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Survivorship Following Childhood, Adolescent, and Young Adult Cancer

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Pediatric Oncology".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 7117

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Special Issue Editors

Dr. Magdalena Balcerek

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Guest Editor

Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and HumboldtUniversität zu Berlin, Augustenburger Platz 1, 13553 Berlin, Germany
Interests: cancer survivorship; supportive care

Dr. Judith Gebauer

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Guest Editor

Cancer Survivorship Care Unit, Universitiy Hospital of Schleswig-Holstein, Lübeck, Germany
Interests: cancer survivorship; late effects; health prevention and promotion

Special Issue Information

Dear Colleagues,

This Special Issue of Cancers will be dedicated to the current challenges and opportunities in cancer survivorship care, a medical field of growing importance. It is crucial that we work to better understand late effects and their dynamics after cancer treatment, to develop risk-adapted, individualised survivorship care. While suitable survivorship care models are required to promote health surveillance in survivors, it is also essential that a return to normal life be supported in the best possible way, for example, through preventive and supportive measures. This Special Issue will present research results in the form of in-depth evidence-based findings on late effects and innovative care approaches, contributing to strategies for optimising cancer survivorship.

Dr. Magdalena Balcerek
Dr. Judith Gebauer
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cancer survivorship
late effects
long-term follow-up care
supportive care
health prevention and promotion

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Published Papers (6 papers)

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Research

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14 pages, 436 KB

Open AccessArticle

Long-Term Young Adult Cancer Survivors with Ovarian Cancer: Subgroup Analysis of the Study “Expression VI–Carolin Meets HANNA–Holistic Analysis of Long-Term Survival with Ovarian Cancer”: The International NOGGO, ENGOT, and GCIG Survey

by Desislava Dimitrova, Eleftherios Pierre Samartzis, Dario Zocholl, Maria-Pilar Barretina-Ginesta, Katharina Leitner, Pavel Havelka, Patriciu Achimas-Cadariu, Cagatay Taskiran, Suzana Mittelstadt, Els Van Nieuwenhuysen, Gerd Bauerschmitz, Viola Heinzelmann-Schwarz, Ainhoa Madariaga, Uta Ringsdorf, Tibor Zwimpfer, Caterina Madroñal, Hans-Martin Enzinger, Sara Al Rubaish, Jalid Sehouli and Hannah Woopen

Cancers 2026, 18(7), 1183; https://doi.org/10.3390/cancers18071183 - 7 Apr 2026

Viewed by 492

Abstract

Background/Objectives: Ovarian cancer is typically diagnosed in postmenopausal women, so there are limited data available for young adult cancer survivors (YACS). The aim was to assess the patient perspective of YACS. Methods: In this international and multicenter cross-sectional survey study, patient history, long-term side effects, and patient perspective were assessed. Long-term survival was defined as survival of at least five years after cancer diagnosis. Two groups were defined: (1) 18–40 years and (2) ≥41 years. Results: Altogether, 1833 long-term survivors (LTS) have been recruited, with 1771 patients ≥41 years and 62 patients 18–40 years at recruitment. FIGO stages were similar; among the patients, 99.0% had received primary surgery followed by chemotherapy in 90.3%. Almost 50% still experienced long-term side effects. Patients ≤ 40 years reported more frequently not only gastrointestinal symptoms such as nausea/vomiting (44.4%, p = 0.01), bloating (59.3%, p = 0.038), and constipation (60%, p = 0.015) but also depression (31.4%, p = 0.02), lymphedema (45.3%, p = 0.026), and concentration difficulties (30.6%, p = 0.002). Distress levels were also higher in YACS, especially concerning insurance/finances, work/school, child care, worries, and sadness. Polyneuropathy and secondary cancer were the only side effects that were more frequent in the elder cohort (polyneuropathy: 20.3% vs. 4.3%, p = 0.002, and secondary cancer: 8.4% vs. 0%, p = 0.014). YACS were more physically active (p = 0.003) and interested in studies about long-term cancer survivorship in 87.2%. Conclusions: Long-term side effects are equally common in YACS after ovarian cancer, but with a focus on practical problems, mental health, gastrointestinal problems, and sexuality. This knowledge should be incorporated into follow-up care of ovarian cancer patients in order to improve quality of life. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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12 pages, 335 KB

