ABSTRACT
The improvements in cancer curability, long-term survival and organ preservation after radiation treatment, as well as improvements in combined modality therapy have resulted in many patients living with the late adverse effects of treatment.1 The number of people diagnosed with cancer each year in the US is over 1 million and is expected to double by 2050, reflecting an aging population and increase in population size.2 Long-term follow-up of these individuals reveals progressive fibrosis and functional impairment of organs along with associated co-morbidities such as reduced tissue compliance, accelerated senescence of organs, the decline of endocrine function, cardiac dysfunction, joint stiffness, myelopathy, cognitive impairment and others.3 Evidence suggests that long-term survival after treatment for cancer in childhood is associated with increased risk of impaired quality of life with adverse consequences for many aspects of everyday life including personal care, education, employment and family and social relationships.4 Late adverse effects after cancer treatment during childhood cause substantial morbidity.
