ABSTRACT
According to Langeveld and Arbuckle (2008), in the past survivors were often left on their own in the post-treatment period but increasing realisation of the complexity of long-term medical and psychosocial sequelae have resulted in late effects clinics being established. These clinics use a multidisciplinary approach to the ongoing support of survivors’ needs and clearly play a crucial role in maximising the likelihood of the best outcome for the young person. Recommendations for long-term follow-up include ‘yearly physical examination and history, risk modification, avoidance of heavy isometric exercise in higher risk patients, periodic echocardiograms … and early cardiology referrals for any detected abnormalities.’ (Soliman and Agresta 2008: 57)
Different malignancies necessitate differing lengths of time for follow-up. Earle (2007) says that as solid tumours are much less likely to recur after five years surveillance may become less intense over time than, for example, for melanoma which can recur decades later. He documents arguments that surveillance should continue until survival expectation approximates that of matched controls; but for patients with a personal cancer history that puts them at risk of new primaries, Earle suggests life-long follow-up may be appropriate.