Open AccessArticle

Structured and Unstructured Physical Activity, Screen Time and Quality of Life in Childhood Cancer Survivors

by Lauren Ha, Darcy Singleton, Claire E. Wakefield, Richard J. Cohn, David Simar and Christina Signorelli

Cancers 2026, 18(5), 752; https://doi.org/10.3390/cancers18050752 - 26 Feb 2026

Viewed by 551

Abstract

Background/Objectives: Childhood cancer survivors face long-term cancer-related health risks, and daily behaviours, such as physical activity and recreational screen use, may influence their long-term overall wellbeing. Yet, little is known about survivors’ knowledge and understanding of recommended guidelines or their patterns of structured and unstructured activity. This study aimed to (i) assess survivors’ knowledge of physical activity and screen time guidelines, (ii) describe their self-reported (un)structured activity and screen use across weekdays and weekends, and (iii) examine associations with health-related quality of life. Methods: This secondary analysis used data from a feasibility pilot study of an intervention for survivors aged 8–13 years who had completed cancer treatment at least 12 months earlier. Participants self-reported physical activity, recreational screen use, knowledge of guidelines, and health-related quality of life (HRQoL). We used descriptive statistics and non-parametric tests to analyse behavioural patterns and associations. Results: Over one-third of survivors underestimated or overestimated the recommended physical activity and screen time (35%), whilst 23–50% reported ‘don’t know’. Participation in ‘Physical Education’ classes at school did not differ between summer and winter school terms, yet there was greater participation in structured physical activities in winter compared to summer school terms (median 270 vs. 170 min/week). For unstructured physical activities, 69% reported engaging in a median of 60 min/week at school on most days of the week in summer, whilst most survivors (96%) did not report any unstructured activity in winter. Only 19% met the recommended daily minimum of 60 min of physical activity year-round. Excessive screen use increased from school days (19%) to weekends (46%), notably handheld device screen time. We did not find any significant associations between meeting physical activity and screen time recommendations and HRQoL. Conclusions: Survivors frequently engage in irregular structured and unstructured physical activity levels and increased screen time. These findings emphasise the need for targeted, year-round interventions to improve physical activity, reduce recreational screen use, and support long-term survivorship health. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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26 pages, 742 KB

Open AccessArticle

Understanding the Experiences of Adolescents and Young Adults Diagnosed with Cancer During Higher Education—An Exploratory Interview Study

by Anke W. Boumans, Margo J. van Hartingsveldt, Angela G. E. M. de Boer, Maaike M. Brus, Floor M. Hoddenbagh-Bosdijk, Milou J. P. Reuvers, Jack D. Morgan, Martijn M. Stuiver and Olga Husson

