Long-Term Follow-Up Guidelines and Organization of Long-Term Follow-Up Care for Childhood and Young Adult Cancer Survivors

Long-term survival rates of childhood and young adult cancer patients improved significantly during the last decades. However, treatment used to cure cancer can cause secondary diseases, which can occur even many years after the end of therapy (late effects), resulting in high morbidity and reduced health-related quality of life. These sequelae are determined by cancer entity, treatment received, and individual risk factors. Late effects can affect different organs or even neurocognitive functions and range from mild disorders to life-threatening conditions appearing as accelerated aging. In this chapter, long-term follow-up recommendations (living, active guidelines) are described and illustrated by the examples of secondary neoplasm, endocrinological, and cardiac diseases. Furthermore, the topics “transition” and “new long-term follow-up structures” are discussed, since most patients are already adults at the time of the occurrence of late effects and are no longer in regular pediatric oncological care. These aftercare structures are designed to support autonomous people who have never been educated about their risk of late complications providing adapted aftercare information and follow-up care plans and to help returning into daily live.