Childhood Cancer and Functional Impacts Across the Care Continuum (2021) / Chapter Skim
Currently Skimming:
1 Introduction
1 Introduction
Pages 15-26
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. A child who applies for SSI is considered "disabled" if the child has a medically determinable physical or mental impairment or combination of impairments that results in "marked and severe functional limitations" (SSA, 2020c)
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, SSA evaluates it under the medical criteria for the cancer body system. When evaluating impairments under the cancer listings,2 SSA considers factors that include • origin of the cancer, • extent of involvement, • duration and frequency of and response to therapy, and • effects of any posttherapeutic residuals (SSA, 2020e)
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STUDY CHARGE AND SCOPE In 2019, SSA requested that the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine convene a committee of relevant experts to conduct a focused review of the medical literature to identify and investigate updated information on medical and technological advances, treatments, and prognoses involving childhood cancers3 (see Box 1-1 for the committee's Statement of Task)
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: (1) body functions and structures, which encompasses physiological functions of the body, including psychological functions, as well as the functioning of body structures (e.g., movement of limbs, cardiac function)
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While SSA recognizes some patients may have difficulty accessing care or particular forms of treatment due to financial circumstances, others do successfully access those treatments. SSA may receive information about those treatments in the medical records SSA considers when making disability determinations and conducting continuing disability reviews (CDRs)
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compared to the performance of other children their age who do not have impairments." In particular, SSA considers functioning in six domains: • acquiring and using information, • attending and completing tasks, • interacting and relating with others, • moving about and manipulating objects, • caring for oneself, and • health and physical well-being.7 6 See 20 CFR 416.926a.
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The committee identified three timeframes of interest with respect to childhood cancers. The first, which addresses the question of "the minimum period appropriate to consider a childhood cancer disabling," is the period from the child's cancer diagnosis through active treatment and an anticipated period of recovery from the acute effects of treatment.
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. Selection of Cancer Types The committee was asked to "provide an overview of the current status of the diagnosis, treatment, and prognosis of select childhood cancers, including different types of malignant solid tumors." The committee understood the phrase "malignant solid tumors" to refer specifically to a category within SSA's child cancer listings with the same label, which appears to include all types of malignant solid tumors that are not otherwise specified in the listings.
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Its clinical trials include front-line treatment for various childhood cancers; studies to determine their underlying biology; and trials involving new and emerging treatments, supportive care, and survivorship. The COG is supported by NCI and involves thousands of childhood cancer experts at more than 200 leading children's hospitals, universities,
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, Comprehensive Cancer Care for Children and Their Families: Summary of a Joint Workshop by the Institute of Medicine and the American Cancer Society (NASEM, 2015) , The Promise of Assistive Technology to Enhance Activity and Work Participation (NASEM, 2017)
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2015. Comprehen sive cancer care for children and their families: Summary of a joint workshop by the Institute of Medicine and the American Cancer Society.
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2020f. Substantial gainful activity.
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