scholarly journals eHealth tools for childhood cancer survivorship care: A qualitative analysis of survivors’, parents’, and general practitioners’ views.

2021 ◽  
Author(s):  
Maria Schaffer ◽  
Jordana McLoone ◽  
Claire Wakefield ◽  
Mary-Ellen Brierley ◽  
Afaf Girgis ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
General Practitioners ◽  
Medical Information ◽  
Childhood Cancer Survivors ◽  
Survivorship Care ◽  
Perceived Benefits ◽  
Telephone Interviews ◽  
Childhood Cancer Survivorship ◽  
Survivors Of Childhood Cancer

Purpose: The long-term management of childhood cancer survivors is complex. Electronic health (eHealth) technology has the potential to significantly improve the management of late effects for childhood cancer survivors and assist their General Practitioners (GP) to coordinate their care. We assessed the acceptability of and perceived benefits and barriers to eHealth use amongst survivors, parents, and GPs. Methods: We conducted semi-structured telephone interviews with survivors of childhood cancer, parents of childhood cancer survivors and their nominated GP. We described a hypothetical eHealth tool and asked participants how likely they would use the tool to manage their survivorship care and their perceived benefits and concerns for use of the tool. We used content analysis to synthesise the data using QSR NVivo12. Results: We interviewed 31 survivors (mean age: 27.0), 29 parents (survivors’ mean age: 12.6) and 51 GPs (mean years practising: 28.2). Eighty-five percent of survivors and parents (n=51), and 75% of GPs (n=38) indicated that they would be willing to use an eHealth tool. Survivors and parents reported that an eHealth tool would increase their confidence in their ability, and their GP’s ability, to manage their survivorship care. GPs agreed that an eHealth tool would provide easier access to survivors’ medical information and increase their capacity to provide support during survivorship. 7% of GPs (n= 4) and 43% of survivors (n=26) reported being hesitant to use eHealth tools due to privacy/security concerns. Conclusion: Overall, eHealth tools were reported to be acceptable to childhood cancer survivors, their parents, and their GPs.

scholarly journals Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study

2019 ◽  
Vol 37 (24) ◽  
pp. 2120-2130 ◽  
Author(s):  
Chaya S. Moskowitz ◽  
Joanne F. Chou ◽  
Joseph P. Neglia ◽  
Ann H. Partridge ◽  
Rebecca M. Howell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivor ◽  
De Novo ◽  
Childhood Cancer Survivors ◽  
Childhood Cancer Survivor ◽  
Malignant Neoplasms ◽  
Childhood Cancer Survivor Study ◽  
Survivors Of Childhood Cancer

PURPOSE Female survivors of childhood cancer have a high risk of subsequent breast cancer. We describe the ensuing risk for mortality and additional breast cancers. PATIENTS AND METHODS Female participants in the Childhood Cancer Survivor Study, a cohort of 5-year survivors of cancer diagnosed between 1970 and 1986 before age 21 years, and subsequently diagnosed with breast cancer (n = 274; median age at breast cancer diagnosis, 38 years; range, 20 to 58 years) were matched to a control group (n = 1,095) with de novo breast cancer. Hazard ratios (HRs) and 95% CIs were estimated from cause-specific proportional hazards models. RESULTS Ninety-two childhood cancer survivors died, 49 as a result of breast cancer. Overall survival after breast cancer was 73% by 10 years. Subsequent risk of death as a result of any cause was higher among childhood cancer survivors than among controls (HR, 2.2; 95% CI, 1.7 to 3.0) and remained elevated after adjusting for breast cancer treatment (HR, 2.4; 95% CI, 1.7 to 3.2). Although breast cancer–specific mortality was modestly elevated among childhood cancer survivors (HR, 1.3; 95% CI, 0.9 to 2.0), survivors were five times more likely to die as a result of other health-related causes, including other subsequent malignant neoplasms and cardiovascular or pulmonary disease (HR, 5.5; 95% CI, 3.4 to 9.0). The cumulative incidence of a second asynchronous breast cancer also was elevated significantly compared with controls ( P < .001). CONCLUSION Mortality after breast cancer was higher in childhood cancer survivors than in women with de novo breast cancer. This increased mortality reflects the burden of comorbidity and highlights the need for risk-reducing interventions.

