Frailty and quality of life in adult survivors of childhood cancer

Ness, Kirsten K.; Howell, Carrie R.; Bjornard, Kari L.

doi:10.1080/23809000.2017.1300507

Cited by 32 publications

(28 citation statements)

References 45 publications

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“…4 This is important because reversal and/or prevention of frailty may reduce the burden of disease, improve quality of life, and extend lifespan in this ever-growing population. 5 Components of the frailty phenotype are amenable to intervention in animal models, 6 and they show promise among the elderly. 7 However, interventions to remediate or prevent frailty in childhood cancer survivors have not been tested.…”

Section: Frailty In Adult Survivors Of Childhood Cancermentioning

confidence: 99%

Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer

Ness

Kirkland

Gramatges

et al. 2018

JCO

111

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The improvement in survival of childhood cancer observed across the past 50 years has resulted in a growing acknowledgment that simply extending the lifespan of survivors is not enough. It is incumbent on both the cancer research and the clinical care communities to also improve the health span of survivors. It is well established that aging adult survivors of childhood cancer are at increased risk of chronic health conditions, relative to the general population. However, as the first generation of survivors age into their 50s and 60s, it has become increasingly evident that this population is also at risk of early onset of physiologic aging. Geriatric measures have uncovered evidence of reduced strength and speed and increased fatigue, all components of frailty, among survivors with a median age of 33 years, which is similar to adults older than 65 years of age in the general population. Furthermore, frailty in survivors independently increased the risk of morbidity and mortality. Although there has been a paucity of research investigating the underlying biologic mechanisms for advanced physiologic age in survivors, results from geriatric populations suggest five biologically plausible mechanisms that may be potentiated by exposure to cancer therapies: increased cellular senescence, reduced telomere length, epigenetic modifications, somatic mutations, and mitochondrial DNA infidelity. There is now a critical need for research to elucidate the biologic mechanisms of premature aging in survivors of childhood cancer. This research could pave the way for new frontiers in the prevention of these life-changing outcomes.

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Section: Frailty In Adult Survivors Of Childhood Cancermentioning

confidence: 99%

Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer

Ness

Kirkland

Gramatges

et al. 2018

JCO

111

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show abstract

“…Late effects in childhood cancer survivors may be psychosocial/behavioral related, such as depression, anxiety and risky health behaviors, or physical related, such as cardiovascular disease, secondary malignancies, and hormone and immune deficiencies [4,5]. Many childhood cancer survivors thus carry a significant risk of late morbidity and mortality [6,7]. Health-promoting interventions aimed at assisting and supporting them in order to promote optimal quality of life in light of these difficulties are therefore needed.…”

Section: Introductionmentioning

confidence: 99%

A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors

et al. 2021

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Objectives Systematic mapping of the concept, content, and outcome of wilderness programs for childhood cancer survivors. Design Scoping review. Search strategy Searches were performed in 13 databases and the grey literature. Included studies describe participation of childhood cancer survivors in wilderness programs where the role of nature had a contextual and therapeutic premise. At least two authors independently performed screening, data extraction and analysis. Results Database searches yielded 1848 articles, of which 15 met the inclusion criteria. The majority of programs (73%) employed adventure therapy. Five activity categories were identified as components of wilderness programs: challenge/risk, free time/leisure, experiential learning, physical activity and psychotherapeutic activities. A majority of the participating childhood cancer survivors were female, white, aged 8–40 years, with a wide range of cancer diagnoses. Reported outcomes included increased social involvement, self-esteem, self-confidence, self-efficacy, social support, and physical activity. Key gaps identified included the absence of randomized controlled trials (RCTs), lack of studies on long-term effects, lack of information on the multicultural aspects of programs, and missing information on engagement in nature activities after the program ended. Conclusions This scoping review guides childhood cancer survivors, their families, practitioners, clinicians and researchers in the development and optimization of wilderness programs for childhood cancer survivors. In addition, it informs the utilization of these programs, and identifies gaps in the evidence base of wilderness programs. It is recommended that future study reporting on wilderness programs include more detail and explicitly address the role of nature in the program. Performing RCTs on wilderness programs is challenging, as they occur in real-life contexts in which participants cannot be blinded. Creative solutions in the design of pragmatic trials and mixed method studies are thus needed for further investigation of the effectiveness and safety of wilderness programs in childhood cancer survivors.

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“…This condition is known as frailty [ 6 , 7 ]. Frailty is a condition characterized by the onset of diseases related to aging and an increase in mortality; it can be observed both in older adults and childhood cancer survivors (CCS) [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Biological Aspects of Inflamm-Aging in Childhood Cancer Survivors

Paola

Pota

Argenziano

et al. 2021

Cancers

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Anti-cancer treatments improve survival in children with cancer. A total of 80% of children treated for childhood cancer achieve 5-year survival, becoming long-term survivors. However, they undergo several chronic late effects related to treatments. In childhood cancer survivors a chronic low-grade inflammation, known as inflamm-aging, is responsible for frailty, a condition characterized by vital organ failure and by premature aging processes. Inflamm-aging is closely related to chemotherapy and radiotherapy, which induce inflammation, accumulation of senescent cells, DNA mutations, and the production of reactive oxygen species. All these conditions are responsible for the onset of secondary diseases, such as osteoporosis, cardiovascular diseases, obesity, and infertility. Considering that the pathobiology of frailty among childhood cancer survivors is still unknown, investigations are needed to better understand frailty’s biological and molecular processes and to identify inflamm-aging key biomarkers in order to facilitate the screening of comorbidities and to clarify whether treatments, normally used to modulate inflamm-aging, may be beneficial. This review offers an overview of the possible biological mechanisms involved in the development of inflamm-aging, focusing our attention on immune system alteration, oxidative stress, cellular senescence, and therapeutic strategies.

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Frailty and quality of life in adult survivors of childhood cancer

Cited by 32 publications

References 45 publications

Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer

Premature Physiologic Aging as a Paradigm for Understanding Increased Risk of Adverse Health Across the Lifespan of Survivors of Childhood Cancer

A scoping review to map the concept, content, and outcome of wilderness programs for childhood cancer survivors

Biological Aspects of Inflamm-Aging in Childhood Cancer Survivors

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