Childhood cancer survival rates have increased dramatically over the years. Today the National Cancer Institute (NCI) reports that about 80 percent of children diagnosed with cancer are alive five years after their diagnoses. And many of those survivors are living long into adulthood.

The NCI estimates that there are more than 10 million cancer survivors living in the United States alone, and at least 270,000 of them are considered to be childhood cancer survivors, meaning that they were diagnosed at age 21 or younger.

But along with long-term survival have come long-term late effects. Whereas the focus of childhood cancer treatment decades ago was simply to keep the child alive, the focus of treatment today is to keep the child alive and to minimize the chance of late effects that may cause significant health problems later in life.

"Our approach to getting rid of the mouse in the house seems to be to burn down the house, and that's not the best idea," says Joseph Neglia, M.D., M.P.H., a pediatric oncologist and member of the Masonic Cancer Center. "It would be nice to just be able to catch the mouse and put him back outside. But we do tend to rely on creating a lot of damage and hoping that the host will be able to recover and the cancer cannot."

Neglia says that is changing, however. The way oncologists can deliver radiation today, for instance, is much more targeted than it was 10 or 20 years ago, he says, which should reduce the amount of damage it does to normal tissue and reduce the occurrence of late effects.

New chemotherapy drugs are also coming out that don't have such harsh side effects, he says. And now that physician-researchers have started to make correlations between certain cancer drugs and late effects, they can try to ward off some of those long-term effects by giving their patients protective drugs—to prevent heart damage or hearing loss, for example—with their cancer treatment.

So through clinical research, Neglia hopes to find the right balance—where the therapy effectively gets rid of the cancer but doesn't cause long-term health problems. "It needs to work better," he says.

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The Growing Up After Cancer section of the Masonic Cancer Center Web site was produced by University of Minnesota School of Journalism and Mass Communication graduate student Nicole Endres. The section's medical content was written under the advisement of Masonic Cancer Center member Joseph Neglia, M.D., M.P.H.