Childhood Cancer—Treatment at a Cost

Extract

Over the last 30 years, more effective treatments, as well as enhanced methods for early diagnosis of cancer have resulted in major improvements in survival for childhood malignancies. The relative 5-year survival rate has risen from 56% for children diagnosed between 1974 and 1976 to 79% for those diagnosed in the period 1995–2001 ( 1 ) , and the current 10-year survival rate is approximately 75% ( 2 ) . This increased survival means that the majority of children with cancer can look forward to a long life; however, they may experience multiple late health problems. One of the most alarming long-term consequences of childhood cancer is the occurrence of a second primary malignancy. Although the etiology of many second cancers is unknown, treatment-related cancers are a well-recognized sequela of both radiotherapy and chemotherapy ( 3 , 4 ) . An excess risk of subsequent malignancies of the thyroid, breast, bone, soft tissue, and central nervous system (CNS) following radiation treatment for childhood cancer have been reported, whereas secondary leukemia is the main malignancy associated with chemotherapy ( 5 , 6 ) .