Transition of Care

Given the long-term risk for medical and emotional sequelae of cancer diagnosis and treatment, ongoing surveillance is recommended (Children's Oncology Group 2008). This recommendation has presented some challenges. Oncology treatment centers for adults are not accustomed to pediatric treatment protocols and their sequelae. Adult survivors of pe-diatric cancers feel awkward about continuing to visit a children's hospital when they are in their 30s or 40s. Specific transition or long-term follow-up clinics have been created to address these medical concerns within a developmentally appropriate framework. Long-term follow-up requires specific training for staff and protocols for screening and prevention (Freyer and Brugieres 2008). These long-term follow-up clinics provide developmentally appropriate care for adults who are generally healthy, but still at risk, and are emerging from the protected and somewhat dependent role of a pediatric patient (Freyer and Kibrick-Lazear 2006). A survey found that over 60% of young adult survivors of childhood cancer reported a desire for more age-appropriate information on cancer, diet, exercise, nutrition, complementary and alternative health services, infertility, mental health counseling, and camp or retreat programs for young adults (Zebrack 2009).

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