Late effects following childhood cancer treatment. A special challenge for transitionmedicine

BackgroundChildhood cancer survivors are at risk of cancer- and treatment-related chronic health conditions. Since these sequelae may occur years after the end of treatment, many patients are already adults and have completed pediatric oncological care. Thus, successful transition is essential in order to ensure long-term surveillance.ObjectivesThe present review outlines the most frequent late effects of childhood cancer treatment. Moreover, difficulties in transition of these patients are discussed and interdisciplinary models of care are presented.ResultsLate effects following childhood cancer treatment occur in over two thirds of patients 30years after the end of the oncological treatment and can affect different organs. The most frequent sequelae are endocrine disturbances, cardiac conditions, and subsequent neoplasms. Many late effects are effectively manageable if detected early. This necessitates an interdisciplinary approach as well as life-long surveillance.ConclusionsTransition from pediatric to internal medicine care as well as achange in the focus of care, shifting from relapse centered follow-up to late-effects centered surveillance, constitute aspecial challenge for asuccessful transition of long-term childhood cancer survivors. Specialized late-effects survivorship clinics offering interdisciplinary care from pediatric oncologists, specialists of internal medicine, and further disciplines enable the early diagnosis and treatment of late-effects.