Interdisciplinary center for multi-professional aftercare and prevention for children and adolescents after a successful cancer therapy

The combination of local therapy treatments like surgery and radiotherapy with systemic therapies gives a rising number of patients a chance of healing. The number of children, who survived a cancer disease, could be more than doubled in the last 40 years.

These complex therapies can not only extend survival time and increase healing chances, but they can also lead to an increased and more severe occurrence of acute and long-term side effects. Besides physical problems like restricted capacity, damages of the nerve system or heart insufficiency, around a half of the patients suffer also from psychical problems after their cancer therapy. Moreover, the integration back to day-to-day life (school, professional training or occupation) is not easy and often takes a while.

Special patient groups are children, adolescents and young adults (so-called AYAs for Adolescents and Young Adults), which are highly endangered for physical and psychical problems due to their diagnosis and therapy at a very young age. For these patient groups a transition from childrens' and adolescents' medicine (pediatrics) to adults' medicine (inner medicine) is a hard step, at which patient-specific information can get lost and patients often quit their continuous therapy.

In order to fulfill the specific needs, a continuously and interdisciplinary care during and after the therapy is needed, which exceeds normal tumor aftercare. Therefore, a multi-professional care of specialists of different medical areas but especially social workers, psychologists, sports therapists and nutritionists is very important.

For this special patient group the University Cancer Center Hamburg (UCCH) implemented a consultation hour in cooperation with childrens', adolescents' and adults' physicians. With this continuous care no information loss will occur. Furthermore, an accompanying psychosocial care and involvement of further professionals is possible, depending on the individual need.

Currently several study projects run to decrease side-effects of chemotherapy (restricted capacity) and to improve the life style of this patient group through physical activity and healthy nutrition. For example we currently investigate, if an expanding sports consultation through a personal consultation and further consultations via phone done by sports therapists can improve the physical activity of patients after a successful cancer treatment. This is explicitly of high relevance for this patient groups, because of the above mentioned treatments in the childhood the risk of dying due to a cardiovascular disease is significantly increased.

Especially those projects, which have been proven to be effective, shall get quickly integrated into the regular treatment schedule for young patients. Therefore not only new locations are needed but also the extension of personnel, because the aftercare and prevention increases on one side and the number of affected patients rises on the other side.

Besides the study projects of increasing care, the AYA – Survivorship program defined its goal to create a graduated aftercare and prevention according to the patient’s individual risk profile for the reoccurrence of the cancer or the development of long-term side-effects. Therefore, a high-quality long-term aftercare shall be made possible, which is also realistic under economic aspects.