Thalamo-accumbal circuit adaptations following extended oxycodone abstinence.

Increasing long‐term survival rates of cancer diagnosed before the age of 18 years result in a constantly growing number of childhood cancer survivors (CCSs) worldwide []. In Germany, over 46,000 CCSs, who have survived their disease for 5 years or more, have been registered in the German Childhood Cancer Registry (GCCR) since 1980 []. The GCCR regularly carries out a questionnaire‐based follow‐up to track mortality, relapses, and subsequent neoplasms as well as maintain current contact details from this cohort as part of mandated duties [, , , ]. Even many years after a cure from the initial cancer, many CCS may experience cancer treatment‐related late effects resulting in increased morbidity and reduced health‐related quality of life [, ]. As these may present as complex chronic physical and mental health impairments, including fatigue [, ], CCS require risk‐adapted long‐term follow‐up (LTFU) care aiming at diagnosing and treating late effects in time. Despite increasing evidence that multidisciplinary life‐long LTFU reduces mortality and both physical and mental morbidity [, , ], optimal strategies to motivate CCS to engage in regular LTFU care remain unclear [], particularly among those who have not yet been systematically informed about potential late effects and care recommendations. Ideally, a first approach avoids inducing fear and insecurity. While CCS usually receive continuous LTFU while treated in the pediatric oncology department, care likely is disrupted at transition time points, for example, when CCS enter adulthood. In Germany, many of the adult CCS do not receive regular LTFU care, especially concerning mental health issues. Current guidelines recommend systematic screening for psychological disorders including psychological distress, mood disorders, anxiety, post‐traumatic stress disorder (PTSD) or related symptoms (PTSS) as well as fatigue [] at every LTFU visit [, ]. Besides counseling on mental health issues, CCS with significant impairments should also receive adequate mental health interventions that consider their childhood or adolescent cancer history. Such screenings and targeted interventions are essential for promoting a healthy lifestyle and enhancing adherence to LTFU care, as conditions such as mood disorders may increase the likelihood of risky health behaviors or avoidance of medical care [, ]. In addition, social aspects need to be considered in LTFU care of CCS, as some are at risk for poor educational and occupational outcomes, resulting in early retirement, unemployment, or long‐term incapacity for work, sometimes influencing their ability to live independently from their parents or other care persons []. Vice versa, such limitations to social inclusion may decrease mental and physical health [], highlighting the need for holistic, multidisciplinary LTFU and adequate care structures.