Impact and Sequelae of Cancer

Treatments of pediatric cancer include surgery, chemotherapy, radiation, and various combinations of these elements, depending on the histology and stage of the malignancy (Ludwig 2008). All of these treatments have the immediate impact of being strange and often frightening for pediatric patients and their families. Most treatment protocols also involve discomfort or pain, removal from familiar environments, and interference with usual developmental tasks, such as school and peer relationships. In addition to the acute impact of treatment, cancer diagnosis and treatment have long-term effects that are life altering physically and emotionally for the family and child. We consider first what is known about the acute emotional and physical impacts of pediatric cancer on child and family and then discuss the long-term emotional and physical sequelae.

Table 15-2. Cancer death ratesa in U.S. children ages 0-19 years by sex, 2002-2006

Site

Male

Female

Total

All sites

3.0

2.4

2.7

Leukemia

0.9

0.7

0.8

Acute lymphocytic

0.4

0.3

0.4

Brain and other nervous

0.7

0.6

0.7

Non-Hodgkin's lymphoma

0.2

0.1

0.1

Soft tissue

0.2

0.2

0.2

Bone and joint

0.3

0.2

0.2

Kidney and renal pelvis

0.1

0.1

0.1

aPer 100,000, age-adjusted to the 2000 U.S. standard population.

Source. Adapted from Horner MJ, Ries LAG, Krapcho M, et al. (eds): SEER Cancer Statistics Review, 1975-2006. Bethesda, MD, National Cancer Institute, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 Surveillance, Epidemiology and End Results (SEER) data submission, posted to the SEER Web site, 2009.

aPer 100,000, age-adjusted to the 2000 U.S. standard population.

Source. Adapted from Horner MJ, Ries LAG, Krapcho M, et al. (eds): SEER Cancer Statistics Review, 1975-2006. Bethesda, MD, National Cancer Institute, http://seer.cancer.gov/csr/1975_2006/, based on November 2008 Surveillance, Epidemiology and End Results (SEER) data submission, posted to the SEER Web site, 2009.

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