Treatment, Behavioral, and Psychosocial Components of Cardiovascular Disease Risk Among Survivors of Childhood and Young Adult Cancer

Berkman, Amy M.; Lakoski, Susan G.

doi:10.1161/jaha.115.001891

Cited by 19 publications

(14 citation statements)

References 105 publications

(128 reference statements)

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“…3,4 In the Childhood Cancer Survivor Study cohort of over 14,000 survivors, two thirds had at least one chronic condition (e.g., second malignancy, premature cardiovascular disease, endocrinopathy) 25 years postdiagnosis; 3,[5][6][7][8] about half develop a severe or disabling chronic condition. 2,9 Survivors are at increased risk of psychosocial distress (e.g., anxiety, depression, post-traumatic stress), and many have neurocognitive dysfunction.…”

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confidence: 99%

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Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

Mouw

Wertman²,

Barrington³

et al. 2017

Journal of Adolescent and Young Adult Oncology

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Purpose: Most adolescent and young adult (AYA)-aged childhood cancer survivors develop physical and/or psychosocial sequelae; however, many do not receive long-term follow-up (LTF) critical for screening, prevention, and treatment of late effects. To develop a health services research agenda to optimize care models, we conducted qualitative research with LTF providers examining existing models, and successes and challenges in maintaining survivors' connections to care across their transition to adulthood. Methods: We interviewed 20 LTF experts (MDs, RNs, social workers, education specialists, psychologists) from 10 Children's Oncology Group-affiliated institutions, and analyzed data using grounded theory and content analysis techniques. Results: Participants described the complexity of survivors' healthcare transitions. Survivors had pressing educational needs in multiple domains, and imparting the need for prevention was challenging. Multidisciplinary LTF teams focused on prevention and self-management. Care and decisions about transfer were individualized based on survivors' health risks, developmental issues, and family contexts. An interplay of provider and institutional factors, some of which were potentially modifiable, also influenced how transitions were managed. Interviewees rarely collaborated with community primary care providers to comanage patients. Communication systems and collective norms about sharing care limited comanagement capacity. Interviewees described staffing practices, policies, and informal initiatives they found reduced attrition. Conclusions: Results suggest that survivors will benefit from care models that better connect patients, survivorship experts, and community providers for uninterrupted LTF across transitions. We propose research priorities, framing attrition from LTF as a public health concern, transition as the central challenge in LTF, and transition readiness as a multilevel concept.

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confidence: 99%

“…2,10 Some, particularly those treated with cranial radiation, experience social isolation and struggle in school and the workplace. 5,6,[11][12][13] Thus the practice of LTF care has grown at pediatric oncology centers in recent decades.…”

mentioning

confidence: 99%

Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

Mouw

Wertman²,

Barrington³

et al. 2017

Journal of Adolescent and Young Adult Oncology

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“…We report on a female amateur triathlete born in 1997 who is suffering from AML diagnosed in September Her medication nowadays consists of diuretics, Beta blocker, ACE-inhibitor and an additional hormone therapy 2 . No relapse was found since then.…”

Section: Case Reportmentioning

confidence: 99%

Juvenile competitive triathlete after cardiotoxic anthracycline therapy for Acute Myeloid Leukemia

et al. 2016

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Objective: The treatment of Acute Myeloid Leukemia (AML) leads to several functional limitations. Especially cardiac burden following cardiotoxic chemotherapy, which limits exercise and competitive sport in the long-term survivors. Subject and methods: We report on a young female amateur triathlete born in 1997, who was diagnosed with AML at the age of fifteen. She had chemotherapy with a cumulative dose of about 1000 mg/m 2 anthracyclines and allogeneic stem cell transplantation which was successful, but she suffered from cardiotoxic systolic heart failure with a left ventricular ejection fraction (LVEF) <55 % and an impaired peak oxygen uptake of 23.2 ml/min/kg and 53 % of predicted, respectively. After medical examination and counselling with a sport scientist she started a tailored training of aerobic exercise. She was evaluated at regular intervals which resulted in increasing the training load and volume. Eventually her training hours was stepwise increased to 12 h training per week, which includes high intensity intervals. Results: Within almost 3 years, her exercise performance improved tremendously. Workload doubled from 2.1 W/kg to 4.2 W/kg, peak oxygen uptake increased from 23.2 ml/min/kg to 49.1 ml/min/kg and from 53 to 135 %, respectively. Moreover, she participated in several competitions. However, LVEF remains almost unchanged. Conclusion: With the right training and under medical surveillance competitive exercise with an anthracycline-damaged heart is still achievable. Moreover, competitive training and exercise seems to be safe and feasible.

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“…Insufficient levels of daily physical activity are commonly observed in children who undergo cancer treatment [10]. Unfortunately, such a phenomenon also adversely affects the daily habits of children cancer survivors [11], affecting their quality of life and overall fitness [12].…”

Section: Introductionmentioning

confidence: 99%

Does Daily Physical Activity Level Determine the Physical Efficiency of Children After Treatment of Leukemia?

Malicka

Kowaluk

Woźniewski

2020

IJERPH

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The aim of the study was to assess daily physical activity level and its influence on the physical efficiency of children after the treatment of leukemia. The study was comprised of 34 children (23 boys and 11 girls) after the treatment of acute lymphoblastic leukemia or myeloid leukemia (mean age of 11.29 ± 2.81 years, mean body height of 146.88 ± 16.11 cm, and mean body weight of 43.68 ± 13.93 kg). The mean time since treatment completion was 3.09 ± 1.80 years. The level of physical activity was assessed with the Health Behavior in School-Aged Children questionnaire (HBSC). Physical efficiency was assessed based on the palant ball throw (assessment of strength, coordination, and upper limb speed), the long jump (assessment of jumping ability, speed and coordination) and the 60 m run (assessment of speed). Measurements of motor skills were normalized, classified according to age and sex, and converted into grades. The mean values obtained in the run and the ball throw showed low pass grades in the study group. In the case of the long jump, satisfactory grades were obtained. A correlation of r = 0.512 was found between vigorous physical activity (HBSC 3) and the grade in the run. A correlation of r = −0.437 was observed between the duration of computer use in leisure time (HBSC 6) and the grade in the long jump, whereas correlations of r = −0.482 and −0.485 were noted between the number hours per week spent on games (HBSC 5) and the duration of computer use in leisure time (HBSC 6) and the grade obtained in the ball throw, respectively. In addition, different levels of physical activity and physical efficiency were demonstrated depending on the time elapsed since treatment completion. Supervised programs promoting daily physical activity should include children after the treatment of leukemia. These programs should also be aimed at improving their physical efficiency.

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Treatment, Behavioral, and Psychosocial Components of Cardiovascular Disease Risk Among Survivors of Childhood and Young Adult Cancer

Cited by 19 publications

References 105 publications

Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives

Juvenile competitive triathlete after cardiotoxic anthracycline therapy for Acute Myeloid Leukemia

Does Daily Physical Activity Level Determine the Physical Efficiency of Children After Treatment of Leukemia?

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