Northeast Florida Medicine
Vol. 66, No. 2 2015
19
Pediatric Oncology
are now available and, if used appropriately, will result in
better long-term health outcomes for childhood cancer
survivors.
30,31
Depending on the healthcare community,
multiple models of long-term follow-up care have been
suggested. All require health care providers who understand
the complex needs of the pediatric cancer survivor and can
provide appropriate preventative healthcare, psychosocial
support and help with navigation of a complex health care
system.
32-34
These include:
1. Ongoing care by healthcare providers who have ex-
pertise specifically in cancer late effects and can screen
and refer for needed intervention.
2. Transition programs with expertise in the issues related
to transition to adult care for young adults with com-
plex medical problems.
3. Primary care models which provide navigation
specifically for young adult survivors of childhood
cancer and provide all recommended screenings and
treatment for these young adults, with the oncologist
acting as a consultant.
Muchwork is ongoing toprovide further recommendations
on the best practices for development of such models
in communities.
Conclusion
Although the list of potential toxicities and morbidities of
pediatric cancer therapy can be intimidating, the risks must
be kept in perspective.Without these treatments, few of these
individuals would live into adulthood. New treatments, more
targeted to the cancer cells and with less co-morbidities, are
rapidlybeingdeveloped, and current treatments are constantly
being modified to reduce the risks, where possible, for future
patients. In addition, risk groups are being refined so that
we can deliver the right treatment intensity to each patient.
With more and more pediatric cancer patients being cured
of their disease, it is imperative that appropriate monitoring
and follow-up are offered to all survivors.
v
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