Presentation Description: This session reviewed the research literature on risks for psychological late-effects in AYA survivors, illustrated common presentations of psychological distress in survivors, and considered how the effects of cancer on adolescent development may impact later adjustment.
Speaker:
Christopher J. Recklitis, PhD, MPH
Clinical Psychologist
Dana-Farber Cancer Institute
Assistant Professor of Pediatrics
Harvard Medical School, Boston
Presentation Description: For the survivors of childhood or adolescent cancer, life-long follow-up is recommended to ensure appropriate surveillance for late complications of treatment and psychosocial support. In order to accomplish this, transition of follow-up care from pediatric to adult-focused providers is necessary. In addition, transition from adolescence to young adulthood raises numerous issues characteristic of the cancer survivor, including ensuring access to appropriate care, maintaining health insurance, finishing formal education, choosing a vocation, and adapting to new roles in the family and society. Many of these are especially acute for survivors with neuro-cognitive deficits. This panel utilized case vignettes to frame these issues and stimulate open discussion highlighting the challenges and strategies for addressing them.
Panel:
Kevin C. Oeffinger, MD
Full Member and Attending
Director, MSKCC Adult Long-Term Follow-Up Program
Department of Pediatrics and Medicine
Memorial Sloan-Kettering Cancer Center, New York
Wendy Hobbie, MSN, PNP-BC, FAAN
Associate Director
Cancer Survivorship Program
The Children’s Hospital of Philadelphia
David R. Freyer, DO, MS
Director, LIFE Cancer Survivorship & Transition Program
Children’s Center for Cancer and Blood Diseases
Children’s Hospital Los Angeles
Professor of Clinical Pediatrics
Keck School of Medicine, University of Southern California
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
Speakers:
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.
Panel:
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 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.
Speaker:
Lisa Diller, MD
Pediatric Oncologist
Dana-Farber/Boston Children’s Cancer Center
Professor of Pediatrics
Harvard Medical School, Boston