“Chemobrain” in childhood cancer survivors — the impact on social, academic, and daily living skills

Abstract Background Chest wall abnormalities are a poorly studied complication after treatment for childhood cancer. Chest wall abnormalities are not well-described in the literature, and little is known on the impact on daily life of survivors. Methods We investigated prevalence and risk factors of chest wall abnormalities in childhood cancer survivors in a nationwide, population-based cohort study (Swiss Childhood Cancer Survivor Study) with a questionnaire survey. We then interviewed a nested sample of survivors to validate types of chest wall abnormalities and understand their impact on the daily life of survivors. Results Forty-eight of 2382 (95%CI 2–3%) survivors reported a chest wall abnormality. Risk factors were older age at cancer diagnosis (16–20 years; OR 2.5, 95%CI 1.0–6.1), lymphoma (OR 3.8, 95%CI 1.2–11.4), and central nervous system tumors (OR 9.5, 95%CI 3.0–30.1) as underlying disease, and treatment with thoracic radiotherapy (OR 2.0, 95%CI 1.0–4.2), surgery to the chest (OR 4.5, 95%CI 1.8–11.5), or chemotherapy (OR 2.9, 95%CI 1.0–8.1). The nature of the chest wall abnormalities varied and included thoracic wall deformities (30%), deformations of the spine (5%) or both (55%), and scars (10%). Chest wall abnormalities affected daily life in two thirds (13/20) of those who reported these problems and necessitated medical attention for 15 (75%) survivors. Conclusion It is important that, during follow-up care, physicians pay attention to chest wall abnormalities, which are rare late effects of cancer treatment, but can considerably affect the well-being of cancer survivors.

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The impact of CNS-directed treatment on quality of life in childhood cancer survivors

Quality of Life Research ◽

10.1007/s11136-021-02984-1 ◽

2021 ◽

Author(s):

Keagan G. Lipak ◽

Joseph R. Rausch ◽

Rachel S. Fisher ◽

Kemar V. Prussien ◽

Olivia E. Clark ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

The Impact

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Cycling Through Cancer: Exploring Childhood Cancer Survivors’ Experiences of Well- and Ill-Being

Adapted Physical Activity Quarterly ◽

10.1123/apaq.2016-0011 ◽

2017 ◽

Vol 34 (4) ◽

pp. 345-361 ◽

Cited By ~ 2

Author(s):

Shaunna M. Burke ◽

Jennifer Brunet ◽

Amanda Wurz ◽

Christina Butler ◽

Andrea Utley

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Case Analysis ◽

Childhood Cancer Survivors ◽

Study Approach ◽

Multiple Case ◽

Multiple Domains ◽

Physical Changes ◽

Cross Case Analysis ◽

The Impact

The benefits of informal physical activity during recovery from childhood cancer have rarely been investigated. This study adopted a multiple case study approach to explore the impact of recreational cycling on childhood cancer survivors’ experiences of well- and ill-being. Three semistructured interviews were conducted over a 3-month period with four survivors to explore their experiences of physical, psychological, and social well- and ill-being. Within-case analysis followed by cross-case analysis identified three themes that captured their well- and ill-being experiences with recreational cycling and cancer: (a) cultivating feelings and emotions, (b) experiencing physical changes, and (c) encountering positive and negative social interactions. The results from this study show that recreational cycling may be a useful adjunct to conventional treatments for the self-management of multiple domains of well- and ill-being during recovery from childhood cancer.

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Identification of Biochemical and Molecular Markers of Early Aging in Childhood Cancer Survivors

10.1101/2021.04.01.438017 ◽

2021 ◽

Author(s):

Silvia Ravera ◽

Tiziana Vigliarolo ◽

Silvia Bruno ◽

Fabio Morandi ◽

Danilo Marimpietri ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Antioxidant Defenses ◽

