Physical and psychosocial outcome for young adults with treated malignancy

We reexamined the physical, neurological, neuropsychological, social, and psychiatric circumstances of a group of 27 (10 females, 17 males) patients at the ages of 16-26 years who had survived a malignant disease during childhood. Twenty survivors had had leukemia and the rest different solid tumors. Only a third (31%) of the subjects were considered to be without any clinically significant physical health problems or functional symptoms, musculoskeletal and endocrinological disorders being the most common. In the neuropsychological test panel including verbal and performance IQ the survivors had significantly lower scores. Early onset of the disease and receiving radiotherapy correlated with impaired test results most significantly, especially on memory functions. One in five of the survivors reported having suffered from reading and writing problems that interfered with success in school and the subjects of the study group had progressed to high school less often than control subjects. The social indices indicated delayed development of sexuality and separation from parents. Overt mental problems appearing at a one-off interview were the same as in the control group. In conclusion, up to two thirds of the childhood cancer survivors as young adults still have physical or neuropsychological health problems and half showed delayed psychosexual maturation. This magnitude of various disorders indicates a long-term but individually oriented follow-up of this small group with the opportunity of physical, social, or psychological management of their main problem.