TABLE 1

Long-term Effects of Childhood Cancer

SystemRisk FactorPotential Effect
CardiacRadiation therapyValvular disease
AnthracyclinesPericarditis
Myocardial infarction
Congestive heart failure
Sudden death
PulmonaryRadiation therapyRestrictive lung disease
Carmustine/LomustineExercise intolerance
Bleomycin
Renal/urologicRadiation therapyAtrophy or hypertrophy
PlatinumsRenal insufficiency or failure
Ifosfamide and cyclophosphamideHydronephrosis
Cyclosporine AChronic cystitis
Nephrectomy
EndocrineRadiation therapyGrowth failure
Alkylating agentsPituitary, thyroid, and adrenal disease
Ovarian or testicular failure
Delayed secondary sex characteristics
Infertility
Central nervous systemRadiation therapyLearning disabilities
Intrathecal chemotherapy
PsychosocialChildhood cancerPosttraumatic stress disorder
Employment and educational difficulties
Insurance discrimination
Adaptation and problem-solving difficulties
Difficulties with transition to independence
Second malignanciesRadiation therapySolid tumors
Alkylating agentsLeukemia
EpipodophyllotoxinsLymphoma
Type of primary malignancyBrain tumors