Surviving Adult Cancers. Part 1: Physiologic Effects

PURPOSE: To provide an overview of the physiologic long-term and late effects of adult cancers and cancer treatments by a review of the medical and nursing literature. DATA IDENTIFICATION: Primarily from an English-language literature search using MEDLINE (1980 to 1988) and Index Medicus (1980 to 1988). STUDY SELECTION: After a consensus review by four observers, 285 articles were selected that addressed the stated purpose. DATA EXTRACTION: Four observers assessed the literature using predetermined criteria for eliciting information about long-term and late effects. RESULTS AND DATA SYNTHESIS: Much has been written about the acute phases of cancer and cancer treatments. In comparison, relatively few data are available that define physiologic long-term: and late effects of cancer treatments in adult survivors. Review of the existing data showed that these sequelae may affect virtually any body system months or years after treatment ends. In addition, few prospective studies dealing with physiologic survivorship issues have been done. CONCLUSIONS: Health care providers need to be aware of long-term or late complications that may affect the increasing number of adult cancer survivors. Attention to treatment regimens in the acute cancer phase and careful follow-up once the disease is eradicated may help to prevent or manage these complications. More prospective research should be done in this area.