Early Interventions and Survivorship in Pediatric Cancer

Improving lifelong support for cancer survivors and families.

When a child has cancer, families need guidance for dealing with immediate care decisions and a road map for survivorship. Debra Friedman, M.D., director of Pediatric Hematology and Oncology at Vanderbilt-Ingram Cancer Center (VICC) and medical director of VICC’s REACH for Survivorship Program, is an internationally recognized expert on pediatric and adult cancer survivorship. Her research focuses on improving long-term outcomes and developing novel therapeutic protocols to decrease adverse long-term effects of therapy.

“We are curing more children and adults or keeping their cancer at bay for years, but those same successes are leading to new challenges in the area of survivorship,” Friedman said.

Friedman is an investigator on multiple grants, funded by the National Cancer Institute and several foundations, to study cancer health outcomes. At the 2019 ASCO Annual Meeting, Friedman shared her expertise on “Early Interventions to Support Patients, Parents and Survivors” during a discussion session.

Long-term Survivorship Care

VICC’s REACH for Survivorship Program is a clinic for survivors of all ages—children and adults—who have faced any type of cancer and who have received cancer treatment from any healthcare provider.

“Every time you have a transition in care, you risk losing a part of your story.”

“We offer a survivorship clinic for all patients in one place,” Friedman said. “Pediatric patients are going to grow into adults and will still need follow-up for long-term effects. Why should they be transferred for care during their lifetime? Every time you have a transition in care, you risk losing a part of your story and someone not knowing what’s needed.”

Patients complete a comprehensive health history and receive a personalized Cancer Survivorship Care Plan. The plan is designed to address physical, emotional and practical patient needs.

“The clinic is not intended to take the place of oncology, but it is really focused on the education of the patient, caregiver and primary care physician,” Friedman said. “Patients seen in our clinic will have a written document that summarizes all cancer therapy and offers recommendations for screening and a list of things to be concerned about if they should occur.”

Current Research and Initiatives

Friedman is leading clinical trials to improve outcomes with novel therapeutic regimens, trials to measure long-term health outcomes for rare cancers, as well as trials that focus on supportive interventions, like yoga, for cancer survivors. She is also involved in studies focused on cancer care delivery to the underserved.

Friedman continues to partner with others at VICC to improve health outcomes for pediatric and adult patients throughout their cancer journey. A major initiative under development will implement research on optimizing cancer care for all patients in the 123 counties (across three states) that are served by VICC.