Cancer does not prevent compulsory conscript service

Submitted on Wed, 10/04/2017 - 10:33
Kai Parkkola/ Kuva: Jonne Renvall
Kai Parkkola, professor of military medicine at the University of Tampere, praises Finnish register practices. The Finnish Cancer Registry and the results of tests conducted by the Finnish Defence Forces enable unique research.  Photograph: Jonne Renvall

Due to new treatments and changed attitudes, increasingly more former cancer patients are able to complete their military service

The Finnish Defence Forces approve increasingly more cancer survivors for compulsory military service. A recent study found that slightly over half of cancer survivors are accepted into military service. Kai Parkkola, professor of military medicine at the University of Tampere, was one of the researchers.

“This is a delightful result. Our study shows that the young men who have recovered from cancer do quite well during their military service,” Parkkola says.

The study also discovered that the youngest cohorts did the best in the call-ups and during the first few weeks of their military training.  According to Parkkola, this is because of improved cancer treatments.

In order for a cancer survivor to be accepted into military service, he or she must be estimated to be able to perform the service safely and be eligible for war time duty on the basis of a medical examination and a review by the call-up panel. Military service is currently only compulsory for men in Finland and about 27,000 conscripts are trained annually.

The study found that cancer survivors did not interrupt their compulsory military service more frequently than conscripts without a history of cancer. On average, they also attained the same level of education or ranks than the other conscripts.

This is only possible in Finland

The study followed-up on a total of 1,680 male patients born between 1960 and 1992 with a malignancy diagnosed before the age of sixteen.

“There are annually only about fifty men who fit the criteria of the research. That’s why we had to investigate conscripts over such a long period of time,” Parkkola explains.

Before 1991, cancer survivors were automatically exempt from compulsory military service.

“Finland is an excellent place to conduct such a study because the Finnish Cancer Registry is first-rate and the Finnish Defence Forces conduct physical and cognitive tests on the young men. This means that we are able to undertake research that would be practically impossible elsewhere,” Parkkola says.

Cancer survivors do well in the tests

Even though cancer treatments often leave a mark on the patient, the tests carried out by the Finnish Defence Forces did not reveal many differences between the former patients and the control group.

“The standing long-jump test was the only muscular strength test for which survivor groups performed worse than the controls. Another difference was the case of brain tumour survivors and their cognitive test results. There was a clear difference in their basic ability P1-test results, which measure general intelligence and visuospatial and mathematical abilities,” Parkkola says.

The study demonstrates that there are differences between how young men with different types of cancer are likely to manage in military service. For example, no differences were found in the case of former leukaemia patients. Radiation therapy, especially for brain tumours, involves the weakest prognosis.

Renal cancer survivors did the best in the call-ups, with 69 percent of the men accepted for military service. However, a significant number of them were classified in the class B fitness class.

According to the study, the opportunity to complete military service may improve cancer survivors’ social adaptation and their coping after cancer.

“I predict that in the future even larger numbers of cancer survivors will complete their military service in the usual way,” Parkkola says.

Text: Jaakko Kinnunen
Photograph: Jonne Renvall

Ahomäki Ritva, Harila-Saari Arja, Parkkola Kai, Matomäki Jaakko & Lähteenmäki Päivi M.: Compulsory military service as a measure of later physical and cognitive performance in male survivors of childhood cancer. Acta Oncologica, Accepted 29 June 2017, Published online: 15 July 2017