In their article in The Lancet (Dec 9, p 2569),1 Bhakta and colleagues provide compelling data and novel statistical analysis to quantify the overwhelming lifetime cumulative burden of chronic health conditions caused by curative pediatric cancer therapies. As a 27-year survivor of Hodgkin’s lymphoma, I applaud the authors’ suggestion that it might be time to rethink the methods by which we provide care for long-term childhood cancer survivors. As a patient, I have had numerous encounters over the past three decades that have left me frustrated by the scarcity of easy access to coordinated comprehensive care for survivors. As a physician and pediatric oncologist, I also possess the knowledge that has allowed me to advocate for my care. I survived open-heart surgery at age 35, and a mild stroke at age 38—two of the many late health effects that impact my life. My good fortune is that I have been immersed in the medical system throughout my lifespan as a survivor, which has positioned me to receive the very best medical care. But what about survivors that do not have easy access to health care? Most survivors face financial obstacles and have difficulty finding high-quality coordinated care. Our current system does not effectively manage this medically underserved population. Childhood cancer survivors are frequently used to highlight the amazing successes of modern medicine. We owe it to these patients to develop more robust and comprehensive care systems to help address their ongoing chronic health needs.
