Long-term follow-up of childhood cancer survivors: future directions for clinical care and research

Improvement in survival after childhood cancer has resulted in a growing population of childhood cancer survivors, causing the healthcare community to focus on providing appropriate care to the survivors, and addressing issues related to the etiology and prevention of long-term sequelae of cancer and its treatment. The overarching goal is to decrease the morbidity related to cancer treatment, and improve the overall quality of life, such that cancer survivors can successfully integrate back into society and lead productive lives. In order to achieve this goal, several issues need to be addressed, such as education of survivors and healthcare providers regarding the potential late effects; provision of standardized guidelines for appropriate follow-up of the survivors in a setting that is feasible and practical for the cancer survivor; ongoing communication between the cancer center that provided acute care for the patient and the healthcare facility providing follow-up care. Several challenges remain in addressing these issues, and will be the focus of this article.