A model for care across the cancer continuum

Area of Science:

• Pediatric Oncology
• Cancer Survivorship Research
• Long-term Health Outcomes

Background:

• Curative therapies for pediatric cancers lead to significant long-term adverse health outcomes.
• These outcomes impact survivors' quality of life, fertility, organ function, and increase secondary cancer risk.
• Early recognition of treatment toxicities drives the development of risk-adapted pediatric cancer treatments.

Purpose of the Study:

• To emphasize the necessity of long-term follow-up for pediatric cancer survivors.
• To highlight the evolving challenges in identifying and managing late effects of cancer treatment.
• To propose an optimal approach for defining high-risk profiles in survivors.

Main Methods:

• Long-term follow-up of pediatric cancer survivors.
• Monitoring for adverse health outcomes, including growth, organ function, fertility, and secondary cancers.
• Utilizing a multidimensional approach incorporating host, cancer, genetic, and lifestyle factors.

Main Results:

• Adverse effects of cancer treatment manifest years later, necessitating ongoing surveillance.
• Evolving cancer therapies and survivor aging create dynamic risk factors for morbidity.
• Transitioning care from pediatric oncology to community providers poses challenges for managing late effects.

Conclusions:

• Long-term follow-up is essential for defining and mitigating adverse health outcomes in pediatric cancer survivors.
• A comprehensive, multidimensional approach is optimal for identifying high-risk survivors.
• Proactive identification and intervention are key to improving long-term quality of life and reducing mortality.