Initial Consultation & Treatment Summary
Prior to an initial long-term follow-up consultation, a patient's past cancer treatment record is reviewed and summarized. A team -- which includes a radiation oncologist, neuropsychologist, cardiologist, and primary medical oncologist -- meets to discuss the patient's past treatment and develop a plan for future health care management and screening. This summary is given to the patient and reviewed thoroughly at the first visit. "We talk with the patient and family about all the potential late complications and the likelihood that they will or will not have these problems," says Dr. Sklar. In this way, an individualized screening and counseling program is established for each patient.
Screening & Treatment for Late Effects
Early detection and treatment of existing or potential problems that may arise as a result of past cancer therapy is a major focus of the Long-Term Follow-Up Program. While we anticipate that most survivors will have healthy, productive lives, some develop problems as a result of their past diagnosis and therapy. These delayed or late effects occur in some but not all people, and may be mild, moderate, or severe. Some late effects may not become obvious until years after treatment.
Whether or not late effects occur depend on several factors, including the type of cancer, type of treatment received, and a patient's age during treatment. Late effects can be detected early and easily in most patients. If a problem is identified, treatment is often available.
Some late effects may include disturbances to the endocrine system (hormone disturbances) that may cause short stature, disturbances of puberty, and thyroid or fertility disorders. Frequently, these conditions are treated by the Long-Term Follow-Up Program. Other problems, such as heart and learning difficulties, are closely monitored by the team and referred to appropriate clinical specialists when necessary.
Referrals & Coordination of Health Care
The Long-Term Follow-Up Program works closely with patients' oncologists and other healthcare providers to ensure well-coordinated care. The program is not intended to replace the primary care provider or pediatric oncologist. Once off treatment, it is recommended that patients establish a relationship with a regular, local healthcare provider who is available for sick visits as well as routine, yearly physical examinations. In addition to making referrals to appropriate specialists, we also make referrals to various community resources that may be available to childhood cancer survivors.
