: 20 Years of Childhood Cancer Survivorship. After the Cancer Experience

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1 : 20 Years of Childhood Cancer Survivorship After the Cancer Experience

2 Of the 12,400 children and adolescents diagnosed each year with cancer, 9,300 can now be cured. Survivors often find that the illness and its treatment changed their lives in many ways. Long-term survivors can develop health problems caused by the treatment that saved their lives, but monitoring progress along with excellent medical care can help patients make the most of the lives they have won.

3 What is ACE? After the Cancer Experience (ACE) is the pediatric and young adult survivor program at Children s Medical Center and UT Southwestern. It is designed to provide long-term medical monitoring for child, adolescent and adult survivors of childhood cancer. Established in 1989, this nationally recognized program follows cancer patients who are disease-free and have been off therapy for at least two years. The ACE Program is one of only a few long-term follow-up childhood cancer survivor programs in the nation that bridges the medical care from childhood to adult life within a centralized medical system. As survivors age, it is important to monitor their health and provide updates about potential ways to reduce the risk for late effects. Late effects are the health problems that may occur after chemotherapy, radiation therapy or surgery. Not everyone will experience a late effect or problem from therapy, but as survivors age, the ACE program provides ongoing medical monitoring and updates on any actual or potential late effects based on current research. What to expect The ACE pediatric program is directed by a pediatric oncologist and managed by certified nurse practitioners. The nurse practitioners are the primary outpatient unit contacts and conduct the physical examinations and collaborate with the physician. The medical evaluation includes a physical examination, laboratory tests and other monitoring tests as determined by the patient s treatment history. Patients are provided individualized education about their risk for long-term complications based on their specific treatment exposures. Each childhood cancer survivor who participates in the ACE Program receives a Cancer Treatment Summary that includes a description of their cancer diagnosis, detailed treatment information (chemotherapy, radiation and surgeries), complications encountered during treatment or any late effects, as well as a plan for long-term follow-up care.

4 For young adult survivors When a survivor of childhood cancer reaches age 18, the patient transitions to the ACE Young Adult Program at UT Southwestern. This program combines the pediatric oncology experience with adult medicine and focuses on the health needs of the young adult survivor. The ACE Young Adult Program is directed by a physician from the Department of Internal Medicine at UT Southwestern. The ACE nurse practitioners coordinate ACE visits in the young adult outpatient unit in conjunction with the ACE Young Adult director as acting physician. These annual visits continue throughout the survivor s life. Medical records follow the patient to the ACE Young Adult outpatient unit at each medical evaluation.

5 Features of the ACE program Monitoring for late effects of cancer and cancer therapy Individualized Cancer Treatment Summary Routine screening for second malignancies Education - Targeted at reducing risk and promoting long-term health and improved quality of life - ACE Navigator computer program for survivor education Simplified referrals to appropriate subspecialties Access to social services, child life specialists and other services accessible in the medical community Participation in the NIH-sponsored Childhood Cancer Survivor Study and other research aimed at improving the health of survivors and their families To make an appointment Pediatric ACE Program To schedule an appointment in the pediatric ACE program, call Young Adult ACE Program If you are a young adult survivor (over 18 years of age), call to schedule an appointment. For more information Tel: Fax: ccbdinfo@childrens.com

6 Medical District Dr Redfield St Lofland St Record Crossing Rd Southwestern Medical Ave Locations Pediatric ACE Program Children s Medical Center Dallas 1935 Medical District Drive Dallas, Texas Children s Medical Center Legacy 7609 Preston Rd., (entrance off Hedgcoxe) Plano, Texas Young Adult ACE Program Internal Medicine 5959 Harry Hines Blvd. Professional Office Bldg. 1 Suite 1122 Dallas, Texas Department of Internal Medicine-PCIM 7th fl. - Ambulatory clinic building 5201 Harry Hines Blvd. Dallas, Texas 75235

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10 Medical District Dr Redfield St Lofland St Record Crossing Rd Southwestern Medical Ave Ubicaciones Programa pediátrico ACE Children s Medical Center Dallas 1935 Medical District Drive Dallas, Texas Children s Medical Center Legacy 7609 Preston Rd., (entrada por Hedgcoxe) Plano, Texas Programa ACE para adultos jóvenes Medicina interna 5959 Harry Hines Blvd. Professional Office Bldg. 1 Suite 1122 Dallas, Texas Departamento de Medicina Interna (PCIM) 7th fl. - Ambulatory clinic building 5201 Harry Hines Blvd. Dallas, Texas 75235

11 Notas:

12 Adultos jóvenes que hayan sobrevivido al cáncer Cuando un paciente que tuvo cáncer infantil cumple 18 años, se deriva al programa ACE para adultos jóvenes en UT Southwestern. Este programa combina los conocimientos de la oncología infantil con el tratamiento médico para adultos y se centra en las necesidades de salud del adulto joven. El programa ACE para adultos jóvenes está a cargo de un médico del Departamento de Medicina Interna de UT Southwestern. El personal de enfermería del programa coordina las consultas de ACE en la unidad de atención ambulatoria para adultos jóvenes en colaboración con el director del programa ACE para adultos jóvenes que actúa como médico. Estas consultas anuales continuarán a lo largo de la vida del paciente. La historia del paciente se trasladará a la unidad de atención ambulatoria de ACE para adultos jóvenes para analizarla en cada una de las evaluaciones médicas.

