treatment called chemo-embolization is used to treat childhood liver cancer. This involves injecting chemotherapy drugs into the main artery of the liver with substances that slow or stop tumor growth.

SUMMARY AND CONCLUSIONS

The trajectory of care for children with cancer spans diagnosis and treatment to later stages, including surveillance, rehabilitation, palliation, and end-of-life care. This report focuses on what happens after treatment, and in particular on the care related to late effects of cancer and its treatment. Childhood cancers are a diverse set of diseases and the treatment of each type of cancer varies considerably; and within each type of cancer, the intensity and approach used may vary depending on the child’s age, general health, and characteristics of the cancer. Because late effects arise following an interaction between the individual with cancer, the cancer, and the specifics of treatment, there is no clear map between a particular type of cancer or a specific treatment and an expected spectrum of late effects. Each factor must be considered in anticipating outcomes. Understanding late effects is further complicated by the constant evolution of treatments; they are, in effect, a moving target. While these aspects pose challenges to researchers and clinicians, patterns of late effects have emerged and their recognition has contributed to an appreciation of cancer as a chronic disease.

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