290 Late effects of the treatment for childhood cancer

Abstract

<h3></h3> Major advances in the treatment of paediatric malignancies have resulted in significant and impressive results, with the overall 5-year survival rate exceeding 80%. Childhood cancer survivors (CCSs), though being cured of cancer, often experience late effects, both physical and psychological, secondary to their cancer or its treatment. Many survivors are unaware of their personal risk, and there is a general lack of information among healthcare providers about long-term treatment-related complications. To address this, the PanCare network was created in 2008. PanCare is a pan-European multidisciplinary network of health professionals, survivors of childhood cancer and their families, collaborating to reduce the frequency, severity and impact of late side-effects of treatments, with the aim to ensure that every CCS receives an optimal long-term care. The Survivorship Passport (SurPass) has been developed by the ENCCA project with significant contributions from PanCare and SIOPE (The European Society for Paediatric Oncology), together with parents, patients, and survivors’ organisations within the European Union, to meet the needs of survivors. The SurPass provides a summary of each survivor’s clinical history, with detailed information about the cancer and treatments received, together with personalised follow-up and screening recommendations. It is estimated that there are between 300,000 and 500,000 CCSs in Europe, with a median age between 25 and 29 years, and approximately 8000 to 10,000 new survivors are added every year. Two thirds of survivors have at least one chronic health problem and 30% have severe long-term sequels. The most significant late effects of childhood cancer include those that are neurocognitive and psychological, cardiopulmonary, endocrine including fertility and reproduction, musculoskeletal, and those related to second malignancies. The emergence of late effects depends on many factors, including age, exposures to chemotherapy and radiation, and the severity of the disease. The SurPass provides instant access to the medical history of patients, and includes recommendations for follow-up, depending on individual risk factors. Both survivors and health professionals have the possibility to access this information via a dedicated secured website. It is of great importance that paediatric oncologists ensure that the national health systems implement services to carefully monitor survivors well beyond the paediatric age. Primary and secondary prevention strategies need to be set up to prevent adverse events whenever possible, or to aid their early diagnosis. The SurPass is potentially an essential tool for improved and more harmonised follow-up of all European CCSs.

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