Children with CNS tumor should go for regular follow up care even after the end of the treatment. The follow-up cancer is performed for surveillance and screening of cancer, management and assessment of long-term effects as well as for care coordination.
Treatment for children diagnosed with a CNS tumor does not end with the end of treatment. The child’s medical team will continue to check for tumor recurrence, monitor the child’s overall health, and manage side effects. This is called follow-up. All children receiving treatment for CNS tumors should be monitored lifelong.
Additional care for the child may include regular medical examinations, physical examinations, or both. The doctor will want to track the child’s recovery in the months or years to come1.
- Follow up for surveillance and screening.
One of the most frequent concerns of cancer patients is the fear of cancer recurrence. Doctors in such cases should respond with careful examination and investigation to detect signs and symptoms of local and distant recurrence. Some studies have demonstrated the benefits of more frequent follow-up visits in comparison to less frequent follow-up visits. Children with CNS tumor should be tested for other malignancies in the same way as patients at moderate risk.
- Assessment and management of long-term effects
Many cancer patients experience long-term physical and psychosocial effects from cancer and the associated treatment, which includes pain, lymphedema, fatigue, and psychological discomfort. Risk factors for increased suffering include a history of depression or anxiety, poor social support, and young age. Physicians should look for these symptoms and carefully assess those at risk. Studies have reported that early diagnosis of distress using standardized screening tests improves outcomes, and recently published guidelines are a valuable resource for physicians to assess and manage the psychosocial consequences of cancer and its treatment. Cancer treatments using anthracyclines (epirubicin, doxorubicin), radiotherapy, and targeted drugs such as trastuzumab have been associated with heart failure, arrhythmias, myocardial ischaemic, etc. thromboembolism, and hypertension. In addition, cardiovascular risk factors such as diabetes, high blood pressure, dyslipidaemia, obesity and a sedentary lifestyle are more common in cancer patients than in the general population.
- Care Coordination
Although physicians are increasingly advocating medical follow-up for cancer survivors, the challenges faced by some cancer patients are best addressed using a multidisciplinary approach. The physician should actively consider whether other healthcare professionals can assist the patient’s recovery and initiate referrals immediately. It starts with building relationships with local oncologists or doctors who focus on oncology, who can oversee cancer treatment and serve as an excellent resource for comprehensive care for cancer survivors2.
- 1.Otth M, Wyss J, Scheinemann K. Long-Term Follow-Up of Pediatric CNS Tumor Survivors—A Selection of Relevant Long-Term Issues. Children. Published online March 22, 2022:447. doi:10.3390/children9040447
- 2.Sisler J, Chaput G, Sussman J, Ozokwelu E. Follow-up after treatment for breast cancer: Practical guide to survivorship care for family physicians. Can Fam Physician. 2016;62(10):805-811. https://www.ncbi.nlm.nih.gov/pubmed/27737976