CION Ameerpet
Survivorship & transition care
Moving From Paediatric to Adult Follow-Up Care — What Happens at the Handover, and What Must Travel With You
Somewhere between sixteen and nineteen, care moves from the paediatric oncology team to an adult one. This is the point at which survivors most often drop out of follow-up — not because anyone decides to stop, but because the treatment history stops travelling with them. Here is when the move happens, what gets handed over, and the one document you should never be without.
Medically reviewed by Dr. Gangadhar Vajrala, Radiation Oncologist, MBBS · MD (Radiation Oncology) · MPH · Last reviewed August 2026
- Transition is a process, not a birthday — preparation usually begins around fourteen and the transfer itself happens somewhere between sixteen and nineteen, so there are years to get ready rather than one appointment.
- A written treatment summary does most of the work — fields treated, total dose, the chemotherapy record and the dates — an adult clinician holding that page can continue the right checks without guessing.
- Growth, schooling and fertility stay on the agenda — the questions that matter at nineteen are not the ones that mattered at nine, and the adult clinic should pick them up rather than close them.
- Late-effect risk runs for decades — surveillance thins out with time but does not end, which is exactly why the handover has to be planned rather than assumed.
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The timing
When Does the Move From Paediatric to Adult Follow-Up Happen?
Usually between the ages of sixteen and nineteen, and it should be planned rather than sudden. Preparation typically starts around fourteen, with the young person gradually taking the lead in their own appointments. The transfer itself happens once active treatment is well behind you and the follow-up schedule has settled into a steady rhythm.
The exact age varies from centre to centre, so there is no single national rule to quote. What matters far more than the number is whether the date is discussed or simply arrives. Ask at your next visit: at what age does this clinic transfer, and who will I be transferred to? A date you know about is a date you can prepare for.
Two things move at once. The clinical file moves from a paediatric team to an adult one. And the ownership of the story moves from the parent to the young adult. The second shift is the slower of the two, which is why it needs a running start rather than a single handover appointment. By the final year in paediatric care, the young adult should be able to name their diagnosis, the year of treatment, which parts of the body were irradiated and which checks fall due.
Radiotherapy for children, teenagers and young adults is delivered at NABH-accredited partner centres; CION Cancer Clinics coordinates the treatment plan, the oncology team and the follow-up that continues long after the final session.
Did you know?
Survivors are most likely to fall out of follow-up in the years immediately after leaving paediatric care. NCCN survivorship guidance and paediatric long-term follow-up guidance recommend the same fix — a written treatment summary and a risk-based survivorship care plan handed to the survivor themselves, not only posted to the next clinician.
The handover itself
What Is Actually Handed Over at Transition?
Three things. A written treatment summary recording what was treated and with what. A risk-based surveillance plan saying which checks are due and how often. And a named adult clinician who has accepted the file. If any one of the three is missing, ask for it in writing before the last paediatric visit ends.
Document 1
The treatment summary
Diagnosis and dates, the radiation fields and total dose, the chemotherapy record, any surgery, any transplant. One page if it can be done in one page.
Document 2
The surveillance plan
Which organ systems are being watched, which test does the watching, and at what interval — written out as a schedule, not buried in a paragraph.
Document 3
The plain-language letter
A short note the survivor can hand to any new doctor or clinic explaining the treatment history and what should be looked out for.
A person
A named adult clinician
Ask for the name and the department. A file transferred to “adult oncology” with no name attached is the file most likely to stall.
Access
How to get back in
The number to call if something changes between visits, and whether you can contact the clinic directly or need a fresh referral each time.
Consent
Who may be told what
From eighteen the young adult holds their own consent. Agree early what parents will and will not be copied into, rather than letting it change overnight.
The one thing that fixes this
What Must the Survivor Carry Forward?
One document, in your own hands: a treatment-summary card carrying your diagnosis, the treatment dates, the radiation fields and total dose, and the chemotherapy record. Keep a photograph of it on your phone. Every new doctor you meet over the coming decades will ask for it, and old hospital records are slow to retrieve.
