Childhood and adolescent cancer survivors may be at higher risk for chronic physical and mental health problems, according to studies published in the Journal of the American Medical Association on Nov. 19.

Researchers of two separate studies found that children and young adult cancer survivors may be more at risk to develop chronic diseases and medical conditions, as well as cognitive issues once they reach adulthood. Further research will be needed to determine more precisely the effects of chemotherapeutic treatments in the long run.

In one study, researchers from the Danish Cancer Society found that children who survived cancer were most likely to end up hospitalized when they become adults. In a separate study made by St. Jude Children's Research Hospital, young bone cancer survivors were also more likely to have poor thinking and reading skills.

The Danish researchers studied hospital records of more than 33,500 five-year survivors of childhood or adolescent cancer diagnosed between 1943 and 2004, when they were about 15 to 39 years old. The records were then compared to the data of more than 228,000 healthy individuals matched to the cancer survivors by sex and birth year.

Among the cancer survivors, researchers noted at least 53,000 hospitalizations within 14 years. They also noted that those with leukemia, Hodgkin's lymphoma and brain cancer were the ones at highest risk for future hospitalizations.

The second study, done by the St. Jude Children's Research Hospital, assessed neurocognitive function and symptoms for abnormal behavior and emotional distress in 80 bone cancer survivors and were then compared to 39 unrelated, healthy people.

Long-term survivors gained lower average scores in cognitive functions such as reading, memory and information processing. However, these issues were not found to be associated with the cancer treatments rendered to them, including the administration of methotrexate.

"Care of the cancer patient doesn't stop with the cancer," said Dr. Kevin Krull of St. Jude Children's Research Hospital. "We have to continue to monitor these chronic health conditions because they can impact brain growth and development and affect daily life skills."

With the increased rate of survival and longevity of cancer patients in recent years, doctors need to consider both short- and long-term outcomes when it comes to cancer treatment.

In their Journal of the American Medical Association editorial, Stanford University pediatric hematologist-oncologists Dr. Karen Effinger and Dr. Michael Link said that while advances in cancer therapy in children and adolescents have led to increased survival, interventions would need to be done. They stated that as numbers of cancer survivors continue to increase, research should also focus on improving patient quality of life.

"Going forward, we must apply our knowledge of late effects to improve monitoring and interventions for patients," Effinger and Link concluded.

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