A recent edition of the Journal of Clinical Oncology (JCO) has attracted our attention for the disturbing statistics it revealed about the issues related to the acceleration of aging among adult survivors of childhood cancer. For 27 years, the National Coalition for Cancer Survivorship (NCCS) has focused on patient-centered policy matters dealing with basic, clinical, and behavioral cancer research that includes information on how we can improve the quality of care and the quality of lives for people with a diagnosis of cancer. This original report, “Physiologic Frailty As a Sign of Accelerated Aging Among Adult Survivors of Childhood Cancer: A Report From the St. Jude Lifetime Cohort Study,” deserves attention not only for its compelling statistics on survivors of childhood cancer, but also for its inference for all cancer survivors who are at increased risk for premature aging and frailty.
To add more to the consequences of exposure to radiation and chemotherapy at a young age, an article published in the Annals of Internal Medicine (AIM), reports on a survey of over 2000 internists (> 61% response rate) conducted by researchers at the University of Chicago. Researchers set out to determine the attitudes and knowledge about the care of childhood cancer survivors who were treated by pediatric oncologists. Seventy two percent of those surveyed reported they never received a treatment summary from the treating physician. Internists reported feeling uncomfortable with routine medical treatment of childhood cancer survivors because of their unfamiliarity with long-term surveillance guidelines for this population. These two findings—increased frailty and premature aging of adult survivors of childhood cancer and the lack of coordination and follow-up care by internists to monitor and mitigate these consequences—requires our attention.
These data warrant further study but also call for immediate attention to clinical guidelines to lessen the consequences of exposure to anticancer therapies for children and for their follow up surveillance, which, if implemented, could lessen some of the morbidities for adult survivors of childhood cancer. In addition, treatment summaries should become necessary tools for internists, who will be doing follow-up care for this vulnerable population.