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Spring 2005

Childhood Cancer Survivors Face Late Effects of Disease

Just 30 years ago, the prognosis for children with cancer was bleak. Today, nearly 75 percent of all children with cancer survive five years and beyond thanks to remarkable advances in treatments. The dramatic growth in survivorship has resulted in a new population that may face unique health and psychological challenges as they age, challenges referred to as the “late effects” of the disease and its treatment, notes Jacqueline Casillas, M.D., director of the Life After Cancer Clinic at UCLA’s Jonsson Cancer Center.

Some common late effects include cardiac problems, learning disabilities, growth and fertility issues, psychological dysfunction and second malignancies. Because children with cancer are treated with surgery, radiation and/or chemotherapy during important periods of physical and psychological growth and development, they are vulnerable to late effects. As many as twothirds of childhood cancer survivors experience at least one late effect, with about one-fourth of survivors experiencing a severe or life-threatening late effect.

The Life After Cancer Clinic at UCLA was created to address the medical and quality-of-life issues of childhood cancer survivors through comprehensive health evaluation, a psychosocial assessment and targeted specialty referrals. In addition, the program helps survivors with educational, vocational and insurance coverage challenges.

Psychological effects of childhood cancer may not be as obvious as the physical repercussions but are equally as important and may include post-traumatic stress, depression, self-esteem problems and difficulty socially.

“Other late effects can surface when the survivor faces new challenges, such as dating, getting married or having children,” says David Wellisch, Ph.D., psychologist at UCLA’s Neuropsychiatric Institute. “The UCLA clinic can help survivors deal with these and other issues.”

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