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Epidemiology
Diagnosis
Prognosis
Common Chemo Drugs
Long Term Considerations
100
There are approximately 300,000 of these in the United States and the vast majority of them receive their care from a primary care physician and not an oncologist.
What is a "Childhood Cancer Survivor?" Approximately one out of every 1,000 Americans, most between the ages of 20 and 34 years. Am Fam Physician. 2010 May 15;81(10):1250-1255.
100
A cancer that generally develops during puberty and occurs primarily in the distal femur and proximal tibia.
What is Osteosarcoma? The most common bone cancer of childhood. Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
100
This statistic measured at 5 years from diagnosis has improved dramatically since 1962 with an overall increase from only 28% to 74%?
What is survival? Am Fam Physician. 2010 May 15;81(10):1250-1255.
100
An anthracycline antibiotic, closely related to the natural product daunomycin, that like all anthracyclines, it works by intercalating DNA (topoisomerase II), with the most serious adverse effect being life-threatening heart damage. It is commonly used in the treatment of a wide range of cancers, including hematological malignancies, many types of carcinoma, and soft tissue sarcomas. In formulation, the medication is dark red and has has earned the nickname "red devil" or "red death."
What is doxorubicin (adriamycin or rubrex)? Up-To-Date and Wikipedia
100
Typical follow up interval for a survivor of childhood cancer for long term primary care.
What is "annual visits?" Children's Oncology Group
200
The number of Americans that are younger than 20 years of age that are diagnosed with cancer annually. Credit for being within 5,000 of the correct answer.
What is 12,000? Mertens AC, Yasui Y, Neglia JP, et al. Late mortality experience in five-year survivors of childhood and adolescent cancer: the Childhood Cancer Survivor Study. J Clin Oncol. 2001;19(13):3163–3172.
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A cancer which is commonly discovered by the findings of anemia, especially if accompanied by reticulocytopenia or a high mean corpuscular volume, thrombocytopenia, leukopenia or leukocytosis.
What is Leukemia? Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
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This renal tumor name after the German surgeon (1867–1918) who first described this kind of tumor, has seen an increase in 5 year cancer survival rate from 50% in 1962 to 90% in 2007.
What is Wilm's Tumor? http://www.stjude.org/stjude/v/index.jsp?vgnextoid=5b25e64c5b470110VgnVCM1000001e0215acRCRD&vgnextchannel=4bbafe08dc835110VgnVCM1000001e0215acRCRD
200
This platinum based chemotherapy agent is well known to cause sensorineural hearing loss and to be nephrotoxic. It binds to and causing crosslinking of DNA.
What is cisplatin? Am Fam Physician. 2010 May 15;81(10):1250-1255.
200
An infectious agent that may need to be screened for if the patient was diagnosed with cancer and treated during the 1970s and 1980s and the patient received blood products.
What is HIV? or What is Hepatitis B (or C)? http://www.survivorshipguidelines.org/pdf/LTFUGuidelines.pdf
300
Annual incidence of pediatric cancer cases per 1 million U.S. children,making it the second leading cause of childhood deaths. Credit for being within 100 of the correct answer.
What is 150? Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
300
The generally preferred method of imaging in a child suspected of an intracranial or CNS space-occupying lesion.
What is a "contrast MRI of the brain and spine?" This often must be ordered in conjunction with hematology/oncology and pediatric anesthesiology (for sedation). Urgent CT should be ordered if elevated ICP is a concern. When to image? ■Persistent headache in the following settings: •Wakes a child from sleep •Occurs upon waking •In any child less than 4 years of age •Associated with disorientation or confusion ■Persistent vomiting upon waking ■Visual findings including papilledema, optic atrophy, new onset nystagmus, reduced acuity not due to refractive error, visual field reduction, proptosis, and new onset paralytic (non-comitant) squint ■Motor findings including regression in motor skills, focal motor weakness, abnormal gait and/or coordination, bell’s palsy with no improvement over four weeks, and swallowing difficulties without an identifiable local cause Am Fam Physician. 2000 Apr 1;61(7):2144-2154. Up-To-Date
300
This consortium partners with research scientists from around the world in efforts to understand the causes of cancer and find more effective treatments for pediatric cancer. They collaborate within a well-established clinical research infrastructure. Every child with cancer in a participating nation is registered, data and frozen samples are collected, and all information can be accessed by almost any research entity.
