Based on the medical history of each individual as summarized in the passport, follow-up recommendations are included.
The recommendations are based on guidelines developed as part of the international EU funded project PanCareSurFup in collaboration with the International Guidelines Harmonization group. Each guideline is defined after extensive literature review and discussion among experts and identifies:
- who is at risk of possible late effects such as infertility, thyroid or other endocrinal dysfunctions, cardiac, renal or other problems;
- what examinations are suggested to diagnose the condition in useful time;
- when and how often such examinations should be performed;
- what to do if an anomaly is observed.
Currently, the passport includes guidelines for screening on secondary breast cancer, male and female gonadal insufficiency, cardiomyopathy.
The risk of cancer increases for everyone as they get older. A survivor of childhood cancer may have an increased risk of developing a cancer in adulthood compared to people of similar age in the general population. There are several factors that can affect this:
Radiotherapy: receiving radiotherapy, especially at a young age and in a large dose, increases the risk of developing a second cancer in the area of your body that received radiation. These cancers are more likely to develop 10 years or more after treatment. The most common sites include the skin, the breasts, the bones, the brain, and the thyroid.
Treatment with certain chemotherapy drugs: there is a small risk of developing leukaemia after treatment with certain drugs e.g. etoposide, cyclophosphamide and drugs like adriamycin (doxorubicin). If leukaemia does develop this is usually within 10 years of treatment.
People who have a history of cancer in their family: some patients have inherited gene changes (mutations) that increase the chances of getting a second cancer.
Some cancer treatments can affect the heart.
Problems can arise even several years after the treatment has been completed.
Symptoms of heart failure can include:
- Feeling short of breath (breathless), especially during
activities such as walking up stairs, and when lying
flat at night. However, breathlessness may also be
due to other conditions such as lung problems, or
being unfit or overweight
- Increasing fatigue (extreme tiredness)
- Palpitations
- Dizziness or loss of consciousness
- Swollen ankles
Some cancer treatments can affect the heart.
Problems can arise even several years after the treatment has been completed.
Symptoms of heart failure can include:
- Feeling short of breath (breathless), especially during
activities such as walking up stairs, and when lying
flat at night. However, breathlessness may also be
due to other conditions such as lung problems, or
being unfit or overweight
- Increasing fatigue (extreme tiredness)
- Palpitations
- Dizziness or loss of consciousness
- Swollen ankles
