Presentation Description: This session provided an overview of four late effects research studies, funded by CIHR (Canadian Institutes of Health Research):
1) Neurocognitive-Phenome, Genome, Epigenome and Nutriome In Childhood Leukemia Survivors: N-PhenoGENICS
2) Preventing Cardiac Sequelae in Pediatric Cancer Survivors
3) Applying Biomarkers to Long-Term Effects in child and Adolescent Cancer Treatment
4) Early-Detection of Adverse Long-Term Treatment Effects in Childhood Leukemia Survivors
Shinya Ito, MD, FRCPC
Head, Division of Clinical Pharmacology/Toxicology, the Hospital for Sick Children
Professor, University of Toronto
Paul Nathan, MD, MSc, FRCPC
Director, AfterCare Program, The Hospital for Sick Children
Associate Professor, Pediatrics and Health Policy, Management & Evaluation, University of Toronto
Kirk R. Schulz, MD
Director, Childhood Cancer and Blood Research, BC Children’s Hospital and Child and Family Research Insittute, Michael Cuccione Childhood Cancer Research Program
Professor of Pediatrics, University of British Columbia
*NOTE – Kirk Schultz was unable to attend the Symposium. David Malkin (MD, FRCPC) presented his slides.
Daniel Sinnett, PhD
Professor, Department of Pediatrics, Université de Montréal
Research Scientist, Department of Hematology-Oncology, CHU Sainte-Justine Research Center
Presentation Description: Fertility preservation for female pediatric oncology patients is an issue of critical importance, but one that is fraught with ethical challenges. Since decisions regarding fertility preservation must ideally be made before treatment begins, parents, physicians, and patients are required to make complex decisions in a short amount of time under extreme stress. This session discussed both the ethics of preventing pediatric patients from becoming infertile in the first place, as well as ethical considerations related to survivors who are at high-risk of infertility.
Karen Glass, MD, FRCSC, FACOG
Reproductive Endocrinology & Infertility, Sunnybrook Health Sciences Centre & Women’s College Hospital, CReATeIVF Centre
Assistant Professor, University of Toronto
Ellen M. Greenblatt, MD, FRCSC; FACOG (REI)
Medical Director, Centre for Fertility and Reproductive health, Mount Sinai Hospital, Toronto
Associate Professor, University of Toronto
Randi Zlotnik-Shaul, JD, LLM, PhD
Director of Bioethics, The Hospital for Sick Children
Assistant Professor, Department of Pediatrics, Joint Centre for Bioethics, University of Toronto
Presentation Description: This presentation discussed cardiac complications seen in survivors of childhood cancer, including complications caused by anthracycline-associated cardiotoxicity and radiation. Approaches to cardiac late effects of cancer treatments, diagnosis and monitoring and best practices for prevention and treatment were also covered.
Ross Davies, BSc, MD, FRCPC, FACC
Member, Heart Failure, Transplant and Pulmonary Hypertension Programs
Head, Cardiology Referral Clinic, Division of Cardiology
University of Ottawa Heart Institute
Professor of Medicine
University of Ottawa
Presentation Description: This presentation focused on the clinical data that support interventions in survivor care which might impact favorably upon early detection or prevention of secondary malignancies. After a brief review of that data regarding the risks of specific types of cancers in survivors of childhood cancer and the associated risk factors for these cancers, this presentation reviewed available information that might drive clinical prevention or screening interventions. Recent advances in the understanding of oncogenesis that may define our thinking about cancer prevention in survivors were also discussed.
Lisa Diller, MD
Dana-Farber/Boston Children’s Cancer Center
Professor of Pediatrics
Harvard Medical School, Boston
Presentation Description: When a child is treated for cancer, the number of malignant cells exposed to chemotherapy and radiation is a tiny fraction of the normal cells also exposed. This unwanted exposure of normal tissues to the damaging effects of treatment is the cause of a wide array of acute and late toxicity, including infertility, cognitive impairment, and second malignancy.
This presentation described strategies to minimize the exposure of normal tissues to toxic exposures, principally radiation therapy but also chemotherapy, by advances in imaging, radiation delivery, and targeted therapeutics.
David Hodgson, MD, MPH, FRCPC
Princess Margaret Hospital, Toronto