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Recognizing health risks in childhood cancer survivors


  • Mary Baron Nelson MS, RN, CPNP, CPON, ,

  • Kathy Meeske PhD, RN

  • Authors
    Mary Baron Nelson and Kathy Meeske are from the Long-term Information, Follow-up and Evaluation (LIFE) Program, Children's Center for Cancer and Blood Diseases, Childrens Hospital, Los Angeles. Mary Baron Nelson, MS, RN, CPNP, CPON, is a pediatric nurse practitioner at Childrens Hospital Los Angeles. Contact Ms. Nelson by e-mail at Kathy Meeske, PhD, RN, is a nurse researcher at the University of Southern California and Childrens Hospital Los Angeles. Contact Dr. Meeske by e-mail at

  • Acknowledgments
    The authors would like to thank Kathy Ruccione, RN, MPH, FAAN, for reviewing this manuscript.



To provide information about the special health needs of childhood cancer survivors through a discussion of Wilms’ tumor, a common childhood renal tumor, and case studies of two survivors of Wilms’ tumor, who encountered significant health problems as adults. This information may be generalized to many cancer survivors.

Data sources

Actual case studies as well as extensive review of the current literature on childhood cancer survivorship.


Adult healthcare practitioners may help to decrease morbidity of childhood cancer survivors in adulthood when they are knowledgeable about the risks of this population. Resources are readily available, both in the medical literature and on the Internet.

Implications for practice

With well-established success in the treatment of childhood cancer, there are many young and middle-aged adult survivors of the disease. However, as many as two-thirds of survivors may have chronic long-term effects of treatment. Most survivors eventually discontinue follow-up with their pediatric oncologists and receive primary health care from adult providers, many of whom are unaware of survivors’ health risks. Awareness of primary care providers regarding the special health needs of childhood cancer survivors is critical to decrease morbidity and improve quality of life. The ever-increasing number of childhood cancer survivors is creating a public health issue as they transition into adulthood.