This case study describes the treatment of a 29-year-old man diagnosed with medulloblastoma, a rare pediatric brain tumor. He faced challenges due to being in the adolescent and young adult (AYA) population with limited access to insurance and care. Through multidisciplinary coordination between pediatric and adult specialists, he received aggressive treatment including surgery, radiation, and chemotherapy according to a pediatric protocol. While treatment caused morbidity, he remains disease-free one year later, demonstrating how comprehensive care can benefit AYAs despite the unique barriers they face.
Marina Kastelan, Neuro Oncology Care Coordinator,
Sydney Neuro Oncology Group, RNSH presents at the Brain Tumour Patient Forum, hosted by the Cure Brain Cancer Foundation.
Differences between family/primary care/acute care nurse practitionersRicky Phan
This presentation discusses the differences between family/primary care/acute care nurse practitioners. It will help readers understand more about the definition of nurse practitioner, independent practices and skill training among nurse practitioners. The novice nurse practitioners should know the above information and LACE to avoid legal ramifications.
OMICS Publishing Group | Journal of Cancer Science & TherapyOMICS International
OMICS Publishing Group journal, Cancer Science & Therapy aims to provide the most reliable source of information on current research and developments in the field of cancer science and therapies. It publishes monthly issues along with current topics of cancer as special issues which covers all areas of novel cancer techniques for timely diagnosis and prevention.
Ortopedia şi traumatologia este specialitatea care se ocupă cu depistarea, diagnosticarea, tratarea şi recuperarea afecţiunilor congenitale şi dobândite, traumatice şi netraumatice, ale aparatului locomotor.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Oncologia medicală este specialitatea care se ocupă cu studiul apariţiei şi dezvoltării neoplaziilor maligne, urmărind depistarea, diagnosticul, tratamentul cât şi evoluţia posterapeutică a pacienţilor.
O artigo fala sobre a reabilitação em pacientes com tumores cerebrais sob uma visão multidisciplinar, visando a funcionalidade e tratamento das sequelas.
Marina Kastelan, Neuro Oncology Care Coordinator,
Sydney Neuro Oncology Group, RNSH presents at the Brain Tumour Patient Forum, hosted by the Cure Brain Cancer Foundation.
Differences between family/primary care/acute care nurse practitionersRicky Phan
This presentation discusses the differences between family/primary care/acute care nurse practitioners. It will help readers understand more about the definition of nurse practitioner, independent practices and skill training among nurse practitioners. The novice nurse practitioners should know the above information and LACE to avoid legal ramifications.
OMICS Publishing Group | Journal of Cancer Science & TherapyOMICS International
OMICS Publishing Group journal, Cancer Science & Therapy aims to provide the most reliable source of information on current research and developments in the field of cancer science and therapies. It publishes monthly issues along with current topics of cancer as special issues which covers all areas of novel cancer techniques for timely diagnosis and prevention.
Ortopedia şi traumatologia este specialitatea care se ocupă cu depistarea, diagnosticarea, tratarea şi recuperarea afecţiunilor congenitale şi dobândite, traumatice şi netraumatice, ale aparatului locomotor.
We know that mesothelioma patients would rather stay local when receiving treatment,rnso we will review options for private medical centers, surgical consultants, clinical trials,rnand match you up with friendly, local physicians wherever we can.
Oncologia medicală este specialitatea care se ocupă cu studiul apariţiei şi dezvoltării neoplaziilor maligne, urmărind depistarea, diagnosticul, tratamentul cât şi evoluţia posterapeutică a pacienţilor.
O artigo fala sobre a reabilitação em pacientes com tumores cerebrais sob uma visão multidisciplinar, visando a funcionalidade e tratamento das sequelas.
Put to the test as genetic screening gets cheaper and easier,.docxamrit47
Put to the test: as genetic screening gets cheaper and easier, it's raising questions that health-
care providers aren't prepared to answer
The American Prospect, November 2010
When my children were born in the mid-1990s, new parents could already see that prenatal genetic
testing was altering the terrain of pregnancy and childbirth. Growing numbers of educated women were
having children at older ages, with resulting difficulties and risks. More and more parents faced
challenging, deeply personal decisions about whether to engage in genetic testing and what to do if they
received unfavorable results.
