Sat. Nov 28th, 2020

This year alone, The American Cancer Society says that 14,660 new cases of cancer will be diagnosed in children and adolescents. About 1,850 children and adolescents die of cancer every year – this is one of the leading causes of death in this age group. However, now an increasing proportion of children Cancer survivors.

Dr. Jean M. Tursk, an oncologist and director of the Survivorship Program, Drs. Jean M. UPMC’s Children’s Hospital in Pittsburgh. For many children with leukemia, the survival rate is over 90 percent. But childhood cancer survivors face health-related challenges from regular treatment as they get older, which severely affects their quality of life and can lead to early death. Oncologists From these so-called late effects range chemo Leading to heart problems and infertility Radiation Affects mental development and causes secondary cancer. Hence Top hospital Those nationwide who treat cancer in children are not only focusing on treatment with care, but reducing the so-called late effects from treatment.

As part of that effort, some hospitals are participating in large-scale research such as the National Institute of Health-funded Childhood Cancer Survivor Study, which uses data from more than 14,000 childhood cancer survivors. Who were diagnosed between 1970 and 1986, and more than 10,000 survivors between 1987 and 1999.

“This is the only way we will ever understand the cost of treatment,” said Tershak of the Children’s Hospital in Pittsburgh of Childhood, with participation in research including the Childhood Cancer Survivor Study. The study found that survival outlook improved for those who had beaten. Childhood cancer: “Looking at patients who were diagnosed between 1970 and 1986, patients between 1987 and 1999 were diagnosed – the latter group had other cancers and heart failure and other late events. Has little effect – based on the things we learned earlier with the group, and things. We turned to therapy, “notes Tarasak.

She sees the reduction in the use of radiation treatment to the brain as the greatest advancement in reducing the late effects, including cognitive deficits that can put children back in school and as adults when they enter the workforce May reduce their professional choices. In addition, physicians are using more targeted radiation therapy – such as in adults – that are chanting cancer cells, while normal healthy cells have less damage. Oncologists are also subsequently experimenting with new combinations of chemo drugs that reduce side effects, including heart problems. In addition, doctors want to estimate late effects before administering treatments like chemo. At Children’s Hospital in Pittsburgh, some patients are being put on a beta blocker medication commonly used for treatment high blood pressure To see if can reduce cancer treatment related problems with heart function. This is being done as part of another national study through the Child Oncology Group, which conducts research for children, adolescents and young adults for cancer. “We will follow those patients over time to see if the medicine has made a difference,” Tarak says.

Although preliminary evidence suggests progress is making a difference in reducing late effects, experts say much remains to be done. According to the Childhood Cancer Survivor Study, by the age of 50, more than half of survivors have experienced a serious or fatal health condition compared to only 19 percent of siblings. Can range from Stop heartbeat To Secondary Cancer Diagnosis. And studies have found that the “health gap” is widening with age.

Given those challenges, cancer survivors and pediatric oncology experts say that for someone Facing a new cancer diagnosis, It’s important not to talk about life After Cancer – even if it can seem counterproductive to do so. Clinical Director of the Cancer Survivor Center, Dr. “We start talking about life after cancer right from the beginning,” says Karen Burns. Cincinnati Children’s Hospital Medical Center And an assistant professor of pediatrics at the University of Cincinnati. According to Burns, it has two benefits: “First, it shows the family that we intend to get them through it.” Although high survival rates still provide no guarantee, clinicians say it is important for a child’s mind and body to be future-oriented in treatment. Secondly, the concept of survival and late effects is initially introduced. “We can’t control everything and there is a late effect, but knowledge is power and often your greatest ally,” she says.

In clinical practice and research, Burns is looking for ways to improve the treatment of long-term cancer survivors Reproductive problems And prevent similar issues caused by chemo and radiation for future childhood cancer patients. “Our goal is to address future fertility with every patient and whatever we can take steps to ensure is protected, so the child can have its own family one day,” she says. Burns says he works closely with the hospital’s juvenile gynecology and urology divisions to deliver the most comprehensive and cutting-edge care in fertility preservation, from sperm banking or testicular tissue cryopreservation to male patients to female patients. To ovarian tissue cryopreservation. Still being evaluated as an option, the hope is that these preserved tissues may someday be used by survivors to start a family, where otherwise not possible.

Katie Wilson is now a nurse at Cincinnati Children’s Hospital Medical Center, where she treated cancer as a teenager.(Courtesy of Cincinnati Children’s Hospital and Katie Wilson)

Along with understanding treatment options, experts say it is important patients and doctors talk about limitations and potentially set expectations for late-onset effects. As a teenager with a rare type of leukemia, Kati Wilson now takes medications to maintain her blood pressure Heart rate She developed as a result of chemo due to a severe heart condition called cardiomyopathy. The 28-year-old from Fort Thomas, Kentucky says, “Because of a heart issue, I haven’t really been able to go through pregnancy, because it’s a lot of danger on my heart.” As a patient at Cincinnati Children – where she is now a nurse treating oncology patients – she says her medical team worked early in the process to alert her to the potential late effects of treatment . She and her husband got married four years ago and are thinking about having a family recently. “I’m talking a lot about that with my cardiologist,” she says. However, she says they have held onto things for now, saying they are open to adoption.

Katie Wilson(Courtesy of Cincinnati Children’s Hospital and Katie Wilson)

On MD Anderson Cancer Center of University of Texas In Houston, physicians have used proton beam radiation, a highly targeted therapy, to concentrate brain tumors – Pediatric patients include. “If you can concentrate in a small area where the tumor is, you may not have the cognitive effect,” MD Anderson’s pediatrician Dr. Cindy Schwartz, Division Head and Chair says Ed Interim. Experts say the cognitive late effect is particularly evident in children because young brains are still developing, and these deficiencies can affect everything a child learns, from the child’s ability to later occupational possibilities.

No matter how long term Treatment cost – or a means by which late effects can be reduced – clinicians say that it is possible to improve the best possible long-term approach to monitor patients long after treatment for their cancer. Approaches differ on how to do this, however, some research is being done on using telemedicine, such as adult survivors not having to travel long distances where they were originally thought to be children – And adult doctors to hand off. But experts agree that patients and their loved ones are best served by seeing physicians who are fully aware of their cancer treatment and its potential effects, and that the health of childhood cancer survivors The provider should, at a minimum, be in contact with doctors or the institution. Where that patient was treated.

Meanwhile, experts say more studies are still needed to take care of childhood cancer survivors in the years after they are deemed cancer-free. “We need to continue trying to figure out how to support these patients,” Schwartz says – “to try to find better ways to heal them without harming them in the long run”. “

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