Survivors rarely get lost at the handover because a clinician made a decision. They get lost because a letter went to an address someone had moved away from, or a file went to a department rather than a person, or a young adult moved city for college and nobody knew which clinic now held the schedule. A card in a wallet and a photograph on a phone quietly solves all three.
If you already have a summary, read it before you accept it. Check the fields treated, the total dose and the treatment end date against what you remember and against any letters you kept. Errors are far easier to correct while the paediatric team still holds the file. If you never received one, you can still request it — write to the unit that treated you and ask specifically for a treatment summary rather than the full record, because a summary is quicker to produce and much more useful to carry.
The questions do not close at transfer either. Growth and puberty are tracked through the teenage years. Schooling, exams and career plans keep colliding with appointments. Fertility should have been raised before treatment where that was possible, and it deserves raising again as an adult, directly, with or without a parent in the room. Carrying the card is what lets the next clinician pick those threads up instead of starting from nothing.
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Planning the Move to Adult Follow-Up?
Talk to a radiation oncologist about what belongs in your treatment summary and which checks should continue once the file has moved.
Stage by stage
How Does a Planned Transition Actually Work?
A typical shape. Ages and stages differ between centres — use this to know what to ask for, not as a substitute for your own clinic’s written plan.
1
Age 12–14 — the conversation starts
The team begins explaining the diagnosis and the treatment directly to the young person, in words they can repeat. Nothing transfers yet.
2
Age 14–16 — taking the lead
The young person answers the history questions themselves and starts confirming their own appointments. Part of each visit happens without a parent in the room, so questions about fertility, mood and relationships can actually be asked.
3
Age 16–18 — the file is written
The treatment summary and the surveillance plan are drafted and checked against the radiotherapy planning records held at the partner centre, then given to the young adult in writing rather than only filed.
4
Around 18 — consent and contact details move
The young adult now holds their own consent and their own contact record. Agree with the family what is still shared, and update the phone number and address the clinic actually uses.
5
Age 16–19 — the transfer visit
A named adult clinician accepts the file, ideally at a joint appointment. Get the name, the department and the date of the first adult appointment before the paediatric clinic closes its file.
6
First adult appointment — confirm the schedule
Bring the card. Confirm which checks continue, at what interval, and who to contact between visits. Leave with the next date written down.
The treatment-summary card
What Goes on the Treatment-Summary Card?
Seven lines do most of the work. Fill them from your records, then have the treating team check and sign them off.
| Line on the card | What to write | Why an adult clinician needs it |
|---|---|---|
| Diagnosis and date | The exact diagnosis, your age at diagnosis and the year it was made | Sets the starting point for every later decision about what to watch |
| Radiation fields | Which parts of the body were treated — brain, neck, chest, abdomen, pelvis, spine, or whole body | Late-effect surveillance follows the field that was treated, not the diagnosis |
| Total dose and technique | The total dose in Gray, the number of fractions, and the technique used | Dose and field together decide which checks are due and how often |
| Chemotherapy record | Copy the treatment sheet exactly as written, including cumulative amounts — do not summarise it | Some treatments carry heart or hearing effects that need lifelong monitoring; the adult team needs the exact record to know which |
| Surgery and transplant | Any operation, and whether a stem-cell transplant with total body irradiation was involved | A transplant history changes the whole shape of the surveillance plan |
| Treatment end date | The date of the final session | Every follow-up interval is counted forward from this date |
| Late effects already known | Anything already identified — hormone, thyroid, hearing, growth, heart, fertility | Stops the adult team re-investigating from zero and losing months doing it |
Where radiotherapy was delivered at an NABH-accredited partner centre, the dose, fields and fraction details sit in that centre’s planning records — name the centre and the approximate dates when you request them. CION Cancer Clinics coordinates that request alongside your oncology team.
For the young adult
What Should You Do in the Year Before Transfer?
