1 / 14

Primary Care for the Pediatric Cancer Survivor

Primary Care for the Pediatric Cancer Survivor. Ann Marie Lam, M.D. Emory Family Medicine October 20 th , 2011. Objectives. Assess provider knowledge/proficiency on primary care for the pediatric cancer survivor Review current guidelines for pediatric cancer survivor care

randilyn
Download Presentation

Primary Care for the Pediatric Cancer Survivor

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Primary Care for the Pediatric Cancer Survivor Ann Marie Lam, M.D. Emory Family Medicine October 20th, 2011

  2. Objectives • Assess provider knowledge/proficiency on primary care for the pediatric cancer survivor • Review current guidelines for pediatric cancer survivor care • Gain competence in providing primary care for the pediatric survivor

  3. Background • Most adult survivors of childhood cancer receive their care from primary care physicians • There is a lack of knowledge among primary care physicians on appropriate long term follow-up and screening • Care for adult survivors of childhood cancer (survivorship care) includes: • Surveillance for secondary cancers and/or recurrence of primary cancer • Early recognition of late effects of therapy • Psychosocial needs • Transition of care

  4. Survival rates • Improved therapies have led to increased survival rates (20% in 1954 to 83% in 2006) • Survival rates for adults < 50 years old who had the following childhood malignancies: • Brain tumor: 60% • Leukemia: 72% • Non-Hodgkin lymphoma: 80% • Hodgkin disease: 91%

  5. Childhood cancer survivors are at risk for: • Endocrinopathies • Obesity, diabetes, metabolic syndrome • Neurologic effects on memory, learning, attention • Hearing loss, dry eyes/mouth, dental problems • Cardiomyopathy • Infertility • Thyroid disorders • Muscle weakness, leg length discrepancy, osteoporosis • Secondary malignancy

  6. Identifying risk for specific long-term complications • Identify type of primary cancer and organ/body location affected • Ascertain type and cumulative dose of radiation/chemotherapy and location • Know what tools to use in managing surveillance

  7. Flowcharts • Acute lymphoblastic leukemia (ALL) • Neuroblastoma • Rhabdomyosarcoma

  8. Late effects and screening

  9. Late effects and screening (cont.)

  10. Barriers to transition of care • Acute care to long-term follow-up • Pediatric to adult care • Knowledge deficits (survivor) • Knowledge deficits (provider) • Psychological factors • Healthcare system gaps • Financial/insurance issues

  11. Barriers to survivorship care

  12. Website/Resources • Long-term follow-up guidelines: www.survivorshipguidelines.org • Survivor link: www.cancersurvivorlink.org

  13. References • Rose, et al. Endocrine surveillance in childhood cancer survivors. UpToDate. 2011. • Children’s Oncology Group. Establishing and enhancing services for childhood cancer survivors: Long-term follow-up program resource guide. 2007. • Schwartz, C. Long-term survivors of childhood cancer: the late effects of therapy. The Oncologist. 1999. • Caring for Childhood Cancer Survivors. American Family Physician. May 15, 2011, 1250-1255.

More Related