What is "The Children’s Oncology Group?" http://www.childrensoncologygroup.org/
300
This glycopeptide antibiotic works by causing breaks in DNA. It has a common side effect of pulmonary fibrosis. Past history of treatment with this agent should therefore always be disclosed to the anaesthetist prior to undergoing a procedure requiring general anaesthesia. Due to the oxygen sensitive nature of tissue after being exposed to this agent, and the theorised increased likelihood of developing pulmonary fibrosis following supplemental oxygen therapy, it has been questioned whether patients should take part in scuba diving following treatment with the drug.
What is bleomycin? Up-To-Date and Wikipedia
300
The follow up interval for any child having received cranial radiation >18Gy given a wide variety of potential side effects not limited to but including growth deficits and developmental delays that are common.
What is 6 months? http://www.survivorshipguidelines.org/pdf/LTFUGuidelines.pdf
400
Number one in incidence of childhood cancer standing at 30.2%
What is Leukemia? Behind Central nervous system tumor 21.7% Lymphoma 10.9% Neuroblastoma 8.2% Soft tissue sarcoma 7.0% Renal tumor 6.3% Bone tumor 4.7% Others 11.0% Linet MS, Ries LA, Smith MA, Tarone RE, Devesa SS. Cancer surveillance series: recent trends in childhood cancer incidence and mortality in the United States. J Natl Cancer Inst 1999;91:1051–8.
400
A cancer whose common symptoms include anorexia and abdominal pain and distention but elevated urinary catecholamines (HVA and VMA) are pathognomonic.
What is Neuroblastoma? Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
400
The average number of months (+ or - 2 months accepted) from diagnosis to death in DIPG. Diffuse Intrinsic Pontine Gliomas occur most commonly between the ages of 5-10 and account for about 5-10 out of every 100 brain tumors in children. Less than 3% survive to 3 years.
What is 11 months? The vast majority of these children die within 9-12 months of diagnosis http://www.reflectionsofgrace.org/index.php/diffuse-intrinsic-pontine-glioma-dipg.html
400
This alkylating agent has severe and life-threatening adverse effects, including acute myeloid leukemia, bladder cancer, and permanent infertility, especially at higher doses. Hemorrhagic cystitis is a frequent complication, but this is prevented by adequate fluid intake and mesna (sodium 2-mercaptoethane sulfonate).
What is cyclophosphamide? Up-To-Date Am Fam Physician. 2010 May 15;81(10):1250-1255.
400
A annual or bi-annual complete blood count and annual examination for lymphadenopathy or splenomegaly is indicated in all patients who were treated with this therapeutic regimen due to the significantly increased risk of lymphoma. These patients should also be highly encouraged to avoid sun exposure and tanning booths due to the extraordinarily high incidence of skin cancers.
What is a Hematopoietic Stem Cell transplant? http://www.survivorshipguidelines.org/pdf/LTFUGuidelines.pdf
500
This neuroendocrine tumor arrising from the sympathetic nervous system has a surprising 65% of primary tumors arising in the abdomen.
What is Neuroblastoma? Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
500
Another name for the constitutional symptoms of intermittent fever, drenching night sweats and loss of greater than 10 percent of total body weight that are common in Hodgkin's disease.
What are "the 'B' symptoms?" Other symptoms include anorexia, fatigue and pruritus. Am Fam Physician. 2000 Apr 1;61(7):2144-2154.
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Establishing a prognosis is a complex and difficult process but one necessary for many in choosing course of treatment. Prognosis often involves staging, molecular biology and cytogenetic profiles, and proposed course of treatment (bone marrow transplant, radiation, chemotherapy, etc...). But this crucial element is often overlooked when determining prognostic statistics and in providing information to pediatric patients and their parents.
What is "access to care" or "insurance status?" St. Jude provides medical care to its patients at no cost to the patient or the patient’s family. This element shows up in their survival statistics when compared with other pediatric institutions around the country. http://www.stjude.org/stjude/v/index.jsp?vgnextoid=249f6f9523e70110VgnVCM1000001e0215acRCRD&vgnextchannel=8bea6f559dd5a210VgnVCM1000001e0215acRCRD
500
This oral alkylating agent can cross the blood brain barrier and can often be effective in slowing the growth of aggressive brain tumors such as glioblastoma multiform. It has a primary side effect of mild nausea and vomiting. It is also genotoxic, teratogenic, and fetotoxic.
What is temozolamide? Up-To-Date
500
The Children's Oncology Group has developed this document for childhood cancer survivors to give to their primary care providers. It should include their disease, chemotherapy agents used, any radiation, any surgery, any hematopoietic cell transplants, and any complications.
What is the "Summary of Cancer Treatment?" http://www.survivorshipguidelines.org/pdf/introductiontoLong-TermFollow-Up.pdf