Guidelines for Complications of Cancer Treatment Vol VIII Part B

of childhood cancer survivors is notable for its vulnerabilityto adverse health outcomes, many of which may not becomeclinically apparent until years after therapy completion. Earlydetection, prevention, and ameliorative interventions providethe opportunity to reduce cancer-related morbidity andmortality. This review is intended to complement the Children’sOncology Group Long-Term Follow-Up Guidelines forSurvivors of Childhood, Adolescent, and Young Adult Cancers.The objective of this review is to familiarize readers with thediverse health risks experienced by childhood cancer survivorsthat stem from the heterogeneous therapeutic interventionsrequired to achieve disease control.5) Long term follow up care in developing countriesP Kurkure, Pediatric blood cancer 2007,SLO62; 49:2Because of improvements in Cancer therapy over last severaldecades more children are surviving cancer than ever before.Approximately 40,000 new childhood cancers are projectedannually in India. Even with conservative estimates of 10-20% long term cure 3.5 – 7000 survivors are added topopulation each year. This is expected to increase exponentiallywith improved survival rates. The potential Public Healthimplication of such large number of high risk individuals insociety are evident. There is a increasingly felt need for optimaldelivery of health care to this growing, vulnerable population.Drawing inspiration from efforts at St. Jude Children ResearchHospital, USA, follow-up clinic for long term survivors ofchildhood cancer was initiated at Tata Memorial Hospital inFebruary 1991. This clinic was appropriately named AfterCompletion of Therapy (ACT) Clinic to emphasize that ACTsare needed beyond therapy to achieve ²CURE ² in its fulldimensions. Aims of this clinic are to monitor growth,development, sexual maturation and somatic late effects oftherapy and to apply corrective measures whenever feasible.418