Implications of cancer therapy to the head and neck on growth and development and other delayed effects.

These studies of late effects related to cancer treatment to the head and neck demonstrate that these patients may develop a variety of abnormalities, the majority of which occur after irradiation. Once a child is "cured" of a primary malignant disorder, visits to oncologists usually continue but decrease in frequency. Regular visits to the dentist continue and are usually at least a biannual event. Attention to the details of the patient's previous medical history is of paramount importance if the delayed effects discussed here are to be suspected and recognized. Early diagnosis of thyroid and GH deficiencies and institution of appropriate hormone treatment may improve these children's growth and development. Recognition of cataracts and dry-eye syndrome is important to prevent visual difficulties. Careful oral examination and attention to the patient's general overall neurological presentation is an important adjunct to diagnosis of learning difficulties and early recognition of second tumors of the head and neck.