Cancer Survivor Care

Aka: Cancer Survivor Care

1. Adverse Effects: Survivors of Childhood Cancers
   1. Skin Effects from Radiation Therapy
      1. Dysplastic Nevi
      2. Skin cancer
   2. Ocular Effects from Bisulfan, Corticosteroids, Radiation or neurosurgery
      1. Cataracts
      2. Retinopathy (Radiation Therapy >30 Gy)
      3. Ocular nerve palsy (neurosurgery related)
   3. Auditory Effects from Cisplatin, Carboplatin, Radiation (>30 Gy)
      1. Sensorineural Hearing Loss
      2. Conductive Hearing Loss (Radiation Therapy)
   4. Dental Effects from radiation or early Chemotherapy prior to seconday Dentition
      1. Dental development effects or Periodontal Disease
      2. Osteoradionecrosis (Radiation Therapy >40 Gy)
   5. Cardiovascular Effects from radiation or doxorubicin, daunorubicin
      1. Cardiomyopathy
      2. Congestive Heart Failure
      3. Arrhythmia
      4. Valvular disease (Radiation Therapy)
      5. Coronary Artery Disease (Radiation Therapy)
      6. Pericarditis (Radiation Therapy)
   6. Pulmonary Effects from radiation, lobectomy or Bleomycin, Busulfan, carmustine lomustine
      1. Pulmonary fibrosis
      2. Interstitial pneumonitis
      3. Restrictive lung disease
   7. Breast Effects from radiation
      1. Breast tissue hypoplasia
      2. Breast Cancer (Radiation Therapy >20 Gy)
   8. Gastrointestinal Effects from laparotomy, radiation (>30 Gy)
      1. Chronic Colitis
      2. Intestinal Stricture
      3. Abdominal adhesions
      4. Fecal Incontinence
      5. Colon Cancer (Radiation Therapy >30 Gy)
   9. Liver Effects from mercaptopurine, thioguanine, Methotrexate or radiation (>30 Gy)
      1. Liver function abnormalities
      2. Veno-occlusive disease
      3. Hepatic fibrosis
      4. Cirrhosis
      5. Cholelithiasis
   10. Renal Effects from Cisplatin, Carboplatin, Isosfamide, Methotrexate, nephrectomy or Radiation Therapy
       1. Glomerular toxicity
       2. Tubular dysfunction
       3. Renal insufficiency
       4. Hypertension
   11. Bladder effects from Cyclophosphamide, isofosfamide, radiation, spine surgery or cystectomy
       1. Hemorrhagic cystitis
       2. Bladder fibrosis
       3. Neurogenic Bladder
       4. Bladder Cancer (Radiation Therapy or cyclophosphamide)
   12. Male reproductive effects from Alkylating Agents, radiation, surgery
       1. Arrested Puberty
       2. Hypogonadism
       3. Infertility
       4. Erectile Dysfunction
   13. Female reproductive effects from Alkylating Agents, radiation, surgery
       1. Arrested Puberty
       2. Premature Menopause
       3. Infertility
       4. Uterine vascular insufficiency (Radiation Therapy)
       5. Vaginal stenosis (Radiation Therapy)
   14. Endocrine effects from radiation (pituitary, neck), Thyroidectomy
       1. Growth Hormone deficiency
       2. Precocious Puberty
       3. Hypothyroidism
       4. Thyroid Nodules and Thyroid Cancer
       5. Hypoprolactinemia (radiation >40 Gy)
       6. Central Adrenal Insufficiency (radiation >40 Gy)
       7. Gonadotropin deficiency (radiation >40 Gy)
       8. Hyperthyroidism (radiation >40 Gy)
   15. Musculoskeletal effects from Corticosteroids, Methotrexate
       1. Osteoporosis
       2. Osteonecrosis
   16. Musculoskeletal effects from Radiation Therapy
       1. Radiation induced Fractures (>40 Gy)
       2. Scoliosis or kyphosis
       3. Secondary musculoskeletal cancers
       4. Reduced function or uneven growth
   17. Neurologic effects from Methotrexate or cytaribine (doses >1000 mg/m2), radiation or neurosurgery
       1. Cognitive deficits
       2. Learning Disorders
       3. IQ Effects
       4. Leukoencephalopathy
       5. Cerebrovascular Disease
       6. Brain Tumors
   18. Peripheral Nervous System effects from vincristine, vinblastine, cisplatin, carboplatin or spine surgery
       1. Peripheral Neuropathy
   19. Immunologic effects from radiation to Spleen, or splenectomy
       1. Asplenia
   20. References
       1. (2009) Pediatrics 123(3): 906-15
2. Follow-up
   1. See Breast Cancer
   2. See Colorectal Cancer
   3. See Prostate Cancer
3. Resources
   1. Survivorship Guidelines Website
      1. http://www.survivorshipguidelines.org
4. References
   1. Kattlove (2003) CA Cancer J Clin 53:172-96
   2. (2009) Pediatrics 123(3): 906-15