The Importance of Long-Term Follow-up Clinic for Childhood Cancer Survivors

Prof. Patrick Yuen Man Pan
The Lady Pao Children's Cancer Centre
Department of Paediatrics
The Chinese University of Hong Kong

Cancer in children differs from adult population in terms of incidence, prognosis and pattern. Annual incidence of cancer in children is reported to be 10-12 per 100,000 children between ages of 0-15 years.

With recent advances in medical sciences, paediatric oncologists have made great strides in the diagnosis and treatment of childhood cancer. Approximately 75-80% of children and adolescents diagnosed to have cancer can be expected to survive five or more years, and vast majority of them will become members of the rapidly growing population of cured patients. This is especially true with patients diagnosed to have acute lymphoblastic leukaemia, the most common cancer children.

The medical profession is faced with an ever increasing number of long-term survivors of childhood cancer, and increasing attention is now being directed towards the development of secondary malignancy and assessment of adverse effects of treatment on the cardiovascular, pulmonary, endocrinologic, reproductive, immunological, skeletal and the neurological systems as well as the psychosocial and neuropsychological well beings of the long-term survivors of cancer therapy. One must remember that a child's perception of health and quality of life are different from an adolescent or adult. The picture is further complicated by the fact that children change physically, emotionally and socially as they mature.

The first step in the establishment of a long-term follow-up clinic during the transitional conference is the identification of the family and patient's concerns. Secondly, the late effects of treatment are made known to the patient and the family and the need of a long-term follow-up is also emphasized. Thirdly, healthy life style is educated to the patients. Fourthly, one should make full use of community resources to rehabilitate these patients.

The ultimate aim of the establishment of a long-term follow-up clinic is to help these long-term survivors of childhood cancer to live normal adult lives and becoming useful member of society. These should be the hope and ideals of every paediatric oncologist. The important information which we can derive in the long-term follow up studies of these children will enable the medical profession to plan and improve on their treatment protocols. In the end, it is these young patients that will benefit from these exercises. No children's cancer centre is complete without a long-term follow-up clinic.