPE (Hematology-Oncology Psychosocial and Education) Program in the Children's Center for Cancer and Blood Diseases at Children's Hospital Los Angeles.

Cancer is the second commonest cause of death, after accidents, among children in developed countries, while in developing countries, improvements in the control of communicable diseases and the occurrence of premature delivery may lead to the emergence of cancer in children as a greater public health problem than in the past. The rationale for considering childhood cancers separately from cancers in adults in that there are differences in the sites of occurrence, in the histological appearance and in their clinical behavior. This book reviews the epidemiology of specific types of childhood cancer to mid-1997. The scale of the problem is first reviewed in a major compilation of data on the descriptive epidemiology of childhood cancer, then separate chapters describe studies of the different postulated causal factors and summarize what can be concluded from them.

It was not long ago that clinicians would say,“study ed at the 1975 meeting revealed. Among them was the late complications of cancer treatments we give to one based on data collected by the Late Effects Study children? You must be joking! We can start worrying Group, an international consortium that consisted about that when we start curing them! Meanwhile, initially of ?ve, then ten, pediatric centers. This was cure must be our only aim. ”These practitioners were the ?rst large scale, cooperative unit of its kind, - only partially correct in what seemed to be a glaring ganized speci?cally for the purpose of studying the truth, for, in fact, increasing numbers of children late effects of cancer therapy (the study of delayed were beginning to survive their malignancy,and the complications had been included as part of the or- long-term consequences of therapy would soon be- inal design in the National Wilms Tumor Study come critical. launched in 1969) [1]. These historical notes demon- It is well to remember that the delayed conse- strate that the epidemiologic,statistical and reco- quences of a cancer treatment delivered to develop- keeping mechanisms necessary for studying lo- ing organisms were ?rst studied long ago. It has been term survivors effectively were in the process of be- 100 years since Perthes reported in 1903 that growth ing established decades before the meeting in 1975.

Since the late 1960s, the survival rate in children and adolescents diagnosed with cancer has steadily improved, with a corresponding decline in the cancer-specific death rate. Although the improvements in survival are encouraging, they have come at the cost of acute, chronic, and late adverse effects precipitated by the toxicities associated with the individual or combined use of different types of treatment (e.g., surgery, radiation, chemotherapy). In some cases, the impairments resulting from cancer and its treatment are severe enough to qualify a child for U.S. Social Security Administration disability benefits. At the request of Social Security Administration, Childhood Cancer and Functional Impacts Across the Care Continuum provides current information and findings and conclusions regarding the diagnosis, treatment, and prognosis of selected childhood cancers, including different types of malignant solid tumors, and the effect of those cancers on childrenâ (TM)s health and functional capacity, including the relative levels of functional limitation typically associated with the cancers and their treatment. This report also provides a summary of selected treatments currently being studied in clinical trials and identifies any limitations on the availability of these treatments, such as whether treatments are available only in certain geographic areas.

This authoritative reference examines in depth the myriad challenges facing pediatric cancer survivors and proposes a robust framework for structured follow-up of these patients through adulthood. Approaches to long-term follow-up include both established models of care and targeted models of lifelong surveillance of late effects by bodily systems and neurological outcomes. Sections devoted to quality of life and re-entry after treatment focus on key concerns such as health risk behaviors, school and career issues, psychological challenges, and care disparities. And a robust resources section adds extra usefulness to the expert coverage. Among the Handbook's topics: • Developmental considerations in the transition from child and adolescent to adult survivorship. • Long-term follow-up roadmaps by disease and treatment. • Neuropsychological effects of pediatric brain tumors and associated treatment. • Building resiliency in childhood cancer survivors: a clinician's perspective. • School issues and educational strategies for survivors of childhood cancer. • Educating and preparing the childhood cancer survivor for long-term care: a curriculum model for cancer centers. A work of rare scope, scholarship, and clinical acumen, the Handbook of Long-Term Care of the Childhood Cancer Survivor is a rewarding, practice-building resource essential to a wide range of healing professionals, including primary care physicians, pediatricians, oncologists, nurses, psychologists, neuropsychologists, child psychologists, and licensed therapists. .

Only more recently has it been realized that the intense effort to care for and cure a child with cancer does not end with survival. Continued surveillance and a variety of interventions may, in many cases, be needed to identify and care for consequences of treatment that can appear early or only after several decades and impair survivors' health and quality of life. The more than two-thirds of childhood cancer survivors who experience late effects-that is, complications, disabilities, or adverse outcomes-as a result of their disease, its treatment, or both, are the focus of this report which outlines a comprehensive policy agenda that links improved health care delivery and follow-up, investments in education and training for health care providers, and expanded research to improve the long-term outlook for this growing population now exceeding 270,000 Americans.