P Yuen

Cancer in children differs from adult population in terms of incidence, prognosis and pattern. Annual incidence of cancer in children is reported to be 10-12 per 100,000 children between ages of 0-15 years.

With recent advances in medical sciences, the paediatric oncologists have made great strides in the diagnosis and treatment of childhood cancer. Approximately 65-70% of children and adolescents diagnosed to have cancer can be expected to survive five or more years, and vast majority of them will become members of the rapidly growing population of cured patients. This is especially true with patients diagnosed to have acute lymphoblastic leukaemia, the most common cancer in children.

The medical profession is faced with an ever increasing number of long-term survivors of childhood cancer, and increasing attention is now being directed towards the assessment of adverse effects of treatment toward the physical, social and mental well-beings of these children. A child's perception and health and quality of life is different from an adolescent or adult. The picture is further complicated by the fact that children change physically, emotionally and socially as they mature.

The first step in the establishment of a long-term follow-up clinic during the transitional conference is the identification of the family and patient's concerns. Secondly the late effects of treatment are made known to the patient and the family and the need of a long-term follow-up is emphasized. Thirdly, the importance of health maintenance is emphasized. Fourthly, one should make full use of community resources to rehabilitate these patients. No children's cancer centre is complete without a long-term follow-up clinic.