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I found the video below to be a frank discussion of long-term side effects that childhood cancer survivors face.
What are the most common long-term side effects that childhood cancer survivors live with?
1. Cognitive and Learning Difficulties
Survivors, especially those treated for brain tumors or with cranial radiation, may experience learning disabilities, memory problems, and attention deficits. These issues can affect academic performance and social skills.
2. Growth and Development Issues
Chemotherapy and radiation can interfere with normal growth, leading to short stature, delayed puberty, or hormone imbalances. This is particularly common in children who received radiation near growth plates or to the brain.
3. Cardiovascular Problems
Certain chemotherapy drugs, especially anthracyclines, and radiation to the chest can cause heart damage. Survivors may develop heart disease, hypertension, or increased risk of heart failure later in life.
4. Secondary Cancers
Some cancer treatments, particularly radiation and certain chemotherapies, increase the risk of developing a second type of cancer later in life.
5. Endocrine Disorders
Damage to the endocrine system, which regulates hormones, can lead to thyroid problems, diabetes, or infertility. Radiation to the brain, neck, or pelvic area is particularly linked to these issues.
6. Hearing Loss
Some chemotherapy drugs, such as cisplatin, can cause hearing loss, particularly high-frequency hearing. Radiation near the ears can also contribute to this problem.
7. Bone and Joint Issues
Treatments can weaken bones, leading to osteoporosis or fractures. Joint pain and stiffness, known as avascular necrosis, can also occur if blood flow to bones is affected by treatment.
8. Pulmonary (Lung) Problems
Radiation to the chest and certain chemotherapy drugs can cause long-term lung damage, leading to reduced lung capacity, breathing difficulties, or chronic lung diseases.
9. Fertility Issues
Treatments, especially those involving radiation to the pelvic area or chemotherapy with alkylating agents, can affect reproductive organs, leading to infertility or early menopause in women.
10. Psychosocial and Emotional Effects
Survivors often experience anxiety, depression, or post-traumatic stress disorder (PTSD) as a result of their cancer experience. They may also struggle with body image issues or difficulties with social relationships.
11. Impaired Immune Function
Some survivors may have compromised immune systems, making them more susceptible to infections, especially if their treatments involved bone marrow transplants or intensive chemotherapy.
12. Hearing and Vision Problems
Radiation near the head and neck or specific chemotherapy drugs can lead to cataracts, dry eyes, or vision loss. Hearing loss, especially high-frequency hearing, is also common.
13. Fatigue
Chronic fatigue is a common complaint among cancer survivors, often persisting long after treatment ends and impacting daily life and energy levels.
I was diagnosed with my cancer at the age of 34. While I don’t consider myself to be a childhood cancer survivor, I do live with many common long-term and late stage side effects of conventional therapies.
The one thing I would add to this entire discussion would be to explore non-conventional therapies. I rely on therapies such as acupuncture, nutritional supplementation, and more to help me manage my long-term side effects.
TOPLINE: About one third of adult survivors of childhood cancer experience a clinically significant or high fear that their primary cancer may recur or that they will develop a subsequent malignancy, according to a recent analysis. The study finds that several factors are associated with a higher risk of experiencing a clinically significant fear of recurrence, including being unemployed or having elevated anxiety or depression.
METHODOLOGY:
Adult survivors of childhood cancer face a high risk of developing subsequent malignant neoplasms — about sixfold greater than the risk in the general population — and studies indicate that these cancer survivors also fear their cancer will recur. However, data on the prevalence of and risk factors associated with clinically significant fear of recurrence in this population remain limited.
This cross-sectional study included 229 adult survivors of childhood cancer (mean age at study completion, 39.6 years), recruited from the Childhood Cancer Survivor Study, who completed online surveys between October 2018 and April 2019.
Fear of cancer recurrence was assessed using the 9-item Fear of Cancer Recurrence Inventory–Short Form, which defines recurrence as the possibility that cancer might return to the same or a different part of the body.
Chronic pain, symptoms of depression and anxiety, self-perceived health, and intolerance of uncertainty were also evaluated.
Among the participants, 21 experienced a recurrence of their primary cancer and 17 were diagnosed with a subsequent malignant neoplasm.
TAKEAWAY:
Overall, 38 (16.6%) adult survivors of childhood cancer reported clinically significant fear that their cancer would recur, and an additional 36 (15.7%) survivors experienced high levels of fear; the remaining 67.7% of participants reported minimal levels of fear.
Survivors who were unemployed (prevalence ratio [PR], 2.5) were more likely to experience a clinically significant fear of recurrence, as were survivors who had undergone pelvic radiation (PR, 2.9) or limb-sparing or amputation surgery (PR, 2.4).
Survivors who had elevated anxiety or depression (PR, 2.6) or both (PR, 3.2) were more likely to experience a clinically significant fear of recurrence, as were survivors who had a chronic neurologic health condition (PR, 3.3) or who perceived their health status to be poor or fair vs good to excellent (PR, 3.0).
Among 94 participants with chronic pain, 25.5% reported clinically significant fear and 13.8% reported high levels of fear. But chronic pain (PR, 1.2; 95% CI, 0.6-2.4) was not significantly associated with a clinically significant fear of recurrence in a multivariable model.
IN PRACTICE: “These findings underscore the substantial psychological and functional burden of FCR [fear of cancer recurrence] and suggest healthcare professionals should routinely assess FCR as a part of providing comprehensive care to long-term survivors,” the authors wrote.