13 Características del programa ACE Control de las secuelas del cáncer y del tratamiento oncológico Resumen personalizado del tratamiento oncológico Exámenes de rutina para detectar otros tumores malignos Educación - Orientada a disminuir los riesgos, promover la salud a largo plazo y mejorar la calidad de vida - Programa informático ACE Navigator, que brinda educación a los sobrevivientes del cáncer Remisiones simplificadas a los especialistas adecuados Acceso a servicios sociales, especialistas infantiles y demás servicios disponibles en la comunidad médica Participación en el estudio de supervivencia al cáncer infantil patrocinado por los Institutos Nacionales de Salud y demás investigaciones con el objetivo de mejorar el estado de salud de los sobrevivientes y sus familias Cómo programar una consulta Programa pediátrico ACE Para programar una consulta para el programa pediátrico ACE, llame al Programa ACE para adultos jóvenes En el caso de los adultos jóvenes (mayores de 18 años) que hayan padecido cáncer infantil, llamar al para programar una consulta. Para obtener más información Tel: Fax: ccbdinfo@childrens.com

14 De los 12,400 niños y adolescentes a quienes cada año se les diagnostica cáncer, hoy en día 9,300 de ellos pueden superar la enfermedad. Quienes han sobrevivido al cáncer dicen que la enfermedad y el tratamiento recibido cambiaron sus vidas en muchos aspectos. Los pacientes pueden padecer otros problemas de salud a raíz del tratamiento que les salvó la vida, sin embargo, hacerse controles regulares y recibir una excelente atención médica pueden contribuir a que disfruten lo más posible de esta segunda vida.

15 En qué consiste el programa La vida tras el cáncer? La vida tras el cáncer (After the Cancer Experience, ACE, por su sigla en inglés) es el programa para niños y adultos jóvenes sobrevivientes del cáncer implementado en Children s Medical Center y UT Southwestern. Se diseñó con el fin de brindar controles médicos de largo plazo a niños, adolescentes y adultos que hayan sobrevivido al cáncer infantil. Fundado en 1989, este programa, que goza de reconocimiento a nivel nacional, hace un seguimiento de los pacientes oncológicos que han superado la enfermedad y que no hayan recibido tratamiento durante al menos dos años. ACE es uno de los pocos programas de seguimiento a largo plazo de niños que hayan sobrevivido al cáncer a nivel nacional que establece un vínculo entre la atención médica brindada al niño y al adulto dentro de un sistema médico centralizado. A medida que los pacientes crecen, se hace importante controlar su estado de salud y brindar información actualizada sobre las posibles maneras de disminuir el riesgo de secuelas. Las secuelas son problemas de salud que pueden manifestarse después de someterse a la quimioterapia, radioterapia o a una intervención quirúrgica. No todos experimentarán las mismas secuelas o problemas como consecuencia del tratamiento, pero, a medida que los pacientes crecen, el programa ACE brinda control médico permanente e información actualizada sobre cualquier secuela posible o existente, según lo que indiquen las investigaciones más recientes. Qué esperar El programa pediátrico ACE está a cargo de un oncólogo infantil y es administrado por personal de enfermería certificado. Los enfermeros y las enfermeras practicantes son el primer contacto de la unidad de atención ambulatoria, realizan los exámenes físicos y colaboran con el médico. La evaluación médica incluye un examen físico, exámenes de laboratorio y demás pruebas de control dependiendo del tratamiento que haya recibido el paciente. Asimismo, a los pacientes se les brinda educación personalizada acerca de los riesgos de que haya complicaciones a largo plazo en función de cuál haya sido el tratamiento específico. Toda persona que haya sobrevivido al cáncer infantil y que participe en el programa ACE recibe un resumen de tratamiento oncológico que incluye una descripción del diagnóstico oncológico, información detallada sobre el tratamiento (quimioterapia, radioterapia e intervenciones quirúrgicas), complicaciones que se presenten durante el tratamiento o cualquier secuela, así como un plan de seguimiento a largo plazo.

16 : 20 años luchando contra el cáncer infantil La vida tras el cáncer (After the Cancer Experience)

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