Episode Transcript
Interviewer: Even when a child's cancer has been successfully treated, often the journey isn't over. We'll find out more about that next on The Scope.
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Interviewer: Dr. Jennifer Wright is a pediatric oncologist and Director at the Pediatric Center Late Effects Clinic at Huntsman Cancer Institute. And it's a clinic that's designed for a very specific need. Dr. Wright, tell us what makes children's cancer treatments different that we need to have this specialized clinic.
Dr. Wright: Children, being generally healthy and young and haven't smoked themselves into a bad medical situation really tolerate much more aggressive chemotherapy and other treatments. That's one of the reasons the cure rate of childhood cancer, or the success rate for childhood cancer, is higher than adult cancers. That comes at a cost that when you're giving really toxic therapy to young and still maturing bodies, there are consequences that may not really appear until 20 to 40 years down the road.
Interviewer: So well into adulthood?
Dr. Wright: Right. And so if you're 70 and getting treated for cancer, you're probably not at risk for developing a complication 40 years down the road. But if you're eight when you're treated for cancer, that's a real possibility. And so this clinic exists to really guide survivors and their families through the expectations of what might be down the road for them, certainly to help them find the specialists that can take care of them if one of these problems actually arises.
One of the other important things that we do is when you're eight and going through childhood cancer therapy you don't really remember a lot of the specifics the drug names, the doses, what side effects we talked about at the time that could come in play down the road. So one of the really important things we do is educate the patients as they become adults as to what potential late effects may arise and really give them ownership of their own medical care that has been in their parents hands for so many years.
Interviewer: Yeah, and this thinking is relatively new, isn't it? Even realizing that there are going to be complications.
Dr. Wright: Right. It wasn't that long ago when patients finished their treatment we said, "Adios, have a great life." Now we're realizing that may not have been the smartest on our parts as physicians. That we really need to keep tabs on these survivors for their long-term health.
Interviewer: And what are some of the common complications that arise in adulthood as a result of being treated for childhood cancer?
Dr. Wright: The most common complications are problems either with heart or lungs. Also in that group are actually second cancers, so some of the treatments we use really can predispose patients to have cancer again as a young adult.
Interviewer: A different type of cancer . . .
Dr. Wright: A different type of cancer.
Interviewer: . . . than what they had before?
Dr. Wright: And research has shown we really have great evidence that shows that if you're being monitored for a second cancer that if you're at risk for a second cancer and being monitored and that's found early, really your outcome for that is much more favorable as opposed to if you weren't being screened and find it on your own. The chances of success in treating that second cancer are lower.
Interviewer: So it sounds like if as a child, you had childhood cancer, you should go to a clinic like the Pediatric Cancer Late Effects Clinic fairly regularly to monitor not only secondary cancers that could happen but also other physical complications that could happen?
Dr. Wright: Right. Other major . . . well, we like to see patients usually yearly when they're not too long after the end of their treatment. And as time progresses, we'll often see them once every two to three years, really just to check in and keep tabs on them, make sure they get refreshers on what medical things they need to be watching out for and we really learn from these patients as they continue to grow into adulthood.
Interviewer: What about an adult that had cancer many years ago before the thought process was there could be complications that arise? What types of things would they want to look out for? Or even if they've had cancer as a kid, they should just go right in?
Dr. Wright: Yeah, generally we recommend at least a one-time checking in because every child's treatment has so many variables in it. And the risk for those patients, be it heart problems or a second cancer or infertility or something like that, are very specific to the treatment they received. So it's a very individualized situation and so even if you can't come to see us, we do recommend that you be seen by somebody to get a plan for follow-up.
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