What is the overall childhood cancer survival rate?
80%
Higher doses of alkylating agents are linked to increased risk of?
infertility
Higher doses of MTX are linked to?
cognitive issues
Radiation to head, face, jaw or upper neck can cause1
lifelong dental problems, shallow roots, decreased saliva –> caries and gingivities
How can chemo lead to poor dental health
Chemotherapy can also change the acidity of the saliva, which can break down the enamel of the teeth and can also result in dental caries and gingivitis.
Along with glucocorticoids, what med can cause decreased bone mineral density?
high dose MTX
Most common causes of cognitive dysfunction?
XRT to brain, IT MTX, HD MTX, ARAC, and neurosurgery. the younger the patient, higher the risk
What is a side effect from radiation narrowing blood cessels
can cause heart issues esp if they have dyslipidemia
Women who have been exposed to >300 mg/m2 of anthracyclines should be cautious about what?
Pregnancy - need to be monitored carefully due to increased blood volume and stress on the heart
Which chemo agents can affect the lung?
lomustin, carmustine, bleomycin and TBI or thorax radiation
Pts who have had bleo should be careful about what activities?
High O2 concentrations, such as general anesthesia or scuba diving.
What chemos can cause long term renal issues
platinum-based (like cisplat, carbo, cpm)
What to warn a survivor with one kidney?
prompt UTI treatment, avoid dehydration, tell all providers
Long term endocrine/growth effects most closely associated with radiation above what amount
1800 cgy to the hypothalamic-pituitary axis
What is another risk of platinum based chemo (cisplat, carbo), or radiation or aminoglycosides
ototoxicity- hearing loss
Who is at the highest risk of therapy related AML
exposure to anthracyclines/alkylating agents
Females who recieved radiation to the thorax are at risk of what? how to screen?
secondary breast cancer, start screening at 25yo or 8y after radiation, whichever is last
