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As Adults, Childhood Survivors Generally Maintain Good QOL

As Adults, Childhood Survivors Generally Maintain Good QOL

NIAGARA-ON-THE-LAKE, Ontario, Canada—Survivors of childhood cancer
generally enjoy good quality of life (QOL) as adults, according to two
reports presented at the 7th International Conference for Long-Term
Complications of Treatment of Children and Adolescents for Cancer, hosted by
Roswell Park Cancer Institute.

The two studies evaluated adult survivors who participated in the
Childhood Cancer Survivor Study (CCSS), a resource designed to investigate
the long-term effects of cancer treatment among 5-year survivors of childhood
and adolescent cancer.

A CCSS study (abstract 13) headed by Melissa M. Hudson, MD, director,
After Completion of Therapy Clinic, St. Jude Children’s Research Hospital,
analyzed self-reported health status of 9,434 survivors (age range, 18 to 48
years). The majority reported good general health status, with only 11% of
participants reported fair or poor health.

Health problems differed according to the type of childhood cancer.
Functional impairment and activity limitations were more common in survivors
of cancers of the central nervous system and bone; survivors of bone tumors,
sarcomas, and Hodgkin’s disease reported higher levels of cancer-related
anxiety and fears; and cancer-related pain was more frequent in survivors of
bone cancer and soft-tissue sarcoma. "Age was a factor, in that survivors 35
years or older reported an increase in general health impairment and activity
limitations," Dr. Hudson said. "Race and insurance status did not predict
deficits in health outcomes."

The study did find that income and educational status were inversely
correlated with health outcomes. This was confirmed by another CCSS study
that focused on the employment status of childhood cancer survivors, which
would affect financial quality of life and the ability to become
self-sufficient (abstract 8).

"One measure of success for childhood survivors is the transition into
adulthood and achieving gainful employment," said Jenny W.Y. Pang, MD,
Department of Pediatrics, Division of Hematology/Oncology, University of
Washington School of Medicine, Seattle. "Many times, health-related effects
can pose barriers to employment and self-sufficiency. We need to identify
those survivors who may best benefit from educational and vocational
services."

In this study, self-reported employment history was obtained from 10,188
participants in the CCSS who were older than age 18 at the time of the
survey. A sibling cohort of 2,662 members served as a comparison group.
Analysis of these reports found that 5.2% of cancer survivors had never been
employed vs 1.4% of the siblings. Unemployment risk was greater among
survivors of brain tumors, recipients of cranial radiation greater than 3,000
Gy, and female sex.

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