scholarly journals Diabetes and Metabolic Syndrome in Survivors of Childhood Cancer

2019 ◽  
Vol 91 (2) ◽  
pp. 118-127 ◽  
Author(s):  
Danielle Novetsky Friedman ◽  
Emily S. Tonorezos ◽  
Paul Cohen
Keyword(s):  
Metabolic Syndrome ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Premature Mortality ◽  
Childhood Cancer Survivors ◽  
Cardiometabolic Health ◽  
Metabolic Complications ◽  
Survivors Of Childhood Cancer ◽  
Risk Reducing

Endocrine complications, including diabetes and metabolic syndrome, are highly prevalent in childhood cancer survivors. These metabolic derangements may contribute to survivors’ risk of excess cardiovascular morbidity and premature mortality. This review summarizes existing knowledge on risk of diabetes and metabolic syndrome among childhood cancer survivors, focusing specifically on known risk factors, potential mechanisms, and screening recommendations. Early diagnosis via standardized risk-based screening can improve long-term outcomes in this population. Additional work is needed to elucidate the mechanisms underlying these metabolic complications and to inform the design of risk-reducing interventions and optimize long-term cardiometabolic health among survivors of childhood cancer.

School Counselors and Survivors of Childhood Cancer: Reconceptualizing and Advancing the Cure

2010 ◽  
Vol 14 (2) ◽  
pp. 2156759X1001400
Author(s):  
Stephanie San Miguel Bauman
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
School Counselors ◽  
Cancer Survivorship ◽  
Academic Career ◽  
Childhood Cancer Survivors ◽  
Research Literature ◽  
Social Concerns ◽  
Survivors Of Childhood Cancer

School counselors increasingly will encounter childhood cancer survivors. This article explains why the cure for cancer consists of more than the eradication of the disease and includes the amelioration of academic, career, personal, and social concerns. Drawing on the research literature, the article discusses different stages of cancer survivorship and possible ways that school counselors may advance a cure for cancer as they meet the needs and encourage the development of every student survivor.

Randomized trial assessing the impact of survivorship care plans on the quality of care for childhood cancer survivors.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10007-10007
Author(s):  
Cary Philip Gross ◽  
Wilhelmenia Lee Ross ◽  
Jaime L. Rotatori ◽  
Hannah-Rose Mitchell ◽  
Xiaomei Ma ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Cancer Survivors ◽  
Randomized Trial ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
The Impact

scholarly journals Randomized Trial of the Impact of Empowering Childhood Cancer Survivors With Survivorship Care Plans

2018 ◽  
Vol 110 (12) ◽  
pp. 1352-1359 ◽  
Author(s):  
Nina S Kadan-Lottick ◽  
Wilhelmenia L Ross ◽  
Hannah-Rose Mitchell ◽  
Jaime Rotatori ◽  
Cary P Gross ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Randomized Trial ◽  
Childhood Cancer ◽  
Childhood Cancer Survivors ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans ◽  
The Impact

scholarly journals METABOLIC SYNDROME PARAMETERS, DETERMINANTS, AND BIOMARKERS IN ADULT SURVIVORS OF CHILDHOOD CANCER: PROTOCOL OF THE DUTCH CHILDHOOD CANCER SURVIVOR STUDY METABOLIC SYNDROME (DUTCH LATER METS STUDY) (Preprint)

2020 ◽  
Author(s):  
Vincent Pluimakers ◽  
Marta Fiocco ◽  
Jenneke van Atteveld ◽  
Monique Hobbelink ◽  
Dorine Bresters ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Previous Treatment ◽  
Adult Survivors ◽  
Childhood Cancer Survivors ◽  
Snp Analysis ◽  
Cross Sectional ◽  
Survivors Of Childhood Cancer

