Multidisciplinary Late Effects Clinics for Childhood Cancer Survivors in Germany - a Two-Center Study

Abstract

Background: Childhood cancer survivors are at risk for therapy-related sequelae and, therefore, require long-term follow-up. At 2 university hospitals in Germany collaborative multidisciplinary late effects clinics were installed to provide specialized care and to evaluate the current health status of these patients in a clinical setting. Patients andMethods: Every patient who visited the late effects clinics at the university hospital in Lübeck and Erlangen over a period of 3 years and met the inclusion criteria was included in the study. Patients' characteristics as well as cancer diagnosis, treatment related factors and the prevalence of chronic health conditions were assessed. Results: 220 patients attended the late effects clinics during the observation period. The median follow-up period was 16 years (range 5-45 years). In total over 64% of the patients were affected by at least 1 chronic health condition, including endocrine disruptions in 19.1% of the patients. Moreover, secondary neoplasms occurred in 9.1% of the study participants. Conclusion: German childhood cancer survivors are affected by multiple therapy-related sequelae. A comprehensive network of late effects clinics should be established to ensure specialized and risk-adapted care for every childhood cancer survivor in Germany.

A Mixed-Methods Investigation of Medical Follow-Up in Long-Term Childhood Cancer Survivors: What Are the Reasons for Non-Attendance?

“…Lastly, our participants had been treated before the challenges of long-term survivors came to the fore of research and practice. Today’s CCS situation might be different as international consortia have been formed to improve CCS’ care and quality of life ( Hjorth et al, 2015 ) and Germany now also has specialized late effects clinics in some locations ( Gebauer et al, 2018 ).…”

Long-Term Follow-Up of Children, Adolescents, and Young Adult Cancer Survivors

“…Therefore, all CAYA cancer survivors should receive a treatment summary and an individualized and risk-adapted follow-up care plan. A new care structure that is currently being developed for adults who had cancer in the CAYA age range involves interdisciplinary transition or follow-up consultations characterized by the close cooperation of pediatric oncologists, internal medicine specialists/hematologists, oncologists and other specialist disciplines, as well as psychosocial services [18]. This should also work together with qualified rehabilitation facilities for young adults and patients’ associations, or self-help groups.…”

“…For childhood cancer survivors in Germany, a few multidisciplinary late-effects clinics [18] as well as transition programs have already been established. However, to ensure risk-adapted, long-term follow-up care, a nationwide transition program from pediatric to adult health care should be established.…”

Langzeitbeobachtung ehemaliger krebskranker Kinder und Jugendlicher

“…interdisziplinäre Nachsorgesprechstunden aufgebaut. Sie sollten von einem Kinderonkologen und einem Internisten/ Allgemeinmediziner o.ä., sowie dem psychosozialen Dienst, interdisziplinär, zusammengeführt werden [7]. Dies muss jeweils individu-ell vor Ort ausgelotet werden.…”