Elderly Subjects ◽

Cancer Type ◽

Metabolism Regulation ◽

Increased Risk ◽

Early Aging ◽

The Impact

ABSTRACTPurposeSurvival rates of Childhood Cancer Patients have improved tremendously over the past four decades. However, cancer treatments are associated with an increased risk of developing an anticipated onset of chronic diseases typical of aging. Thus, we aimed to identify molecular/metabolic cellular alterations responsible for early aging in Childhood Cancer Survivors (CCS).Patients and MethodsBiochemical, proteomic and molecular biology analyses were conducted on mononuclear cells (MNCs) isolated from peripheral blood of 196 CCS, comparing the results with those obtained on MNCs of 154 healthy subjects.ResultsData demonstrate that CCS-MNCs show: i) inefficient oxidative phosphorylation associated with low energy status and a metabolic switch to lactate fermentation compared with age-matched normal controls; ii) increment of lipid peroxidation due to an unbalance among the oxidative stress production and the activation of the antioxidant defenses; (iii) significantly lower expression of genes and proteins involved in mitochondrial biogenesis and metabolism regulation, such as CLUH, PGC1-α, and SIRT6 in CCS, not observed in the age-matched healthy or elderly subjects. The application of a mathematical model based on biochemical parameters predicts that CCS have a biological age significantly increased by decades compared to the chronological age. Overall, the results show that the impact of chemo/chemoradiotherapy on mitochondria efficiency in 196 CCS was rather homogeneous, irrespective of cancer type, treatment protocols, and time elapsed from the end of the curative period.ConclusionsOur study identifies some biochemical and molecular alterations possibly contributing to the pathophysiology of anticipated aging and metabolic deficiency described in CCS. These results may be useful in identifying approaches to restore the mitochondrial function, slowing down the aging and the associated pathological conditions in CCS.

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Randomized trial assessing the impact of survivorship care plans on the quality of care for childhood cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.15_suppl.10007 ◽

2016 ◽

Vol 34 (15_suppl) ◽

pp. 10007-10007

Author(s):

Cary Philip Gross ◽

Wilhelmenia Lee Ross ◽

Jaime L. Rotatori ◽

Hannah-Rose Mitchell ◽

Xiaomei Ma ◽

...

Keyword(s):

Quality Of Care ◽

Cancer Survivors ◽

Randomized Trial ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

The Impact

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The impact of the Affordable Care Act (ACA) on cancer survivorship.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.10072 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 10072-10072

Author(s):

Christine Leopold ◽

Elyse Park ◽

Larissa Nekhlyudov

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Cancer Survivorship ◽

Preventive Services ◽

Childhood Cancer Survivors ◽

Unintended Consequences ◽

Coordinated Care ◽

Screening Programs ◽

Coverage Expansion ◽

The Impact

10072 Background: The ACA of 2010 has been recognized by the cancer community as an important step forward in insurance and payment reform, aiming to expand the number of insured patients, control costs and incentivize health care delivery system changes. In this review, we outline the ACA provisions relevant to cancer survivorship, provide available evidence for their impact, and offer insights for future research. Methods: We conducted a literature search in the PubMed database and grey literature. We searched the terms ‘ACA and cancer survivors’, which resulted in 17 articles and expanded the search to ‘ACA and cancer’ and found 213 articles, of which 75 were relevant for this review. We categorized the ACA provisions into three categories, 1) access to preventive care, 2) access to quality, coordinated care, and 3) coverage expansion and increased affordability. Results: Positive effects of the ACA were: an increased uptake of preventive services and cancer screening; a reduction in hospital admissions, increased guidelines concordance and generic prescribing through the implementation of cancer-specific Accountable Care Organizations; a reduction of unnecessary resource use (e.g. emergency visits) through the implementation of oncology patient-centered medical home models and decreases in costs though bundle payments. These results focus on the general population/cancer patients; specific studies targeting at the effects on cancer survivors are missing. In addition, evidence from literature showed that knowledge about the benefits of the ACA is low among childhood cancer survivors; while insurance coverage rates of cancer survivors, especially for childhood cancer survivors, increased. Conclusions: Evidence regarding the effects of the ACA on cancer survivorship care is limited, though point to greater access to preventive services and screening programs. Effects of provisions focusing on quality, coordinated care as well as coverage expansion and affordability may have beneficial effects. Whether the ACA remains or is reformed, it is critically important that decisions take into account the potential intended and unintended consequences of the ACA provisions on health outcomes and quality of life of this growing population.

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Randomized Trial of the Impact of Empowering Childhood Cancer Survivors With Survivorship Care Plans

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djy057 ◽

2018 ◽

Vol 110 (12) ◽

pp. 1352-1359 ◽

Cited By ~ 4

Author(s):

Nina S Kadan-Lottick ◽

Wilhelmenia L Ross ◽

Hannah-Rose Mitchell ◽

Jaime Rotatori ◽

Cary P Gross ◽

...