Cancers 2026, 18(2), 325; https://doi.org/10.3390/cancers18020325 - 20 Jan 2026

Viewed by 710

Abstract

Background/Objectives: Adolescents and young adults (AYAs) with cancer often begin their careers later in life and are at risk of negative work-related outcomes. Research into and tailored support programs for AYAs diagnosed during higher education remain limited. An improved understanding of AYAs’ experiences is essential in guiding the development of age-appropriate support programs. This study explored the impact of cancer and the challenges AYAs face in educational participation and the transition to work. Methods: A qualitative study was conducted with thirteen AYAs diagnosed with cancer during higher education. Participants were interviewed using a semi-structured guide. In collaboration with patient experts as co-researchers, data were analyzed via thematic analysis. Results: Eight analytically derived themes reflected AYA students’ experiences: (1) Meaning and importance of education, (2) Reduced performance, (3) Recovery and expectations, (4) Interruption and delay, (5) Transition to work, (6) Disclosure, (7) Challenges related to the context of students, and (8) Experienced lack of support. The themes were clustered into four overarching thematic categories: Meaningful participation, Impact on performance, Academic progress and career transition, and Challenges in navigation. Conclusions: Our findings provide greater insight into the significance of educational participation for AYAs. AYA students encounter challenges stemming from both diagnosis-related changes in functioning and from contextual factors tied to their roles as students and new starters in the labor market. Navigating the healthcare, education, and social systems is complex and AYAs often lack adequate support when resuming their education or transitioning to work. Tailored support programs in healthcare and educational settings should be developed to help AYAs harness their strong motivation to resume studies, enter the labor market, and achieve their full potential. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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26 pages, 732 KB

Open AccessArticle

Longitudinal Cohort Study of the Relationship Between Illness Perception, Perceived Social Support, and Psychosocial Quality of Life in Adolescents and Young Adults Newly Diagnosed with Cancer: Outcomes from a BRIGHTLIGHT Study

by Bethany Wickramasinghe, Lorna A. Fern, Rachel M. Taylor and Richard G. Feltbower

Cancers 2025, 17(12), 1918; https://doi.org/10.3390/cancers17121918 - 9 Jun 2025

Cited by 3 | Viewed by 2773

Abstract

Background/objectives: Social support can enhance psychosocial health-related quality of life (PSQOL) in adult cancer patients. Adolescents and young adults (AYAs) with cancer face unique psychosocial challenges that intersect with key developmental milestones. Theoretical models propose that illness perceptions and social support are key determinants of coping strategies and long-term health outcomes in this context. These may be especially salient for AYAs, for whom peer relationships and identity formation are central. Methods: We explored how perceived social support and illness perceptions influence PSQOL over time in AYA cancer patients through a secondary analysis of the BRIGHTLIGHT longitudinal cohort study. Results: BRIGHTLIGHT followed 830 young people aged 13–24 across five time points (6–36 months post-diagnosis). Multi-level modelling revealed that PSQOL improved over time but remained consistently lower in females (mean: 69.62, 95% CI: 70.69 to −68.55). Greater perceived support from friends was associated with poorer PSQOL (β: −0.77, 95% CI: −1.007 to −0.54) and linked to negative illness perceptions, longer hospital stays (β: 0.01, 95% CI: 0.00 to −0.02), longer diagnostic intervals (β: −0.009, 95% CI: −0.02 to −0.00), and poorer clinical communication (β: 0.52, 95% CI: 0.01 to −1.03). A patient interpretation exercise with BRIGHTLIGHT’s Young Advisory Panel contextualized these findings. Conclusions: While peer support could promote normalcy, it could also intensify distress through emotional pressure or social isolation. Future research should address not only access to social support but its quality and relevance to AYAs’ unique psychosocial needs. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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Review

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18 pages, 876 KB

Open AccessReview

Decoding Early-Onset Aging After Cancer: Hallmarks, Biomarkers, and Future Directions for Childhood and Young Adult Survivorship

