Pediatric Cancer Care

Conquering the Cancer Care Continuum – Series Three: Fifth Issue —May 27, 2015
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Editor-in-Chief, JONS; Program Director, AONN+; University Distinguished Service Professor of Breast Cancer, Administrative Director, The Johns Hopkins Breast Center; Director, John Hopkins Cancer Survivorship Programs; Professor of Surgery and Oncology, JHU School of Medicine; Co-Creator, Work Stride-Managing Cancer at Work
shockli@jhmi.edu

There is nothing that pulls at my heart strings more than the sight of a young child dealing with a diagnosis of cancer. This issue of Conquering the Cancer Care Continuum™ focuses on pediatric cancer care, a challenging area of oncology management, but one in which amazing progress is being made. As discussed in the oncology pharmacist perspective, 2 important trends are paving the way for improved clinical outcomes in children with cancer. These are the identification of genetic polymorphisms that affect the way in which patients metabolize certain drugs, and an increase in pharmacogenomic screening, which can be used to identify driver mutations that are likely to respond to specific therapies. The oncology nurse perspective provides a brief history of pediatric oncology, including the high mortality rates that were so common decades ago, and explores promising advances in treatment. Finally, the physician perspective discusses effective strategies for curing cancer in more children in low- and middle-income countries.

Although certainly there are still children and teenagers dying from specific malignancies, fortunately, there are more surviving than ever before. In fact, the very high survival rate in pediatric leukemia is probably the greatest success story in the field of hematology/oncology. With the availability of targeted therapies, we have entered a new era that provides hope for children diagnosed with other types of cancer. However, along with our ability to save more young patients, we are faced with ongoing challenges that need to be addressed, including lingering adverse events and late effects of treatment. Unfortunately, we are uncertain as to what the late effects of some treatments will be, as they have been used in practice for a relatively short period of time.

We are also witnessing an increase in the availability of clinical trials for children with cancer, which is very good news. Children who have achieved remission are typically monitored by pediatric oncology survivorship clinics. A great deal has been learned through this follow-up, which goes on for many decades after treatment. This will remain an important strategy as new drugs and combination regimens continue to be integrated into the treatment paradigm. Clinical trials of various approaches to survivorship management will also be highly important.

As you read this issue, you will have the opportunity to consider what the experience is like for a young patient coping with cancer treatment. Hair loss is perhaps the most obvious sign to a child that something very serious is happening inside of his or her body. Although individuals are often focused on the immediate effects of treatment, pediatric oncologists must look beyond the present and consider future life goals of their patients. For example, there is a need for timely fertility preservation (even for patients in their late 30s and early 40s); limited use of drugs that cause peripheral neuropathy, which may interfere with career goals; and treatments that prevent the body from rapidly aging, which occurs when a person’s body is stripped of its sex hormones. And there is that gray area in which young adults are diagnosed with a childhood cancer and need to decide if they will be managed by a pediatric oncologist or an adult oncologist. That is all the more reason for those of us who are oncology providers to look beyond the pathology of our patients and factor into the treatment plan their known or likely life goals.

We can apply much of what we learn from pediatric oncology survivors to adult survivors, recognizing that adults are living longer—many decades after their treatment was completed. My hope is that the concepts discussed in this issue will help you in the care of your patients with cancer regardless of their age.

Related Articles
The Value of Palliative Care Early in the Treatment Process
Lillie D. Shockney, RN, BS, MAS, ONN-CG
|
Best Practices in Breast Cancer – October 2018 Vol 9
Palliative care has a serious identity problem. Seventy percent of Americans describe themselves as “not at all knowledgeable” about palliative care, and most healthcare professionals believe it is synonymous with end-of-life care.1 This perception is not far from current medical practice, because specialty palliative care—administered by clinicians with expertise in palliative medicine—is predominantly offered through hospice care or inpatient consultation only after life-prolonging treatment has failed. This means that the majority of patients who could benefit from palliative care are not receiving it until they are very close to death. To ensure that patients with metastatic breast cancer receive the best cancer care throughout their disease trajectory, palliative care should be initiated alongside standard oncology care, and it should be implemented early.
Recognizing Progress and Encouraging Further Strides in Breast Cancer
Lillie D. Shockney, RN, BS, MAS, ONN-CG
|
Best Practices in Breast Cancer – October 2018 Vol 9
In addition to the obligatory orange and black decorations of October, it’s also the time of year to don your pink in honor of Breast Cancer Awareness Month! The progress we have made as a nation in elevating the importance of regular breast cancer screenings, funding research, and supporting breast cancer survivors has had a direct impact on our ability to increase and improve survivorship.
“Establishing a Successful Navigation Program”: A JONS Exclusive Series
Lillie D. Shockney, RN, BS, MAS, ONN-CG
|
October 2018 Vol 9, NO 10

How do you establish a successful navigation program? The answers are right here in this issue!

Last modified: June 6, 2018

Subscribe to the Journal of Oncology Navigation & Survivorship®

To sign up for our print publication or e-newsletter, please enter your contact information below.

  • First Name *
    Last Name *
     
    Country
  • Please enter your mailing address.

    Address
     
    Address Line 2
    City
     
    State
    Zip Code