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.

The treatment of childhood cancer has become increasingly successful over the last forty years, and during the last two decades in particular, and the overall cure rate is now 60-70%. This, in turn, has introduced new issues for the clinician as the number of long-term survivors has increased. Some of the therapies that have contributed most to the improvement in survival are now known to have serious consequences for the patient in later life, and many survivors will be affected by physical, educational and psychological disability to a lesser or greater degree. This definitive reference brings together all aspects of long-term effects of treatment for cancer during childhood in a single comprehensive volume. International in perspective, the book is structured according to complication rather than original site of malignancy for ease of reference. Topics covered include problems in the neurological system and special senses of sight and sound, cardiovascular, respiratory, gastrointestinal, urological and musculoskeletal complications, effects on the endocrine system and, in particular, future fertility, and secondary cancers. The book also reviews in detail the important issues of quality of life, prevention initiatives and strategies for long-term follow up. Key point summaries are included throughout, and the references are annotated to guide the reader quickly to seminal primary papers and key review articles. With an accessible and consistent approach throughout, Late Effects of Childhood Cancer is an invaluable source of information and guidance for pediatric oncologists, who need to keep fully informed in order to advise patients and their parents appropriately, and also for pediatric and adult endocrinologists, adult oncologists and other physicians to whom the patient with late effects may initially present.

This book analyzes in detail all aspects related to endocrine and metabolic late effects observed in patients treated for cancer, both in childhood and adulthood. The chapters focusing on the possible pathogenic mechanisms of late effects (i.e., premature aging and chronic inflammation) and on bone health in cancer survivors are particularly interesting and innovative. The volume also deals with hypothalamic-pituitary, thyroid and gonadal disorders, including infertility and how to prevent it. Finally, the relationship between metabolic alterations and cardiovascular diseases in cancer survivors is addressed. Thanks to advances in cancer treatment and supportive care, the five-year survival rate of cancer patients is constantly increasing. However, this undisputable success of medicine has a flip side: the late adverse effects of anticancer therapies. Pediatric oncologists were the first to cope with late complications of treatments, but today also adult oncologists and onco-hematologists recognize the relevance of this issue. Even though late effects observed in cancer survivors can affect any organ or system, endocrine and metabolic dysfunctions are the most frequently reported. Endocrine complications rarely influence life expectancy of cancer survivors, but they can significantly impact morbidity and quality of life. Among endocrine adverse effects, severe hypothalamic damage may be considered the most harmful in survivors, leading to morbid obesity, propensity to metabolic syndrome and cardiovascular disease. This book aims to disseminate the knowledge about endocrine and metabolic adverse effects of cancer therapies and about survivorship care. Since the number of cancer survivors is steadily growing in the general population, this publication is intended not only for endocrinologists but also for oncologists, onco-hematologists, internists, pediatric specialists in those areas and general practitioners, with the aim to better counsel and monitor cancer survivors.

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.

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.

Continuing advances in the management of childhood malignancies result in a rapidly growing number of childhood cancer survivors. However, many of them experience treatment-induced 'late effects' including a significant number of endocrine dysfunctions.In this book experts in the field of late effects of childhood cancer treatment offer clinical insight into pertinent issues such as the impact of cancer therapies on growth, puberty and hypothalamic and pituitary function, male and female fertility, obesity, and metabolic and bone problems.Multidisciplinary long-term follow-up of these patients is essential to monitor, treat and prevent morbidity. Therefore this volume is of great interest to pediatric endocrinologists and oncologists, adult and reproductive endocrinologists, primary care practitioners, nurses and nurse practitioners as well as others involved in planning and delivering the holistic care which this increasingly numerous and important group of patients requires.