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 (Reuters Health) – - Children who’ve had cancer may be more likely
to receive the follow-up care they need in adulthood if their
parents take the time to teach them how to interact with doctors
while they’re young, a recent study suggests.
“Parents who both act as a support for their children as they age
and encourage their young adults to take responsibility for their
health, for example talking to providers and understanding their
health and health care, can provide a valuable balance of support
and promotion of self-advocacy that is so important for young adults
to stay engaged in their care,” said lead study author Dr. Dava
Szalda.
Too often, adult survivors of childhood cancer don’t get appropriate
care even when they do get regular checkups, Szalda, a researcher at
the Children’s Hospital of Philadelphia, added by email.
“They may be seeing medical teams of some sort, but aren't getting
risk-based care which takes into account their cancer history and
treatment to create a long-term follow-up plan or to provide care
that addresses risk related to their prior treatment,” Szalda said.
While plenty of previous research has documented gaps in adult
follow-up care for childhood cancer survivors, the current study
focused on risk factors that parents and doctors of these children
may be able to change.
Researchers examined data on 80 young adult survivors of childhood
cancer who had finished treatment for their tumors at least five
years earlier.
Participants were about 28 years old on average, and ranged in age
from 23 to 36.
Most were diagnosed with cancer at around age 10, though some were
babies or as old as 22.
Roughly 39 percent had leukemia, a cancer of the blood cells, and
about 28 percent had lymphoma, or malignancies in the immune system.
Some of them also had tumors of the brain or other solid tissue.
They were more likely to receive appropriate adult follow-up care
when they were diagnosed at an earlier age, had insurance, got help
with health care decision-making and felt more comfortable speaking
to providers, researchers report in the Journal of Adolescent
Health.
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As young adults, childhood cancer survivors were more than twice as
likely to get needed medical care when they understood the risk of
tumors returning, the study found.
When they were comfortable discussing any concerns about their
health, they were more than three times as likely to get appropriate
follow-up care, the study also found.
These findings suggest that parents can boost the odds that kids get
better care as adults if they encourage their children to become
more involved in treatment while they’re growing up, the study
authors conclude.
Beyond its small size and its reliance on data from a single
hospital system, another limitation of the study is its dependence
on patients to accurately recall and report on their health care
utilization, the authors note.
Even so, the findings add to a growing body of evidence suggesting
that parents and doctors can take steps while cancer patients are
kids to increase the odds that they will get better care as adults,
said Kirsten Ness of St. Jude Children’s Research Hospital in
Memphis, Tennessee.
Many factors, like the long-term health risks linked to specific
tumors or treatments such as radiation may not be possible to avoid,
Ness, who wasn’t involved in the study, said by email.
Survivors may also not be able to influence things like whether they
can afford insurance or demographic factors that might make it less
likely that they receive needed care as adults, Ness said.
But there’s still plenty parents and clinicians can do, Ness said.
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