by Jasper David Feldkamp, Nele Schmitt, Sanem Özayral and Mareike Frick

Cancers 2026, 18(4), 644; https://doi.org/10.3390/cancers18040644 - 16 Feb 2026

Viewed by 1083

Abstract

Survival rates for children, adolescents, and young adults (CAYA) with cancer have markedly improved over recent decades, resulting in a rapidly growing population of long-term survivors. However, many of these individuals experience late and long-term treatment-related effects that resemble conditions typically associated with advanced age, including cardiovascular disease, endocrine dysfunction, neurocognitive impairment, and secondary malignancies. This clinical constellation has led to the concept of therapy-induced accelerated aging, suggesting that cancer treatments provoke biological changes that mirror, and may accelerate, physiological aging processes. In this review, we examine current evidence for aging-associated molecular hallmarks in CAYA cancer survivors, focusing on epigenetic alterations, genomic instability, chronic inflammation, cellular senescence, telomere attrition, and mitochondrial dysfunction. Epigenetic age acceleration is consistently observed across multiple survivor cohorts and correlates with treatment exposures, lifestyle factors, and chronic health conditions, positioning DNA methylation-based clocks as promising integrative biomarkers. Likewise, clonal hematopoiesis—reflecting persistent genomic stress—appears enriched in survivors, particularly decades after therapy, and may serve as an indicator of long-term cardiovascular and hematologic risk. Immune dysregulation, inflammaging, and senescence markers further underscore the systemic impact of cancer therapies on biological aging pathways. While telomere shortening and mitochondrial alterations also contribute to this phenotype, their standalone biomarker utility remains limited. Together, these hallmarks highlight the multifaceted nature of accelerated aging in CAYA survivors. Future work integrating multi-omics biomarkers with clinical phenotyping will be essential to identify high-risk individuals, guide targeted interventions, and advance personalized survivorship care. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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Other

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21 pages, 748 KB

Open AccessSystematic Review

Definition, Prevalence and Management of Dyslipidemia in Patients and Survivors of Childhood and Adolescent Cancer—A Systematic Review

by Fiona L. Wagenseil, Luca Bühlmann, Stephanie B. Dixon, Matthew J. Ehrhardt, Sarah P. Schladerer, Cornelia Vetter, Maria Otth and Katrin Scheinemann

Cancers 2026, 18(5), 837; https://doi.org/10.3390/cancers18050837 - 4 Mar 2026

Viewed by 694

Abstract

Background/Objectives: There is little information on the definition and management of dyslipidemia in patients and survivors of childhood, adolescent and young adult (CAYA) cancer. However, it is known that this population is at higher risk of developing cardiovascular disease (CVD). Dyslipidemia, hypertension, and metabolic syndrome are common among CAYA cancer survivors due to the cancer itself or the treatment received. Therefore, managing dyslipidemia in this population is crucial to mitigate the risk of long-term CVD. The aim of this systematic review was to summarize currently used definitions and cutoffs for dyslipidemia, its prevalence, and management strategies in CAYA cancer survivors. This review further describes reported pharmacological and lifestyle interventions and their impact on lipid levels. Methods: We conducted a systematic literature search in PubMed, including studies published in English, German or French between January 2015 and February 2025. The population included individuals diagnosed with any type of CAYA cancer prior to 25 years of age and either receiving cancer treatment or in follow-up care. We considered all types of publications except for Phase I and II studies. We followed PRISMA guidelines, assessed the quality of the eligible studies according to the respective Joanna Briggs Institute’s Critical Appraisal Tools, and reported the results descriptively. Results: Of 575 identified publications, 53 fulfilled the inclusion criteria. Forty-three studies reported on the definitions of abnormal lipid values, 40 stated the prevalence of abnormal lipid values, and 17 studies described management approaches, of which 12 were case reports and small case series. For all three outcomes, the results were very heterogeneous. Using the example of triglycerides (TGs), the cutoff values for high TGs ranged from 5.17 mmol/L to 6.2 mmol/L and the reported prevalence of high TGs ranged from 0% to 75%, with an average of 31%. The only reported intervention to prevent dyslipidemia in CAYA cancer survivors was lifestyle modification. Preventive strategies that started during treatment were lifestyle modifications and fish oil supplements. Conclusions: Our systematic review provides a comprehensive overview of existing definitions, prevalences, and management of abnormal lipid values in CAYA cancer patients and survivors. However, the identified heterogeneities indicate that reported prevalences and results of interventions must be interpreted cautiously. An internationally harmonized approach to defining and reporting lipid values in CAYA cancer survivors is urgently needed to enable tailored screening and treatment strategies. Full article

(This article belongs to the Special Issue Survivorship Following Childhood, Adolescent, and Young Adult Cancer)

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