This year's list of aftercare centers for childhood cancer survivors in the United States has been compiled by a group of parents of survivors.

"The powerful drugs and radiation used to cure children affect developing minds and growing bodies," said Nancy Keene, co-author of Childhood Cancer Survivors: A Practical Guide to Your Future. "270,000 survivors of childhood cancer live in the U.S. and unfortunately, they often do not get comprehensive follow up to help them make the most of the lives they fought to win."

The list names 39 clinics across the U.S. To be included on the list an institution must:

• Have a dedicated time and place for a clinic designed to treat survivors of childhood cancer.
• Meet at least twice a month.
• Have a clinic coordinator (usually a nurse practitioner with special interest and skills in treating survivors).
• Be staffed by a doctor with experience in the late effects after treatment for childhood cancer.
• Provide state-of-the-art screening for individual's risks of late effects.
• Refer survivors to appropriate specialists (endocrinologists, cardiologists, etc).
• Provide wellness education.

Some examples of late effects after cure from childhood cancer are:

• Breast cancer at an early age in female Hodgkin's survivors who received mantle radiation (chest and neck) in their teens.
• Heart disease after treatment with chemotherapy (anthracyclines) or high-dose chest radiation.
• Learning disabilities in survivors treated with radiation and/or chemotherapy to the brain.
• Second cancers from chemotherapy drugs or radiation used to cure the first cancer.
• Symptoms of posttraumatic stress syndrome in survivors and their parents.
• Infection with the hepatitis C virus in some survivors who received transfusions prior to 1993.

Survivors need experienced help and advice to make the most of their life after cure. "Many of the 250 emails and phone calls we receive weekly are from survivors," said Ruth Hoffman, Executive Director of The Candlelighters Childhood Cancer Foundation. "Survivors need expert follow-up from trained professionals to improve quality of life through early detection and intervention for late effects from treatment. We now send them this list so that they can get the care they deserve."