BACKGROUND Potential late effects of treatment for childhood cancer include adiposity, insulin resistance, dyslipidemia and hypertension. These risk factors cluster together as metabolic syndrome (MetS) and increase the risk for development of diabetes mellitus and cardio- and cerebrovascular disease. Knowledge on risk factors, timely diagnosis and preventive strategies is of importance to prevent cardio- and cerebrovascular complications and improve quality of life. Currently, no studies in national cohorts on prevalence and determinants of MetS in childhood cancer survivors including biomarkers and genetic predisposition are available. OBJECTIVE The objectives of the Dutch LATER METS study are to assess 1) the prevalence and risk factors of MetS and its separate components, and 2) the potential value of additional biomarkers, in the national cohort of adult long-term survivors of childhood cancer. METHODS This is a cross-sectional study, based on recruitment of all survivors treated in the Netherlands between 1963 and 2002. MetS will be classified according to the definitions of the National Cholesterol Education Program (NCEP-ATP III) as well as the Joint Interim Statement (JIS), and compared to reference data. Dual-energy X-ray absorptiometry (DXA) scans were performed to assess body composition in more detail. The effect of patient characteristics, previous treatment, and genetic variation on the risk of MetS will be assessed. The diagnostic and predictive value of novel biomarkers will be tested. RESULTS Patient accrual started in 2016 and lasted until April 2020. A total of 2380 survivors has participated, in seven pediatric oncology hospitals. From July 2020, biomarker testing, SNP analysis and data analysis will be performed. CONCLUSIONS The Dutch LATER METS study will provide knowledge on clinical and genetic determinants of MetS, and the diagnostic value of biomarkers, in childhood cancer survivors. The results of this study will be used to optimize surveillance guidelines for MetS in survivors, based on enhanced risk stratification and screening strategies. This will improve diagnosis of MetS, and prevent complications. CLINICALTRIAL Registered at toetsingonline.nl, NL32117.018.10

Nurse navigation: The key to a seamless transition.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 84-84
Author(s):  
Joy M. Fulbright ◽  
Wendy McClellan ◽  
Gary C. Doolittle ◽  
Hope Krebill ◽  
Robin Ryan ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Cancer Survivorship ◽  
Childhood Cancer Survivors ◽  
Primary Care Providers ◽  
Survivorship Care ◽  
Care Providers ◽  
Nurse Navigator ◽  
Seamless Transition

84 Background: Children's Mercy (CM) established a cancer survivorship clinic that cares for approximately 180 survivors a year. A third of the survivors are 18 years or older requiring transition to adult care. The importance of transitioning childhood cancer survivors from pediatric oncology care to adult primary care has been acknowledged in literature, but obstacles remain. Barriers include patient and provider anxiety, difficulty navigating the complex health care system and lack of knowledge regarding late effects. CM and The University of Kansas Cancer Center (KUCC) collaborated to decrease barriers to transition for childhood cancer survivors. Methods: The work group met for 2 years to develop the clinic at KUCC. Models and delivery of survivorship care, including the breast cancer survivorship clinic at KUCC, were reviewed. A shared nurse navigator was identified as an essential component to a seamless transition. Philanthropic support was obtained and job description was developed. Contracts were negotiated to allow the navigator to be present at both institutions. Results: The Survivorship Transition Clinic (STC) at KUCC launched July 2014, with a navigator supporting patients at CM as they begin their transition. The same navigator then meets with the patient at KUCC STC as they initiate care. The navigator provides treatment summaries, patient education and navigates the referral services for survivors. Since clinic launch, 16 survivors out of 16 have successfully transitioned from pediatric to adult survivorship care. Positive feedback was received from patient satisfaction surveys that were administered. A common theme showed a relief from anxiety due to having a contact person to facilitate communication among providers in a complex healthcare system. Conclusions: The nurse navigator has minimized anxiety about transition for patients and parents as she establishes a relationship with patients at CM, and then is able to provide continuity as they transition to the STC at KUMC. The navigator also improves communication between pediatric providers, adult primary care providers and sub-specialists caring for the patients. Overall, our transition process has been effective and is now serving as a model across both institutions.

