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Editorial |

Childhood Cancer Survivors, Late Effects, and a New Model for Understanding Survivorship

Kevin C. Oeffinger, MD; Leslie L. Robison, PhD
JAMA. 2007;297(24):2762-2764. doi:10.1001/jama.297.24.2762.
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In 1950, at a time when cancer remission was measured in days, Farber stated that “The use of chemotherapeutic agents now available . . . should do much to reduce the number of instances of ‘incurable cancer’ in infants and children.”1 Today, in 2007, approximately 80% of children with cancer are cured.2

However, it gradually was realized that this cure had a cost; ie, the curative therapy could damage a child's developing organ systems. Some problems, such as cognitive deficits following cranial radiotherapy, were apparent soon after completion of therapy. However, many sequelae were not recognized until survivors were a decade or more beyond their cancer. In 1974, Meadows and D’Angio described different methods and approaches to “detect the late effects of cancer therapy”3; thus began the expansion of the concept of cure to include long-term outcomes.

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