Keyword(s):

Cancer Survivors ◽

Randomized Trial ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Survivorship Care Plans ◽

Survivorship Care ◽

Care Plans ◽

The Impact

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Knowledge of diagnosis, treatment history, and risk of late effects among childhood cancer survivors and parents: The impact of a survivorship clinic

Pediatric Blood & Cancer ◽

10.1002/pbc.25509 ◽

2015 ◽

Vol 62 (8) ◽

pp. 1444-1451 ◽

Cited By ~ 24

Author(s):

Robert B. Lindell ◽

Shannon J. Koh ◽

JoAnn M. Alvarez ◽

Tatsuki Koyama ◽

Adam J. Esbenshade ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Late Effects ◽

Childhood Cancer Survivors ◽

Treatment History ◽

The Impact

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The impact of long-term follow-up care for childhood cancer survivors: A systematic review

Critical Reviews in Oncology/Hematology ◽

10.1016/j.critrevonc.2017.04.007 ◽

2017 ◽

Vol 114 ◽

pp. 131-138 ◽

Cited By ~ 19

Author(s):

Christina Signorelli ◽

Claire E. Wakefield ◽

Joanna E. Fardell ◽

W. Hamish B. Wallace ◽

Eden G. Robertson ◽

...

Keyword(s):

Systematic Review ◽

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Follow Up Care ◽

Long Term Follow Up ◽

The Impact

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Health-related unemployment trends among survivors of childhood cancer: A report from the Childhood Cancer Survivor Study (CCSS).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10048 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10048-10048

Author(s):

Neel S. Bhatt ◽

Pamela Goodman ◽

Wendy M. Leisenring ◽

Gregory T. Armstrong ◽

Eric Jessen Chow ◽

...

Keyword(s):

Cancer Survivors ◽

Childhood Cancer ◽

Childhood Cancer Survivors ◽

Chronic Health Conditions ◽

Health Conditions ◽

Health Related ◽

Race Ethnicity ◽

The Impact ◽

Significant Health

10048 Background: The impact of treatment era and chronic health conditions on health-related unemployment among childhood cancer survivors has not been studied. Methods: Childhood cancer survivors (age ≥25 years) enrolled in the CCSS (3,420 diagnosed in the 1970s, 3,564 in the 1980s, and 2,853 in the 1990s) were matched 1:5 on sex, race/ethnicity, census bureau division, age, and year of survey to the Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative population. Among survivors, health-related unemployment was defined as self-reported unemployment due to illness/disability and for BRFSS participants as self-reported inability to work. To standardize follow-up, health-related unemployment was assessed either in 2002-05 or 2014-16 for both cohorts. Sex stratified standardized prevalence ratio (SPR) and relative SPR (rSPR) with 95% confidence intervals (CI) for health-related unemployment were estimated using multivariable generalized linear models, with BRFSS background rates to assess the impact of treatment era and moderate to severe health conditions (per the Common Terminology Criteria for Adverse Events). Results: Prevalence of health-related unemployment in survivors (median age 9 years [range 0-20] at diagnosis and 33 years [25-54] at follow-up) was significantly higher compared to BRFSS participants (females: 11.3% vs 3.7%; SPR 3.0, 95% CI 2.7-3.3; males: 10.5% vs 3.0%; SPR 3.5, 95% CI 3.1-3.9). Health-related unemployment risks declined among survivors in more recent decades (ptrend< 0.001) for females: 1970s SPR 3.8, 95% CI 3.2-4.5, 1980s SPR 2.9, 95% CI 2.5-3.5, 1990s SPR 2.5, 95% CI 2.1-3.0; and males: 1970s SPR 3.6, 95% CI 2.9-4.4, 1980s SPR 3.8, 95% CI 3.1-4.7, 1990s SPR 3.0, 95% CI 2.5-3.7. Among survivors, multivariable models identified associations between presence of specific health conditions and elevated health-related unemployment (Table) adjusting for all statistically significant health conditions, race/ethnicity, treatment era, age at survey, and diagnosis. Among females, rSPR for endocrine conditions differed between 1970s and 1990s (interaction p = 0.04); fewer significant health conditions remained in the final model for males. Conclusions: While prevalence for health-related unemployment has declined over time, childhood cancer survivors remain at higher risk compared to the general population. These elevated risks are associated with chronic health conditions and affect female survivors more than male survivors.[Table: see text]

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