I remember my own anxieties when my wife, Veronica, took a blood test that searched for elevated
alpha-fetoproteins, which are associated with diverse ailments ranging from spina bifida to
anencephaly. The mere prospect of these rare conditions--and even the choice to undergo the tests--
was surprisingly painful. At least genetic counselors and other professionals were available to help guide
us.
By that point, amniocentesis had been in wide use for more than two decades. As researchers identified
the genetic markers associated with a growing list of important conditions, educated, secular, and
affluent communities began to embrace genetic testing. A small but lucrative market in assisted
reproductive technologies quickly emerged, which provided parents with greater control over the
genetic characteristics of their offspring. In some parts of America, new diagnostic technologies
provoked unease regarding their eugenic potential.
In retrospect, these innovations were incredibly tame. Technological limits, cost, intrusiveness, and risk
constrained the scope of screening efforts. Roughly one in every 200 amniocenteses resulted in
miscarriage, which made the procedure too risky to justify screening the full population of pregnant
women. The human genome had yet to be sequenced. Newborn screening was routinely used to
identify a handful of important metabolic disorders, but it was a very expensive process. There was a
certain clarity, too. The most common use of amniocentesis was (and remains) to detect conditions
associated with very serious physical or intellectual disabilities. When such conditions were detected,
most parents chose to terminate the pregnancy.
Fast forward to 2010. Prospective parents can now be tested before pregnancy, and those found to be
carriers for serious conditions have the option of in-vitro fertilization, whereby embryos can be pre-
tested for genetic markers associated with Alzheimer's disease, hemophilia, muscular dystrophy, Tay-
Sachs disease, and more. Many of these same markers can also be detected by do-it-yourself genetic-
testing kits, which are beginning to appear on the Internet and on drugstore shelves. Walgreens may
soon sell a cheap home test that covers 37 genetic conditions. (Sales are postponed pending approval by
the Federal Drug Administration.) You will soon ...
A feature about latest research to improve premature babies' medical care.
Published in The Lancet Neurology:
http://www.lancet.com/journals/laneur/article/PIIS1474-4422%2813%2970041-3/fulltext
Seminário Nacional do Benzeno (5 e 6 dez/12) - Derivação de Limites de Exposição Ocupacional para Substâncias Carcinogênicas e
Mutagênicas - Experiências Internacionais e Nacional
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
1. Smooth Sailing Through The Perfect Storm:
A case study in adolescent & young adult (AYA) oncology
Lara E. Davis, MD1, Kellie Nazemi, MD
Sue Lindemulder, 2, Brandon HayesLattin, MD2, MD3
Oregon Health & Science University, Portland, Oregon, USA
1Divisions of Medical Oncology and Pediatric Hematology/Oncology, 2Division of Pediatric Hematology/Oncology, 3Division of Medical Hematology/Oncology
The Case Discussion
A 29-year-old male presented to a community hospital with a three This case illustrates many of the factors that have limited progress
month history of progressively worsening headache. He sought against cancer in the AYA population as described by the 2006 Progress
evaluation when the pain began to interfere with his ability to perform Review Group of the National Cancer Institute and Lance Armstrong
independent activities of daily living. He was found to have a left-sided Foundation:
posterior fossa mass and was referred to our tertiary academic center
for resection by the adult neurosurgical service. Histopathology Challenge Relevance to Broader
Potential Solutions
confirmed the diagnosis of medulloblastoma with anaplasia, a Encountered AYA Population
Limited access to care No longer covered by parent’s Healthcare reform, including coverage of
predominately pediatric cancer that accounts for <1% of intracranial insurance but often without dependents until age 26 as recently
tumors in adults. The case was reviewed at both the adult and pediatric - Patient had no comprehensive benefits through enacted in the United States
insurance, no primary care employer
neuro-oncology tumor boards. His primary oncology care was assigned physician and limited
to the adolescent & young adult (AYA) oncology financial resources.