Six things that turn a handover into a continuation.
- Ask for the treatment summary in writing — then read it. Errors are far easier to fix while the paediatric team still holds the file.
- Learn to tell your own story in two minutes — diagnosis, age at treatment, what was treated, what is being watched now.
- Take part of every appointment alone — fertility, mood, alcohol, contraception and relationship questions rarely get asked with a parent in the room.
- Raise fertility directly — it should be discussed before treatment where possible and again through the teenage years. If nobody has brought it up with you, bring it up yourself.
- Get the name and the date — the adult clinician’s name, the department, and the date of the first adult appointment, before the paediatric file closes.
- Back the card up — a photograph on your phone and a copy with one trusted family member, so a lost wallet is an inconvenience rather than a gap in your history.
Families who have made the move
Hear From Families Who Have Been Through the Handover
Every treatment history is different, and so is the follow-up that comes with it — talk to our team about yours.
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Common questions
Paediatric to adult follow-up transition — questions survivors and parents ask
When does transition from paediatric to adult cancer follow-up happen?
Usually between the ages of sixteen and nineteen, though the exact age varies by centre. The preparation starts much earlier, often around fourteen. It is meant to be a planned process rather than a single appointment: the young person gradually takes the lead in their own consultations, the treatment summary and surveillance plan are written down, and only then does the file move to a named adult clinician. Ask your paediatric team two questions at your next visit — at what age does this clinic transfer, and who will I be transferred to. A date you know about is a date you can prepare for.
What is handed over when care transfers to an adult team?
Three things. A written treatment summary recording the diagnosis, the dates, the radiation fields and total dose, the chemotherapy record, any surgery and any transplant. A risk-based surveillance plan saying which organ systems are watched, by which test, and at what interval. And a named adult clinician who has accepted the file, with a department and a first appointment date. A file sent to a department with no name attached is the file most likely to stall. If any of the three is missing at your last paediatric visit, ask for it in writing before that visit ends.
What must a childhood cancer survivor carry forward into adult care?
One document, held by the survivor rather than only by a hospital. A treatment-summary card listing the diagnosis and the year, the radiation fields treated, the total dose and technique, the chemotherapy record copied exactly from the treatment sheet, any surgery or transplant, the treatment end date, and any late effect already identified. Keep a photograph of it on your phone and give a copy to one trusted family member. Every new doctor over the coming decades will ask what was treated and with what, and old hospital records can be slow or impossible to retrieve.
What if I never received a treatment summary?
You can still ask for one, and it is worth doing even years later. Write to the paediatric oncology unit that treated you and request a treatment summary rather than the full file — a summary is shorter to produce and far more useful to carry. Where radiotherapy was delivered at a partner centre, the dose, fields and fraction details sit in that centre's planning records, so name the centre and the approximate dates in your request. If pieces cannot be found, record what is known and mark the gaps clearly. An adult clinician can work with a partial history that is honest about what is missing.
Do parents still get told what is happening after the survivor turns eighteen?
From eighteen the young adult holds their own consent, so information is shared with parents only with that person's agreement. In practice most families settle this well before the birthday: who comes into the room, who is copied into letters, and who the clinic calls if an appointment is missed. It helps to agree it openly rather than let it change overnight. Many young adults choose to keep a parent involved for the practical parts and hold the private conversations — fertility, mood, relationships — on their own. Both are reasonable, and the choice belongs to the survivor.
Does moving to adult care mean follow-up appointments stop?
No. The frequency usually falls, but the surveillance continues. Recurrence checks tend to be most intensive in the early years and then ease off, while late-effect surveillance becomes more relevant with time, because it watches for slow changes to hormones, heart, hearing, bone health, fertility and any second cancer in an irradiated area. NCCN survivorship guidance and paediatric long-term follow-up guidance both describe follow-up as risk-based and lifelong rather than ending at a fixed number of years. What changes at transition is who holds the schedule, not whether there is one.