Figure 2. 5-Year Survival Rate, Age 0-19.
Figure 3. Potential for Excess Mortality in Future.
Chemotherapy has a highly adverse effect on the physiologic aging of an individual. Changes noted in survivors are the shortened length of the telomeres which protect the end of chromosomes. Epigenetic alterations are commonly observed. 4 Direct damage to DNA can be produced by both radiation and che - motherapy. 5 On average, childhood cancer survivors are about 10 years older physiologically than their chronologic age. 6 This article outlines the long-term complications adult survivors of childhood cancer may incur. Con- cerning insurability, about 95% will develop a signifi - cant underwriting problem; one third experience a severe or potentially life-threatening complication.
Long-term complications arise from chemotherapy and/or radiation treatments used to treat the ma- lignancy. Radiation-related complications usually develop within the field of treatment and are strongly related to the age of administration. The younger the age of treatment, the greater potential for later complica- tions. Females receiving radiation treatment prior to age 30 are in an especially high-risk group to develop breast cancer. Chemotherapy-related complications are dose- and age-related and can affect multiple organs. To assess the potential for a future life expectancy affecting impairment, the minimal requirements
ON THE RISK vol.40 n.3 (2024)
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