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After Therapy Ends Q."My six-year-old son will be completing therapy for leukemia (ALL) soon. What should I expect in terms of follow up from the doctor?" A. Late Effects Clinic Ending therapy is a challenging time for most families. While it is exciting to be finished, it is scary to not be “fighting” the cancer anymore. The first two years after treatment ends are generally focussed on monitoring for any signs of the cancer returning. But, it is important to be thinking about the future also. Sometime after treatment ends, you should receive a summary of the therapy your son received. This should include names of each chemotherapy agent; the dose each time it was given; how many times he received it; and the cumulative or total dose he received along with the route of administration (pills, IV, spinal, etc). If radiation was involved, you should get a summary including the doses and sites of radiation, as well as the type used. After the treatment summary is prepared, your health care professional (Doctor or Nurse Practitioner) should review the “late effects” that your child may be at risk of developing. Late effects are physical, cognitive, or emotional concerns that occur after treatment ends. For example, children who have treatment for ALL receive some form of intensive therapy to the brain, whether from radiation or chemotherapy. This treatment, especially when given to younger children (less than 3 years of age), can cause learning issues that may not show up for several years after treatment ends. Careful monitoring of your son's school progress should be part of his follow up. Neuropsychological testing should be offered for any school related concerns. More information on school issues after cancer treatment can be found in the book Educating the Child with Cancer , edited by Nancy Keene and available from the Candlelighters Childhood Cancer Foundation free of charge. Depending on the type of treatment your child received, there will be other potential late effects of which you should be aware. There are several websites where you can get more information about these issues: www.beyondthecure.org and www.curesearch.org . |