UICC World Cancer Congress 2006

Objective: Long term survival after childhood cancers has dramatically improved in the last 25 years. However, approximately one third of pediatric cancer survivors have at least one chronic or long-term complication from cancer therapy. This presentation will focus on two sequelae of pediatric cancer treatment - endocrine and psychosocial symptoms. Residual endocrine disorders impact 40% of children and adolescents resulting in altered growth and thyroid function, dysfunction of the HPO axis, bone and mineral metabolism and lipid disorders. Psychosocial survival of cancer is complex both from a measurement perspective as well as assessment of physical and somatic symptoms. In a recent study of late effects in sarcoma patients increased phobic anxiety and symptoms of somatization were found in patients who experienced relapse and those with long term event free survival. Methods: A review of published material in the English language regarding late effects focusing on endocrine disorders and the psychosocial impact of cancer treatment in children was conducted using MEDLINE, PubMed and CINAHL databases. Results: Endocrine function is evaluated with clinical and biochemical markers. Referral to endocrinology, nutrition, and gynecology is often necessary in the multidisciplinary management of identified abnormalities. Regular follow-up after cytotoxic chemotherapy and stem cell transplantation prevents complications. Parents and providers are frequently used as proxy in the assessment of quality of life in children with cancer. Discordance is found between the patient's self assesmment and parental or provider assessment. It is essential to evaluate all new physical symptoms but also to screen for post traumatic stress disorders.