The cost of cure: Chronic conditions in survivors of child, adolescent, and young adult cancers

Abstract

Few children and young adults with cancer have a pre-existing chronic condition which contributes to their cancer risk, highlighting the unique aetiology of most cancers in this age group. Children and adolescents often tolerate acute cancer treatments well, however, the majority will experience life-altering, and some even life-threatening, conditions as a result of the cancer treatments they received. Young people face particular challenges, due to significant disruptions to a developmentally important time of life, placing them at higher risk of physical and psychological conditions. Many chronic conditions related to cancer treatment do not appear until children and adolescents mature, years to decades after completion of treatment. Available data highlights the high prevalence and severe nature of treatment-related conditions, supporting the need for continuing management through long-term follow-up care well into adult life. Both survivors and health care professionals must be knowledgeable about the risk of chronic conditions in survivors of child, adolescent and young adult cancers and must be aware of the appropriate follow-up care aimed at their prevention and management. Knowledge of late complications also informs modification of new treatment, helping to avoid chronic conditions in future survivors. Researchers’ efforts should be focused on the development of strategies to reduce the potential burden of chronic conditions in this vulnerable population.