Childhood Cancer Survivorship Improving Care and Quality of Life (2003) / Chapter Skim
Currently Skimming:
3. The Trajectory of Childhood Cancer Care
3. The Trajectory of Childhood Cancer Care
Pages 37-48
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From page 37... ...
While symptoms may prompt parents to seek evaluation, a suspicion of cancer sometimes emerges during a routine wellchild care visit. Because symptoms may mimic other common pediatric problems and because childhood cancers are rare, the correct diagnosis may be delayed.
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From page 38... ...
Primary Care Children treated for cancer generally maintain their relationship with their primary care pediatrician for preventive care, health maintenance, and acute care. Following primary treatment for cancer, children resume care with their pediatrician, family practitioner, or internist.
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From page 39... ...
As patients and their families complete primary treatment, sources of continued support may include community-based parent self-help organizations (e.g., Candlelighters Childhood Cancer Foundation) , cancer survivor day celebrations, oncology camps,
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From page 40... ...
Rehabilitative Services An array of rehabilitative services may be needed following primary treatment, including physical and occupational therapy, speech and language therapy, and supportive services available at schools. Palliative Care Therapy intended specifically to relieve symptoms, ease distress, provide comfort, and in other ways improve the quality of life of someone with cancer is an important part of quality cancer care, but unfortunately is often not adequately provided (Institute of Medicine, 20011.
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From page 41... ...
Many chemotherapeutic agents are used in the treatment of childhood cancer. Table 3.2 shows the agents most frequently used to treat a cohort of S-year cancer survivors diagnosed between 1970 and 1986 and followed up as part of the Childhood Cancer Survivor Study (Robison et al., 2002~.
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From page 42... ...
What follows is a brief and simplified overview of common approaches to cancer treatment, many of which have implications for subsequent late effects.1 Information on the epidemiology of childhood cancer can be found in Chapter 2. Leukemias Primary treatment for acute lymphoblastic leukemia (ALL)
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From page 43... ...
Radiation therapy and/or chemotherapy usually follow surgery if the tumor cannot be completely removed. Clinical trials are evaluating radiation therapy given in several small doses per day (hyperfractionated radiation therapy)
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From page 44... ...
Limited to participants with complete abstraction of medical records. eliminating the need for radiation therapy in younger patients, as well as prior to or during radiation therapy.
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From page 45... ...
treatment of non-Hodgkin's lymphoma. The most common treatments for Hodgkin's disease are radiation therapy and/or chemotherapy, but treatment may depend on the stage of the cancer and whether the child has reached full growth.
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From page 46... ...
Surgery is the primary treatment of all stages of melanoma, but treatment may also involve chemotherapy, radiation therapy, or biological therapy. Germ Cell, Trophoblastic, and Other Gonadal Neoplasms The standard approach for childhood germ cell tumors is complete surgical excision of the tumor combined with chemotherapy.
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From page 47... ...
Treatment options include enucleation (surgery to remove the eye) ; radiation therapy; cryotherapy (the use of extreme cold to destroy cancer cells)
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From page 48... ...
Childhood cancers are a diverse set of diseases and the treatment of each type of cancer varies considerably; and within each type of cancer, the intensity and approach used may vary depending on the child's age, general health, and characteristics of the cancer. Because late effects arise following an interaction between the individual with cancer, the cancer, and the specifics of treatment, there is no clear map between a particular type of cancer or a specific treatment and an expected spectrum of late effects.
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