The 2017 POGO Multi-Disciplinary Symposium on Childhood Cancer – Cancer in Infancy: Tiny Patients, Huge Challenges – examined clinical and scientific advances in cancer in infancy and the associated physical, psychosocial and medical issues, as well as focus on relevant resources, tools and strategies for a multidisciplinary audience.
Over 230 delegates representing a variety of disciplines attended the conference!
Click on the session titles below to view presentations that POGO has permission to share.
NOTE: The content of each presentation below captures the unedited information and opinions presented by the speakers. Please note that the information contained in the presentations was current at the time it was presented – there may be further information in subsequent literature. Listed speaker credentials were current at the time of presentation.
The Complex Nature of Neuroblastoma in Infancy
Rochelle Bagatell, MD
Developmental Outcomes for Infants with Cancer: Understudied and Underserved?
Melissa Alderfer, PhD
Retinoblastoma: An Eye to the Future
Furqan Shaikh, MD, MSc, FRCPC
In Utero Surgery: Exploring New Dimensions for Infants
Jacob Langer, MD
Anti-Cancer Drug Pharmacology in Infants and Very Young Children
Clinton Stewart, PharmD
Rare Tumours of Infancy
Rajkumar Venkatramani, MD, MS, FAAP
The Art and Science of Keeping Infants with Cancer Well-Nourished
Laura Collins, RD
Debbie O’Connor, PhD, RD
Measuring, Managing and Mitigating Cancer and Treatment Pain in Infants
Anna Taddio, PhD
Jason Thomas Maynes, PhD, MD
Developmental and Psychosocial Aspects of Caring for Infants with Cancer
Melissa Alderfer, PhD
Vanessa Burgess, MScOT, OT Reg. (ONT)
A Fine Balance Infection Control in Infants
Michelle Science, MD, MSc
Dana Devine, PhD
This session will cover unique aspects regarding the presentation and assessment of neuroblastoma in infants. Key features of the natural history of neuroblastoma in infants will be highlighted, as will molecular features of tumours occurring in our youngest patients. Issues pertaining to drug dosing and supportive care for infants with neuroblastoma will also be discussed. In addition, outcomes for infants with neuroblastoma will be compared and contrasted with outcomes in other patient groups.
Rochelle Bagatell, MD
Associate Professor of Pediatrics, Solid Tumor Section Chief, Division of Oncology
Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
Dr. Bagatell is a pediatric oncologist with an interest in extracranial solid tumours. She is the solid tumor section chief at The Children’s Hospital of Philadelphia where she leads a multi-disciplinary team committed to improving outcomes for children with high-risk solid tumours. In addition, she leads clinical research efforts designed to critically evaluate current therapies for children with high-risk and relapsed neuroblastoma, and is committed to conducting studies of new therapies for this population. She is the vice chair of the Children’s Oncology Group (COG) Neuroblastoma Disease Committee, and is chair of the upcoming COG Phase 3 trial for children with newly diagnosed high-risk disease.
It is widely accepted that young age at the time of a cancer diagnosis is a risk factor for poorer neurocognitive development. Tumours and cancer treatments that impact the central nervous system are believed to disrupt the brain growth and development that uniquely characterizes the first few years of life. These concerns have led to clinical trials focused upon modifying treatment protocols to decrease CNS-related insults while maintaining survival rates. However, comparison-controlled prospective studies of the neurocognitive development of infants with cancer are scarce and empirical investigations of interventions to address the poorer developmental outcomes of those diagnosed and treated for cancer during infancy are even more rare. This presentation will provide a review of the current literature regarding neurodevelopmental outcomes and interventions for infants with cancer. It will also summarize current gaps in our knowledge and provide suggestions for moving research and clinical care forward for this special population.
