In 2023, rather than homing in on one specific disease group, we took the opportunity to look broadly at POGO’s 40-year history, and the significant changes in childhood cancer care over four decades. With this broad appeal, more than 215 participants joined the POGO Symposium with representation from nursing, pharmacy, physicians, students, government, allied health and community supporters; a testament to the true team effort required to care for our patients.
Dr. Mark Greenberg, POGO co-founder, opened the two-day event by guiding us from POGO’s inception and the many challenges faced, and the incredible successes along the way, to the important work that remains to be done. It was clear that POGO’s early achievements required tremendous persistence, tenacity and optimism by the founders, and led to POGO becoming a Ministry of Health-funded contributor to the childhood cancer care system. Our respective institutions and the children of this province are so fortunate for the work that has gone into creating and building POGO from the ground up and the vast improvements in childhood cancer care that POGO has facilitated.
A Comprehensive Approach to Childhood Cancer Care
One of the loudest themes that reverberated through this year’s event was the recognition that the best possible cancer care system moving forward will take a holistic approach to treating the child and supporting the family.
We heard about inspiring advances in therapeutics and how novel drugs such as blinatumomab, and entirely new classes of drugs, are showing promise to cure previously incurable cancers. Across all sessions, led by national and international experts, we reflected on improvements in outcomes and strategies for the future across many forms of childhood cancer, including acute lymphoblastic leukemia, neuroblastoma, Hodgkin lymphoma and solid tumours. Taking a step further into the future, Drs. Malkin and Shlien described incredible new technologies that bring together advances in molecular genetics and artificial intelligence, holding the promise to better elucidate the biological differences in seemingly similar tumours and more accurately target treatment to specific biological subtypes.
However, we also had the opportunity to acknowledge that cancer-directed therapy is not the totality of childhood cancer care, and that there are critical elements of high-quality treatment whose value is too often under-appreciated. Dr. Bob Phillips took us on an adventure through the world of supportive care and strategies for implementing clinical practice guidelines, POGO’s included. Dr. Kira Bona discussed the often overlooked and vital need to recognize and intervene on health disparities affecting our patients and their families. Food insecurity and material deprivation can have as big an impact on treatment outcome as many of the conventional prognostic factors we use routinely in clinical practice. Dr. Fiona Schulte spoke about the imperative need to provide psychosocial supports and measurable interventions for our patients, and Maria Talotta shared new opportunities for mental health supports for our patients and their families through Ontario’s Youth Wellness Hubs. As adverse social determinants of health become increasingly prevalent in Canadian society, it is more urgent than ever that we develop methods and infrastructure to reduce their impact on children with cancer.
We must also keep at the forefront of our minds that cure is not where our patients’ cancer journey ends. Many patients are left with late effects, and excellent survivorship care is paramount. Dr. Jennia Michaeli and Stacy Whiteside brought light to the importance of establishing fertility preservation for our patient population as standard of care. Finally, we heard through multiple sessions the inherent value in ensuring that our patients have a voice in their own decision making, and how best to enable this.
Childhood Cancer Survivors Thriving in the Medical Field
We had the pleasure of watching several digital stories from childhood cancer survivors who shared pieces of their journey. Each of these incredible individuals also shared how they were inspired by members of their care team to work in health care, in such roles as a nurse, physician, child life specialist, and program assistant. These stories remind us about the importance of the role we, as care providers, each play in the lives of our young patients.
The Path Ahead
We had the incredible opportunity to hear from a diverse panel about where the next healthcare dollars should be spent in improving care. We heard about the importance of integrating health disparities studies and interventions into our frontline trials, the need for improved psychosocial supports for patients and families, and the future potential of gene sequencing for both early detection and targeted therapy in childhood cancer. Chantelle Bacon and Iain Macri of Fight Like Mason Foundation and Mason’s parents, emphasized the need to provide education and support to physicians in recognizing red flags to enable earlier suspicion and diagnoses of childhood cancers. At the end, it was clear that a comprehensive approach that encompasses all of these elements is imperative.
POGO has shown us over 40 years that we are better together and that our collaboration and collegiality is what builds our successes. Cheers to 40 years of POGO and to the successes to come!
By Dr. Jennifer Seelisch, Director, Pediatric Undergraduate Medical Education, Children’s Hospital, London Health Sciences Centre. Dr. Seelisch was the 2023 recipient of the inaugural POGO Early Career Professional Award.
POGO Pre-Symposium Nursing Seminar Amplifies Nursing Perspective on Childhood Cancer Care
By Denise Mills
On Thursday, November 2, POGO’s 2023 Pre-Symposium Nursing Day presented a rich offering of niche programming that attracted more than 130 nurses and other allied healthcare professionals from across Canada.
Dr. Kitty Montgomery set the stage by discussing Patient Reported Outcomes (PROs), a theme that resonated throughout the entire Symposium. She highlighted how nurses are uniquely positioned to help children voice their symptoms, which is critical to patient-centred care. In her presentation on bioethics at the bedside, Dr. Kim Pyke-Grimm brought the issue of moral distress to the forefront and provided examples of ethics liaison programs.
We heard from many of Ontario’s skilled nurse practitioners as they shared their knowledge and leadership in such areas as late effects of neuroblastoma, skin care for patients receiving MEK inhibitors and providing care with blinatumomab.
The importance of supportive care was a central theme of the day. Dr. Lindsay Jibb shared her findings from her study on “Parental Distress and Trauma in Parents of Children Diagnosed with ALL.” We were also transported into the world of preventing and managing mucositis and how nursing can play a role in implementing clinical practice guidelines. We learned about the role that nurses play in providing care and discussing sensitive topics when caring for adolescent and young adult cancer patients and survivors, and we explored essential knowledge and skills to bring into practice when caring for children with cancer and autism.
Nurses comprise the highest number of healthcare professionals working in pediatric oncology, and this day was important in bringing these clinicians together from across Ontario and beyond to share and discuss nursing practice in caring for patients and families faced with a childhood cancer diagnosis.