Every parent whose child has been diagnosed with cancer wants to hear this word: remission. A complete remission is when the signs and symptoms of cancer have disappeared. Remission can also be partial, where some, but not all, signs and symptoms have disappeared.
Although the word is welcomed and even celebrated, it can also bring its own concerns and challenges. What do we do now? How can we ever relax? Do we need to maintain certain dietary and lifestyle routines? What happens if the cancer comes back? Will we be able to face life from now on without our cancer team by our side 24/7?
Path to better well-being
Remember, referral is a good thing. It means your child feels better physically. They have more strength, more energy, and more time to focus on being children, instead of spending all their time with doctors and treatments. Your son and his entire family have gone through a horrible experience. You may never go back to exactly what life was like before your child’s diagnosis. But life can (and should) be full and enjoyable for all of you in the future.
Today, many medical professionals equate cancer remission with the time and care needed to manage a chronic disease, such as diabetes. It is important to know that childhood cancer survivors will need follow-up and surveillance for the rest of their lives. They are now at greater risk for something called late effects. These effects may occur shortly after or many years after completing treatment.
Talk to your child’s oncologist (cancer doctor) for an overview of treatment. The summary should include what you need to care for your child in the future. Keep it in a safe place so you can share it with your child’s primary care doctor and any other specialists your child may see in the future.
You should also keep records of your child’s history. Right now, everything is fresh in your mind, but dates and events are easy to forget as the years go by. Write down key facts about your child’s cancer and treatment, including:
- The date of diagnosis.
- The type of cancer your child was treated for
- Pathology reports describing the type and stage of cancer.
- Dates and types of any imaging tests (such as MRIs or CT scans)
- Locations and dates of treatments (details of surgeries, sites and total amounts of radiation therapy, names and doses of chemotherapy and other medications, etc.)
- Any side effects or bad reactions to treatments or medications your child took.
- Names and contact numbers of key members of your child’s treatment team.
- Identify the number and title of any clinical trials in which your child participated.
- The end date of cancer treatment
How often your child will need to see the oncologist from now on will depend on the type of cancer and the treatments they have received. But in general, survivors usually return to the doctor every 3 to 4 months for the first 2 to 3 years after treatment. Beyond that, children typically need regular follow-up visits every 6 months to a year.
At each visit, your doctor will do a physical exam on your child and may check your child’s blood and perform tests such as an MRI or CT scan. They will look for side effects of the treatment and check to see if the cancer has returned or spread to other parts of the body.
Eat well and move more
From now on, it is important that your child continue a healthy diet and exercise program. A well-balanced diet can help your child regain energy and reverse some of the damage that medications and radiation may have caused. A healthy diet can also help prevent certain types of cancers that can occur later in life, such as colorectal cancer.
Include a variety of foods in your child’s meal plan. Make sure they include the following in their daily diet:
- Many vegetables, including dark green, red, and orange vegetables, legumes (beans and peas), starches, and other vegetables.
- whole fruits
- Cereals, of which at least half are whole grains.
- Fat-free or low-fat dairy products (such as milk, yogurt, and cheese)
- Different types of proteins, including seafood, lean meats and poultry, eggs, legumes (such as peas and beans), nuts, seeds, and soy products.
- Oils
Your child’s daily diet should limit:
- Saturated fats It’s found in things like fatty beef, butter, and fried foods. They should make up less than 10% of your child’s daily calories.
- Added sugars. Sugar and syrups are added to some foods and drinks when they are processed or prepared. This includes soda, candy, sweetened dairy products like ice cream, and sugary cereals. They should make up less than 10% of your child’s daily calories.
- Trans fat. They are fats that are solid at room temperature. Think stick margarine or anything that has the ingredient “partially hydrogenated oils.”
- Your child should consume less than 2,300 mg per day.
Your child should also get at least an hour of some type of physical activity most days of the week. They may need to start slowly. Start with 10 to 15 minutes of easy walking every day. As they feel stronger, add a few minutes at a time until they reach an hour per day.
Sleep is also important. Ask your doctor how much sleep your child should get each night for his or her age. Remember to limit screen time before bed and distractions in the bedroom so your child gets a good night’s sleep.
Make sure older children understand that smoking, alcohol, and drugs other than those prescribed can worsen the effects of chemotherapy or radiation. They may also increase the risk of secondary cancers.
If your child was under 11 years old when his or her cancer was diagnosed and treated, be sure to get your child vaccinated against HPV. this vaccine helps prevent the spread of the HPV virus, which causes genital warts and several types of cancer (most commonly cervical cancer). The vaccine is given when children are between 11 and 12 years old, but older teens and young adults can still receive it.
Things to consider
When a child has cancer, multiple treatments can be used to fight it. Unfortunately, these treatments do not differentiate between healthy and diseased cells. Because of this, children who have had cancer often experience what are called “late effects.” These are health problems that occur months or even years later. They can affect the child physically and mentally.
The appearance of late effects and their severity will depend on several factors, including:
- The type and location of the cancer.
- The age of the child at the time of diagnosis.
- The treatment used
- Family history
- The child’s future health habits.
That’s why regular follow-up care and a healthy lifestyle are so important for children who have had cancer.
As your child grows into adulthood, think about how to best transition his or her care to doctors who treat adults. While some pediatric oncologists provide follow-up care to their adult survivors, many do not.
Questions for your child’s doctor
- What kind of symptoms should I look for before calling you?
- Which doctors should my child see now that the cancer is gone?
- How often will they see a doctor?
- What can be done to address my child’s problems (pain, fatigue, etc.) after treatment?
- How long will it be until my child feels like himself again?
Resources
American Cancer Institute for Cancer Research: Treatment Tips: Planning and Preparation
American Cancer Society: Can cancer be cured?
National Cancer Institute: Looking Ahead: Life After Cancer Treatment
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