Common Presentations of Childhood Cancer

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Common Presentations of Childhood Cancer

  1. 1. Doernbecher Pediatric Hematology/Oncology Fellowship Program 2008
  2. 2. History • Current 3-yr program ACGME-approved in 1997 – Established by Len Johnson and Gary Jones • First fellow entered program in July 2000 • Kiwanis Clubs of OR and SW WA support 2 positions yearly, + growing an endowment – Grass roots fund raising • Other funding: GME, DCH, NRSA, St Baldricks • 2 first year and 6 total fellows now each year
  3. 3. Applicants • NRMP since 2001 • ERAS starting 2009 • For 2 entry positions July 2009: – 42 applicants – 14 interviewed • 4-yr Adolescent & Young Adult fellowship – for entry 7-09 – combined medical oncology + PHO
  4. 4. Residency Training Programs of our PHO Fellows
  5. 5. PHO Fellowship Programs – National Data For starting date 7-08: 150 applicants 129 positions 54 programs (1 – 6 positions/yr) ↑ from 119 applicants for 7/05
  6. 6. 15 PHO Faculty H.S. Nicholson L Stork L Wolff D Tilford G Thomas T Lamkin S MalempatiB ChangP KurreE Nemecek R TrueworthyM RechtK Nazemi R ButlerS Lindemulder
  7. 7. PHO Clinical and Research Programs • Leukemia & Lymphoma – Linda Stork; Bill Chang • Neuro-Oncology – Kelly Nazemi; Kathy Perko, RN, PNP; Stacy Nicholson • Solid Tumors – Suman Malempati; Thomas Lamkin • Stem Cell Transplant – Eneida Nemecek; Peter Kurre – Tara Berhardt, RN, PNP; Amy Kenagy, RN, PNP • Hemophilia & Non-Malignant Blood Disorders – Michael Recht; Greg Thomas • Palliative Care – Greg Thomas; Kathy Perko, RN, PNP
  8. 8. PHO Programs (con’t) • Investigational Therapeutics – Suman Malempati; Linda Stork • Survivorship – Susan Lindemulder; Larry Wolff; Kelly Anderson, RN, FNP • Adolescent & Young Adult – Susan Lindemulder; Kelly Anderson, RN, FNP • Neuropsychology – Robert Butler, PhD • Bone Marrow Failure – Peter Kurre • Lab-based Research – Peter Kurre; Bill Chang
  9. 9. Some of our 2007 Team Jan Naas: Fellowship coordinator
  10. 10. Purpose - To Train Fellows to: – Deliver exceptional patient care • Treat children • Support families – Engage in scholarship and research • Treat, cure, and prevent – Cancers and blood disorders • Improve the quality of a child’s long life – Teach • Students, residents, fellows, RNs • Colleagues • Patients and families
  11. 11. Training Program • First year – Clinical rotations, continuity clinics – Week day night and weekend call – One month: Research Development • Choose lab mentor before 2nd year • Second and Third Years – 80% research: translational lab-based or clinical, or MPH – Human Investigation Program x 2 years – Continuity clinic ½ day each week – Week day night and weekend call
  12. 12. Learn From Patients Dr. Suman Malempati
  13. 13. Learn From Clinical Mentors and Other Fellows
  14. 14. Learn in the Lab Dr. Veronica Flood
  15. 15. Learn From Other Subspecialists
  16. 16. Fellows’ Research Projects and Mentors • Grover Bagby, MD – Fanconi genes and cancer • Sri Nagalla, MD, PhD – Gaba receptors in neuroblastoma • Rosalie Sears, PhD – C-Myc stabilization • Dave Farrell, PhD – Dysfibrinogenemia • Mather Thayer,PhD – Chromosone instability • Rosalie Sears, PhD – C-Myc in brain tumors • Scott Howard, MD (St Jude’s) – Hodgkin’s lymphoma RX in developing countries • Michael Deininger, MD, PhD – Tyrosine kinase inhibitors in CML
  17. 17. Fellows’ Research Projects and Mentors • Sri Nagalla, MD, PhD – genomics and proteomics of neuroblastoma • Dan Marks, MD, PhD – Glucose Tolerance in ALL survivors • James Huang, MD – In Vitro Drug Sensitivity of ALL blasts • Eneida Nemecek, MD – BMT toxicities in AYAs • Michael Deininger, MD, PhD – Leukemia inhibitors • Grover Bagby, MD – Fanconi proteins and informatics
  18. 18. Where have they gone after training?
  19. 19. 100% PHO Boards passing rate 10 graduates as of July 2008
  20. 20. What motivates our fellows to work so hard? Kids like these

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