fellow under the co-supervision of a pediatric Delayed diagnosis Sense of invincibility Raise awareness in AYAs
Examples: Websites such as stupidcancer.com;
neuro-oncologist and an adult oncologist. - Lack of insurance Low degree of suspicion use of social networking sites; popular films like
50/50
Outpatient care was delivered in the pediatric contributed, as did the
patient’s sense that his
clinic, while all inpatient admissions were on Raise awareness in caregivers
symptoms weren’t serious. Example: Nurse Oncology Education Program
the adult wards. Radiation was delivered by a (NOEP) “At The Crossroads: Cancer in Ages 15-
39” videos
radiation oncologist specializing in both adult Ill-defined treatment Treating site often determined by Educate referral base about unique AYA
and pediatric brain tumors. Prior to systemic setting (“No Man’s Land”) referral pattern rather than needs and availability of AYA oncology
expertise care
chemotherapy, fertility preservation was - Referred to adult
Flair
discussed and declined. Following cranio- neurosurgeon initially, then Logistical barriers often exist to Identify institutional & departmental AYA
to radiation oncologist, identifying the most appropriate “champions” to break down barriers
spinal radiation he was treated per Children’s then to pediatric neuro- treatment setting & practice
Oncology Group protocol ACNS 0332. oncologist.
Although the patient’s disease and treatment- Uncertain standard of Tumor & host biology, drug Multidisciplinary tumor conferences that
care toxicities, regimen adherence, etc incorporate pediatric & adult specialists
related morbidity was mild compared to many are different from both younger
with this disease, it had tremendous impact on - Treated per pediatric and older patients Increase enrollment on clinical trials to
standard of care, but improve understanding of differences
his life. His fatigue prevented him from limited data exists for this seen
working, which impacted the family of four that protocol in adults.
Lack of clinical trials Understudied population Broaden eligibility of current and
was financially dependent upon him, and the upcoming pediatric trials to include
associated stress contributed to the ultimate T2
- There were no frontline Difficult to capture data in a patients up to age 40 (and adult trials
treatment trials available migratory population down to age 15)
failure of his marriage. for this patient due to age
>22y. Novel data capture systems (see abstract by
ADULT
Surgery Loret de Mola et al) prove that it is feasible to
enroll & retain AYA patients
Gross total resection Psychosocial issues Transitioning between child & adult Ensure clinical care team aware of unique
while confronting own mortality needs and is trained in addressing and/or
- Faced morbidity from aware of available resources
disease & treatment, Unique financial concerns
particularly devastating for (supporting young kids, pivotal Establish standard of care policies that
Radiation a young, strong Latino time in career development, etc) incorporate fertility preservation into all
PEDS
family man who was the diagnostic discussions with AYA cancer
31 fractions: 3600 cGy craniospinal with tumor bed boost head of his household. Potential loss of fertility patients
to 5580 cGy and concurrent weekly vincristine x8
Conclusions
Rest
This case, an example of a pediatric cancer occurring in an adult,
Six weeks demonstrates how multidisciplinary coordination can provide excellent
cancer care to the AYA population despite multiple challenges. By
identifying the most appropriate oncologist to lead treatment decisions
and "champions" from other departments to act as liaisons, this patient
ADULT
Chemotherapy
successfully completed intensive multimodal therapy and remains
Vincristine, cyclophosphamide, cisplatin disease free one year off therapy.
given every 28 days x6 (inpatient)
Further Information
Off therapy monitoring
PEDS
Albritton K, Caligiuri M, Anderson B, Nichols C, Ulman D. Closing the gap: Research and care imperatives
MRI brain/spine every 3mo x1y then every 4mo x1y for adolescents and young adults with cancer. Report of the adolescent and young adult oncology
progress report group. Bethesda, MD: National Cancer Institute; 2006.