91黑料不打烊

During treatment for childhood leukemia, the main concerns for most families are the daily aspects of getting through treatment and beating the leukemia. After treatment, the concerns may shift toward the long-term effects of the leukemia and its treatment, and concerns about the leukemia coming back.

It is normal to want to put the leukemia and its treatment behind you and to get back to a life that does not revolve around cancer. Getting the right follow-up care offers your child the best chance for recovery and long-term survival.

Follow-up exams and tests

For several years after treatment, regular follow-up exams will be very important. The doctors will watch for possible signs of leukemia coming back, as well as for short-term and long-term side effects of treatment.

Doctor visits often include careful physical exams and lab tests, and sometimes might include imaging tests. How often you follow up with your cancer care team will depend on the type of leukemia, treatment given, and other factors. Visits will usually be monthly during the first year, and then less often for at least 5 years after therapy. After that time, most children see their doctor at least yearly.

For the most common types of leukemia in children (ALL and AML), if the leukemia does come back, it is most often while the child is still being treated or within a year or so after finishing treatment. It is less common for ALL or AML to return if there are no signs of the disease within the next 2 years.

A benefit of follow-up care is that it gives you a chance to discuss questions and concerns that come up during and after your child’s recovery. For example, almost any cancer treatment can have side effects. Some might last only a short time, but others can last longer or might not show up until months or years later. It is important to report any new symptoms to the doctor right away, so that the cause can be found and treated, if needed.

Ask the treatment team for a survivorship care plan

Talk with the treatment team about developing a survivorship care plan. This plan might include:

• A summary of the diagnosis, tests done, and treatment given
• A suggested schedule for follow-up exams and tests
• A schedule for other tests your child might need in the future, such as an ultrasound to monitor the heart (called an echocardiogram), or tests to look for other long-term health effects from the leukemia or its treatment
• A list of possible late or long-term side effects from your child’s treatment, including what to watch for and when to contact the doctor
• Diet and physical activity suggestions

Keeping health insurance and copies of medical records

As much as you might want to put the experience behind you once treatment is done, it is also important to keep good records of your child’s medical care during this time. Eventually, your child will grow up, be on their own, and have new doctors. It is important for your child to be able to give the new doctors the details of their cancer diagnosis and treatment. Gathering the details soon after treatment may be easier than trying to get them at some point in the future.

Ask your child’s cancer care team where and how to get this information. Learn more in Keeping Copies of Important Medical Records.

It is also very important to keep health insurance coverage. Tests and doctor visits can cost a lot, and even though no one wants to think of the cancer coming back, this could happen.

Late and long-term effects of treatment

Because of major progress in treating leukemia, most children will live long lives. Watching for late effects of treatment as children age is a vital part of their long-term health care.

Just as the treatment of childhood leukemia requires an individual approach, so does follow-up care after treatment. The earlier problems are recognized, the more likely they can be treated.

Many childhood leukemia survivors are at risk for several possible late effects of their treatment. This risk depends on a few factors, such as the type of leukemia and the type and doses of treatments they received. It is important to discuss what these health problems might be with your child’s medical team, so you know what to watch for.

Social and emotional health after cancer

Once treatment is finished, a number of emotional concerns can come up. Some of these might last a long time and can include:

• Dealing with physical changes that can result from the treatment
• Worries about the leukemia returning or new health problems developing
• Feelings of resentment for having had leukemia or having had to go through treatment when others did not
• Feeling guilty for surviving cancer, when other friends with cancer did not
• Concerns about being treated differently or discriminated against (by friends, classmates, coworkers, employers, etc.)
• Concerns about dating, marrying, and having a family later in life

It is normal to have some anxiety or other emotional reactions after treatment, but feeling overly worried, depressed, or angry can affect many aspects of a young person’s growth. It can get in the way of relationships, school, work, and other aspects of life. With support from family, friends, other survivors, mental health professionals, and others, many people who have survived leukemia can thrive despite the challenges they have had to face.

There may be other possible complications from chemotherapy or other treatments as well. Your child’s doctor should carefully review any possible problems with you before your child starts treatment.

Long-term follow-up guidelines

To help increase awareness of late effects and improve follow-up care for childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines are used by your doctor to create a survivorship care plan specific to your child and their treatment. They can help you know what to watch for, what types of screening tests should be done, and how late effects can be treated.

To learn more, ask your child’s doctors about the COG survivor guidelines. You can also read them on the COG website: . The guidelines are written for health care professionals, but patient education on some late effects of treatment is available (as “Health Links”) on the site as well.

For more on the possible long-term effects of treatment, see Late and Long-term Effects of Childhood Cancer Treatment.