scholarly journals Late effects of treatment in survivors of childhood cancer from a tertiary cancer center in South India

2014 ◽  
Vol 03 (01) ◽  
pp. 060-065 ◽  
Author(s):  
Rejiv Rajendranath ◽  
Surendran Veeraiah ◽  
Anita Ramesh ◽  
Tenali Gnana Sagar
Keyword(s):  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Childhood Cancer Survivors ◽  
Cancer Center ◽  
Adult Intelligence Scale ◽  
Intelligence Scale ◽  
Wechsler Adult Intelligence Scale ◽  
Survivors Of Childhood Cancer ◽  
Tertiary Cancer Center

Abstract Background: Improved survival after childhood cancer is attributed to intensive, aggressive therapy, adverse sequelae of which can manifest months to years after completion of treatment. There is little information about the late adverse effects of both childhood cancer and its therapy in survivors in India. Aim: To determine the long-term sequelae associated with therapy in childhood cancer survivors attending a tertiary cancer center in India. Materials and Methods: We studied 155 consecutive survivors of childhood cancer who were ≤14 years at the time of diagnosis and had completed 3 years of follow-up. The study included a complete history and clinical examination, with specific investigations to detect organ toxicity. Quality of life (QOL) was assessed from responses to a standardized questionnaire. Neurocognitive assessment was carried out in 20 survivors with an adaptation of the revised Wechsler adult intelligence scale for adults and the Malins intelligence scale for children. Results: The late effects included impaired fertility in 38 patients (24.5%), impaired growth pattern in 7 (4.5%), endocrine dysfunction in 7 (4.5%) and second malignancy in 2 (1.2%). Three of the 20 patients assessed had severe neurocognitive impairment. A high QOL was reported by 60% of survivors and an "average" QOL by 38%. Conclusion: Our study showed that most survivors had a good QOL and our results will help clinicians to better monitor childhood cancer survivors in countries with limited resources.

scholarly journals Identifying Priorities for Harmonizing Guidelines for the Long-Term Surveillance of Childhood Cancer Survivors in the Chinese Children Cancer Group (CCCG)

2021 ◽  
pp. 261-276
Author(s):  
Yin Ting Cheung ◽  
Hui Zhang ◽  
Jiaoyang Cai ◽  
Lung Wai Phillip Au-Doung ◽  
Lok Sum Yang ◽  
...  
Keyword(s):  
Focus Group ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Childhood Cancer Survivors ◽  
Delphi Survey ◽  
Cancer Group ◽  
Follow Up Care ◽  
Survivors Of Childhood Cancer

PURPOSE Survivors of childhood cancer often experience treatment-related chronic health conditions. Given its vast population, China shares a large proportion of the global childhood cancer burden. Yet, screening and treatment of late effects in survivors of childhood cancer remain underaddressed in most regions of China. This study aimed to identify high-priority late effects for harmonizing screening guidelines within the Chinese Children's Cancer Group (CCCG), as well as barriers and enablers of the implementation of surveillance recommendations in local practice. METHODS To establish clinical consensus, 12 expert panelists who represent major institutions within the CCCG completed a Delphi survey and participated in a focus group discussion. The survey solicited ratings of the prevalence, severity, and priority for screening of 45 late effects. Major themes identified from the focus group were analyzed using thematic analysis. RESULTS The Delphi survey identified eight high-priority late effects for harmonization within CCCG: osteonecrosis, osteoporosis, left ventricular dysfunction, secondary brain tumors, treatment-related myeloid leukemia, gonadal dysfunction, growth hormone deficiency, and neurocognitive deficits. The common barriers to implementing survivorship programs include lack of support and resources for clinicians to provide follow-up care. Patients were also concerned about privacy issues and lacked awareness of late effects. Many institutions also lacked rehabilitation expertise and referral pathways. CONCLUSION By identifying obstacles related to the professional setting, patient behavior, and organization of care, our study identified resources and a framework for establishing collaborative strategies to facilitate follow-up care of childhood cancer survivors in China.

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