Adult Survivors of Childhood Cancer Face Health Risks

A study from St. Jude Children’s Research Hospital has found that adult survivors of childhood cancer are likely to be at high risk for a number of serious health conditions, pointing to the need for careful follow-up even many years after they have been treated.

Despite the seriousness of the findings, one note of caution with the new study is that it is based on a group of adults who were diagnosed with cancer an average of 25 years ago. Due to advances in treatment, children being treated for cancer today are likely to receive less toxic doses of radiation and chemotherapy that can cause these serious side effects.

Melissa Hudson, MD, director of the St. Jude Division of Cancer Survivorship and co-first author of the study said, “Because the risk for many adverse outcomes is related to dose, we anticipate that the prevalence of some conditions will be lower among more recently treated survivors who received less intensive therapy.”

The study was published in the June 12, 2013 issue of the Journal of the American Medical Association. Researchers assessed the health records of 1,713 adults who were part of the St. Jude Lifetime Cohort Study. This program brings survivors of 10 or more years back to the hospital for a battery of medical tests, based partly on the kind of treatment the participants received as children. For example, people considered to be at risk for lung problems because of previous radiation to the chest were tested for lung function.

Overall, researchers found that almost everyone in the study – 98% – had at least 1 chronic health condition, such as new cancers, heart problems, lung problems, or memory or other neurocognitive problems. The most common impairments involved the lungs, hearing, heart, endocrine system (which regulates growth) and nervous system.

The risks appeared to increase with age. They found that by age 45 about 80% of the study participants had at least 1 life-threatening, serious, or disabling condition.

What parents can do

As advances in treatment have allowed more children with cancer to survive into adulthood, doctors have become more concerned about how their treatment may affect them later on. These days, planning for children newly diagnosed with cancer routinely takes into consideration the late health consequences of therapy, according to Dr. Hudson. “During these discussions, it is appropriate for families and patients to ask if there are alternative effective cancer treatments and if there are additional interventions that can be undertaken to protect the health of organs at risk of injury.”

Parents should discuss possible long-term complications with the child’s health care team, and make sure there is a plan to watch for these problems and treat them, if needed.

To help increase awareness of late effects and improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines include information about what to watch for, what type of screening tests should be done to look for problems, and how late effects can be treated.

Recommendations for survivors

The study’s authors say their findings demonstrate the need for adults who had cancer as children to get regular medical screenings for cancer and other conditions to detect health problems as early as possible, when they’re likely to be easier to treat.

American Cancer Society guidelines on nutrition and physical activity recommend that people living with cancer and those who’ve survived cancer maintain a healthy weight, get enough exercise, and eat a healthy diet with an emphasis on fruits, vegetables, and whole grains.

For more information about what you can do stay well after cancer, visit or call 1-800-227-2345. To learn about American Cancer Society programs to help people with cancer, visit

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Clinical Ascertainment of Health Outcomes Among Adults Treated for Childhood Cancer. Published in the June 12, 2013 issue of the Journal of the American Medical Association (Vol 309, No. 22). First author: Melissa M. Hudson, MD, St. Jude Children’s Research Hospital and the University of Tennessee College of Medicine, Memphis.

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