5 things childhood cancer survivors should know about their post-cancer health

For Hematologist/Oncologist Karim Sadak, MD, MPH, MSE, who specializes in the care of childhood cancer survivors, helping survivors progress after their treatments and live healthy lives is a tall order — but it’s a critical one.
Sadak is the Director of the Childhood Cancer Survivor Program (cCSP) for the University of Minnesota Masonic Children’s Hospital. To ensure childhood cancer survivors have the resources and information they need to live healthy adult lives, Sadak shares about five important tips childhood cancer survivors should know about their post-cancer health.

Learning difficulties are possible for all survivors

It’s not unusual for patients who receive radiation to the head or brain to experience learning issues, Sadak said. “Many survivors, as they go through their schooling and education, whether it’s in elementary school or all the way up through graduate school, are at risk for problems with their ability to learn or process or retain information,” Sadak said. Even if a patient did not receive radiation to the brain, they could still develop learning difficulties.
“It’s not just those kids who got brain radiation that may have learning deficits,” Sadak said. Parents should be aware of the risks. If there are issues with learning, specialists at University of Minnesota Masonic Children’s Hospital “absolutely have the resources to help survivors in the school system,” and can even speak with teachers and administrators.

Attend regular follow-up appointments with your primary care physician and a cancer survivor program.

Patients and parents should know that University of Minnesota Health has resources for survivors who are at any stage in their survivorship journey.
“Parents and survivors should know that we are here for them, not just while they’re still children, but also as they grow into and through adulthood,” Sadak said. “Survivor-focused care doesn’t end when the child turns 21. We want and can and will follow them for a lifetime to make sure all their survivor-focused needs are met. And we’ll make sure it’s done in an age-appropriate way.”
Childhood cancer survivors who reach age 21 have a seamless transition to adult care-setting still within the cCSP. The program continues to partner with the survivors’ primary care physician to ensure that the survivor is getting the care they need.

Watch for anxiety—from the survivor or parents—about yearly check-up visits

While a little anxiety associated with the yearly visits is expected, Sadak said that parents—and survivors—should take notice if survivors are reluctant to attend appointments or actually miss them altogether.
“When survivors—and even parents—start wanting to avoid coming back for their yearly visits, that is sometimes a real red flag for some underlying anxiety and/or fears about what’s going to take place or be found during their visit,” he said. “Or they may feel anxiety and fears when talking about their childhood cancer history. It’s natural to feel some level of anxiety, but when it gets in the way of the survivor or their family getting the medical care they need, that becomes a problem.”

Not every childhood cancer survivor will face hormonal issues—but some will.

Not every survivor of childhood cancer is at risk for hormonal or endocrine-related long-term complications, but specialists at University of Minnesota Health can identify those who are at risk based on their previous treatments, Sadak said. If a child’s hormones or endocrine system aren’t working properly, it can cause a wide variety of health issues from fatigue all the way to problems with growth and development.
“A big part of the yearly visit to the cCSP is checking for growth issues: Our survivors get weighed and have their heights measured. We calculate their body mass index and make sure we’re keeping track of their growth and development. So, if there ever is an issue, we can catch it early and get them to the right person.”
Survivors should know that University of Minnesota Masonic Children’s Hospital has hormone specialists available for appointments that are specialists in childhood cancer survivors.
“Some of the treatments for hormonal growth issues can only be done at a certain time within a certain age range. So, if you miss that window of opportunity, the treatments are not as effective and won’t be as beneficial,” Sadak said.

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