Childhood cancer survivors face limitations

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Long-term survivors of childhood cancers are likely to have difficulty with certain activities of daily living and to be generally limited in their physical capabilities, new research suggests.

While treatment for childhood cancers is known to cause functional limitations and impair activities of daily living, it has been unclear how the prevalence of these problems relates to cancer type and treatment received, the report indicates.

To investigate, Dr. Kirsten K. Ness, from the University of Minnesota in Minneapolis, and colleagues analyzed data from 11,481 subjects who were diagnosed with a malignancy before 21 years of age and survived at least 5 years. The cancers included primary brain cancer, leukemia, Hodgkin’s disease, non-Hodgkin’s lymphoma, kidney tumor, Neuroblastoma, Soft tissue sarcoma or malignant bone tumor.

The subjects or their parents were surveyed to assess functional ability, and 3839 unaffected siblings served as a comparison group.

Cancer survivors were 80 percent more likely than their siblings to report performance limitations, the researchers’ report in the Annals of Internal Medicine. In addition, survivors were at least four times more likely to describe restricted ability to participate in personal care, routine activities, and to attend school or work.

The survivors most likely to report performance limitations, restrictions in routine activities, and difficulty in attending school or work were those with brain and bone cancers. Moreover, brain cancer survivors were more likely than other survivors to report impairments in performing personal care.

The results indicate that “adult survivors of childhood cancer are at risk for performance limitations and participation restrictions many years after treatment,” the researchers conclude.

“Although not all late effects can be avoided or eliminated,” they say, “their impact on physical performance and participation in routine activities can be influenced by rehabilitation measures designed to restore function or remediate loss in physical performance that may lead to participation restrictions.”

SOURCE: Annals of Internal Medicine, November 1, 2005.

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