Beyond survival: quality of life and follow-up after childhood cancer

Objectives To discuss (a) the impact of late physical and psychological effects on quality of life (QOL) among survivors of childhood cancer, (b) the rationale for providing follow-up care, and (c) potential value for survivors. Methods Research related to four areas was summarized: (a) the late physical and psychological effects experienced by survivors and possible impact on health-related QOL, (b) assessment of QOL, (c) rationale for offering follow-up, and (d) assessment of its value to survivors. Results Evaluation of follow-up can include identification and treatment of second cancers, but these are rarely identified in clinic. Evaluation, therefore, needs to emphasize value for survivors and can include improved QOL, disease information, screening attendance, and lifestyle behaviors especially smoking. Conclusions Multi-disciplinary models of follow-up are required to address the range of effects identified after childhood cancer. Systematic assessment of QOL should be an integral part of follow-up in order to facilitate communication and broaden the scope of the consultation. Key words adolescents; childhood cancer survival; follow-up; quality of life