Melissa A. Alderfer, PhD
Senior Research Scientist, The Center for Healthcare Delivery Sciences
Nemours Children’s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE
Associate Professor of Pediatrics
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
Dr. Alderfer completed a doctorate degree in clinical psychology at the University of Utah and a post-doctoral fellowship in pediatric psychology in the Division of Oncology at The Children’s Hospital of Philadelphia (CHOP). After fellowship, she stayed on in the Division of Oncology at CHOP and joined the standing faculty in the Department Pediatrics at Perelman School of Medicine at the University of Pennsylvania. She rose to the level of associate professor before transitioning in 2013 to her current position as a senior research scientist in the Center for Healthcare Delivery Sciences within Nemours Children’s Health System. Under the broad umbrella of healthcare delivery science, her program of research focuses on how childhood chronic illness impacts families, how families adapt and learn to manage illness and the healthcare system, and how we can intervene to improve the experience. Her research has been funded by the National Institutes of Health, American Cancer Society, and various other cancer foundations. She currently has 92 peer-reviewed manuscripts and chapters.
Furqan Shaikh, MD, MSc, FRCPC
Staff Oncologist, Solid Tumour Section, Haematology/Oncology
Project Investigator, CHES, Research Institute
Director, Fellow’s Continuity Clinic
The Hospital for Sick Children, Toronto, ON
Assistant Professor, Paediatrics
University of Toronto, Toronto, ON
Dr. Furqan Shaikh received his medical degree from Queen’s University in 2003. He completed his pediatrics residency at the Children’s Hospital of Eastern Ontario in Ottawa and a fellowship in Paediatric Haematology/Oncology at The Hospital for Sick Children in Toronto. Dr. Shaikh is a paediatric oncologist in the Solid Tumour Program within the Division of Haematology/Oncology at The Hospital for Sick Children, and an assistant professor of paediatrics at the University of Toronto. He is a member of the Germ Cell Tumor subcommittee of the Children’s Oncology Group.
While survival rates for childhood cancer have improved considerably, the diagnosis of cancer in a child remains dreadful for caregivers. Psychosocial reactions are especially intense during the first few months of treatment. Caregivers experience negative moods, depression and symptoms of post-traumatic stress disorder. They are distressed. These normal reactions potentially limit caregivers’ ability to advocate for their child and family. This presentation provides an overview of the development of an evidence-based intervention called Bright IDEAS designed to teach coping skills we hypothesized would alleviate distress in caregivers. Bright represents optimism and feeling empowered, and IDEAS represents: Identify the stressor, Define your options, Evaluate your options, Act out your plan, and See if it worked. The presentation traces findings across three randomized clinical trials using Bright IDEAS consistently showing: 1. acceptability to caregivers, 2. Efficacy, 3. teaching coping skills leads to less distress, and 4. no harm. Most significantly, data showing effects after treatment ends are also presented. Current efforts to disseminate within the pediatric oncology community will be discussed in the context of standards of care and training psychosocial professionals, as well as efforts to disseminate to additional cohorts of caregivers (sickle cell, pediatric rehab medicine).
Robert B. Noll, PhD
Children’s Hospital of Pittsburgh, Pittsburgh, PA
Professor of Pediatrics, Psychiatry, and Psychology
University of Pittsburgh School of Medicine, Pittsburgh, PA
Robert Noll completed a doctorate in clinical psychology and did his clinical specialty training in pediatric psychology at Michigan State University following completion of his undergraduate degree and five years of military service as a naval aviator. Upon completion of his doctorate, he accepted a faculty position at Michigan State University in the Department of Pediatrics and Human Development. Dr. Noll subsequently went to Cincinnati Children’s Hospital Medical Center where he served as the director of psychosocial services in the division of hematology/oncology. From 2004-2011, he served as the medical director for behavioral health, and division director of developmental and behavioral pediatrics at Children’s Hospital of Pittsburgh. He served from 2006-2016 as chair of the Behavioral Science Committee within the Children’s Oncology Group. He has published extensively on psychosocial issues in pediatric oncology, notably documenting psychosocial difficulties for caregivers and subsequently developing evidence-based interventions. He is the author of more than 150 peer-reviewed publications and his pediatric oncology research has received funding from the National Cancer Institute, Alex’s Lemonade Stand, St. Baldrick’s Foundation and the American Cancer Society.