Childhood Cancer Survivorship

My childhood cancer survivor turns 19 today.  On his birthday, the anniversary of his diagnosis, and the anniversary of his completing chemotherapy, I am compelled to reflect on where we have been as a family, what we are blessed with, what we have survived, and what we face in the future.

Every year is a gift.  This past year has been eventful in the life milestones arena, with the completion of high school (every trimester on the honor roll), admission to college (the University of Iowa), and completion of a couple of college classes.  It really feels like the end of childhood and the beginning of adulthood.  And with each passing year we are further away from his childhood cancer and further into adulthood.

It is always a challenge to know the right mix of freedom and control that is right for a parent with their offspring, but once the child is in college, the parent has less control over behavior, and so they are left withcontrol over what they will and will not pay for.  The balance changes dramatically, and allows young adults to figure out for themselves what will be the ingredients for their success.  With a childhood cancer survivor, the situations is a little different, because there are significant health risks that are associated with getting radiation and lots of chemotherapy at a very young age.

In June JAMA published the first large study of prospectively gathered data on the health risks that childhood cancer survivors face, and it tells a very sobering tale.  At age 50, 83% of them had heart valve defects, 81% had pulmonary abnormalities, 76% of them had hormonal abnormalities, 86% had hearing loss, and 40% had a diagnosis of breast cancer.  By age 45, over 95% had a health problem directly attributable to their cancer treatment, and some, like breast cancer, were occuring at an early age.  Equally scary is the fact that the study revealed many health problems that the survivor was completely unaware of, and some had potentially treatable illnesses that were unknown to them. 

So, while I look forward to Ethan taking over his laundry and meal preparation,  I will remain in the health care equation for the time being in the hopes that my child will not be one of those who does not know.