1. The Facts about Childhood
Cancer Survivorship
 Secondary to improving outcomes the number of
cancer survivors worldwide increases yearly
 Treatment may lead to adverse long-term outcomes
 Survivors of childhood cancer have higher mortality
rates as adults
 Up to 30 % of survivors experience morbidity
secondary to treatment
 Less than 33 % of survivors receive appropriate risk
adapted, focused care

2. Organ
dysfunction
Growth & Neuro-
development cognitive
Late
Effects
Reproductive Psychosocial
Second
cancers

3. Risk-based Medical Follow-up
ASPHO, SIOP, COG, AAP, Inst. of Med.
Patient-centered
individual plan • Cancer
• Treatment
Life-long • Genetic factors
surveillance • Life-style
behaviors
Screening &
prevention

4. Annual Suggested Screening and Surveillance
Risk – adapted
General health Health
health care
care visits maintenance
visits
Survivor Wellness, Endocrinologist Nutrition,
Late Effects Clinic exercise
Primary care Audiologist No smoking,
Ophthalmologist limit alcohol use
Pulmonologist
Dentist Sunscreen
Laboratory: CBC,
Cardiologist
electrolytes, LFT’s,
cholesterol, Safe sex
urinalysis
Dermatologist practices

5. Behavioral & Psychosocial
Program Needs of AYA Survivors
 Programs that target
 Physical activity
 Relaxation
 Emotional support
 Nutrition and weight
 Emergent themes
 Choice
 Flexibility
 Convenience

6. Information is Power
 Guidance related to the following
 Specific cancer diagnosis
 Treatment
 Late effects
 Physical fitness, nutrition
 Promotion of healthy behavior and life-style choices
 Insurance, community resources public benefits
 Family planning and sexuality
 Development of self-advocacy tools

7. Components of a Survivor Transition Program
Implement a continuum of consistency
• Identify interested health-care professionals
• Mentoring program
• Communication is paramount for success
• Pediatric oncologist to pediatric and/or adult specialist
• Pediatric oncologist to primary care provider
Share information and educate patient
• Build self-advocacy, self-care, and self-efficacy skills
• Build trust
• Provide tools to become a productive and successful survivor
Incorporate innovative practices
• Distal education programs: smart phones
• Internet and social networking
• Education and career development: Job training