Saturday, September 15
7:30 – 8:45 am
CNE Presentation

Healing Hope and the Promise of Healthy Survivorship — Recognition Breakfast for Certified Oncology Nurses* (RB)

Please note that the breakfast has reached the max capacity.

1CNE  Wendy S. Harpham is a doctor of internal medicine, 27-year cancer survivor, best-selling author, nationally recognized speaker and patient advocate. From both sides of the stethoscope, Wendy has used her useful perspective to help patients become Healthy Survivors -- namely, survivors who get good care and live as fully as possible.

Since her diagnosis, Wendy has played an important role in raising awareness among clinicians and in empowering patients to talk with their healthcare team about the challenges of survivorship, such as coping with post-treatment fatigue, raising healthy children when a parent has cancer, and participating in clinical trials.

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Speaker:
Wendy S. Harpham, MD
2:15 – 3:15 pm Saturday, September 15

DSRCT: A Pediatric Oncology Rarity (230)

1CNE  Desmoplastic small round cell tumor (DSRCT) is one of the rarest pediatric tumors and was only recently classified in 1989. Categorized under sarcomas, DSRCT under the microscopic is a fusion of a both a wilms and ewing sarcoma gene. Although known as a mostly surgical tumor, chemotherapy, radiation, and new treatments like immunotherapy are vital in the battle against this fatal disease. DSRCT is known mostly in the adolescent and young adult population, where the rate of occurrence is predominantly in males. In a retrospective cohort analysis published in 2014 from the Journal of Cancer Epidemiology, the 5-year survival rate was found to be just 33.3% (Lettieri, Garcia-Filion, Hingorani, 2014). Factors impacting survival rate are the overall oncology role to treatment and management.

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11:30 am – 12:30 pm Saturday, September 15

Comprehensive Care for Thalassemia (226)

1CNE  Thalassemia is becoming a more common diagnosis seen in pediatric hematology/oncology centers. The term thalassemia describes a group of very complex diseases that requires thorough, comprehensive care to improve outcomes and quality of life for these patients. A complicating factor is that patients often are immigrants or refugees with language and cultural barriers and other socioeconomic issues. The care of these patients require a multidisciplinary approach and a strong understanding of the pathophysiology, specific complications, current treatments, and new and emerging therapies.

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3:15 – 4:15 pm Friday, September 14

Beyond the Cure: The Children’s Oncology Group’s Efforts to Improve Outcomes for Pediatric Cancer Patients Long after Treatment has Finished (C223)

coglogo1CNE  Childhood cancer survivors are living longer than ever before, with overall survival rates exceeding 80%. As a result, survivors also are living with chronic late health effects related to their curative treatments, with 40% of survivors experiencing a severe, disabling, and life-threatening or fatal late effect at 30 years post-treatment. Late effects may include second malignancies, endocrinopathies, cardiomyopathy, infertility, pulmonary function deficits, renal/ocular/auditory disorders, neurocognitive deficits, and metabolic syndrome. Recent studies report that cumulative incidence of late effects may be even higher than previously reported, with survivors having 3 to 5 treatment-related chronic health conditions by the age of 50.

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11:40 am – Noon pm Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Assessment Tools for Peripheral Neuorpathy in Pediatric Oncology Patients: A Systemic Review (216-3)

1CNE  Chemotherapy agents used for the treatment of pediatric cancer cause many side effects including peripheral neuropathy. Using appropriate assessment tools to accurately identify peripheral neuropathy is an important part of pediatric oncology care. A systematic review was performed to determine reliable assessment tools to identify peripheral neuropathy in children receiving vincristine.

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

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11:20 – 11:40 am Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Effect of Proton Therapy on Patient Reported Health-Related Quality of Life and Symptoms in Patients with Craniopharyngioma (216-2)

1CNE  Basis of inquiry: Craniopharyngioma is a brain tumor located near the hypothalamic-pituitary axis. Surgery and conventional photon-based radiation therapy result in long term tumor control; however, survivors are known to have disruptions in patient sleep, endocrine and neurocognitive function, as well as health related quality of life (HRQOL). Proton therapy is a newer form of radiation therapy. Little is known about its effect on patient–reported HRQOL and symptoms when used in the management of craniopharyngioma.

Purpose/Objectives: To describe patient-reported HRQOL and symptoms before and during proton therapy in patients with craniopharyngioma.

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11:00 – 11:20 am Friday, September 14

Paper Presentation: Assessing Symptoms and Symptom Trajectories — Symptom Trajectories among Adolescents during Hematopoietic Stem Cell Transplantation (216-1)

1CNE  Basis of inquiry: Symptom management is major role of pediatric hematopoietic stem cell transplant (HSCT) nurses and a thorough understanding of symptom experiences is needed. Symptoms are complex and their frequency, severity, and distress change over time. Research is needed to identify symptoms over time (trajectories) among adolescents undergoing HSCT.

Purpose/Objectives: 
The aim of this study was to describe symptom trajectories including symptom frequency, severity, and distress among adolescents from pre-HSCT to 100 days post HSCT.

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11:00 am – Noon Friday, September 14

Starvation, Death, and Destruction: The Battlefield of AVN (213)

1CNE  Avascular necrosis (AVN) results from the temporary or permanent loss of blood supply to the bone and can lead to bone destruction, pain, and loss of joint function. Most hematology/oncology nurses are aware that corticosteroid exposure and older age are risk factors for the development of AVN in children treated for acute lymphoblastic leukemia. Are you familiar with other risk factors in children with oncologic disorders? Did you know that AVN of the femoral head is a common complication in children with sickle cell disease? While nonsurgical approaches may be appropriate in the early stages, surgical management is often required for more progressive disease. Through the use of interactive case studies we’ll review the common presenting signs and symptoms of AVN in children with both hematological and oncologic disorders, diagnostic workup and disease staging, and evidence-based management strategies.

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5:25 – 5:45 pm Thursday, September 13

Paper Presentations: Engaging Patients and Providers in the Research Process — The Influence of Pediatric Oncology Summer Camp Attendance on Physical Activity, Fatigue, and Oxidative Stress (210-3)

1CNE  Basis of Inquiry: Childhood cancer patients and survivors are less physically active and report increased fatigue. Improved physical activity may reduce fatigue. Over 130 summer camps serve pediatric oncology patients and survivors. Camps promote physical activity and offer a unique opportunity to explore the relationship between physical activity and fatigue.

Purpose: This study was conducted to determine if summer camp attendance increased physical activity in childhood cancer patients and survivors and how physical activity interacts with fatigue. An exploratory aim was to examine changes in oxidative stress which is hypothesized to impact fatigue.

Methods: A repeated measures study design was utilized. Accrual of 60 children over 2 years planned (data collection ends June 2018).

Eligibility: (a) 8–17 years; (b) English speaking; (c) current diagnosis or history of cancer; (d) willingly wear physical activity monitor daily x 2 weeks (beginning 7 days before camp); (e) complete surveys and provide urine samples x 2; (f) attend a 6 day Oncology Summer Camp (g) no neurological disorders/syndromes; (h) without physical limitations. Physical activity was reported as steps/day and intensity level as minutes/day. Oxidative stress measured as urine isoprostane. Paired t-test were conducted to examine change in scores for the Pediatric PROMIS measures, steps/day and isoprostane levels. Pearson’s r was used to calculate correlation coefficients.

Findings/Outcomes: Thirty children enrolled in year 1.

Demographics: 57% male; 70% Caucasian, 20% Asian, 7% African American; 77% off therapy; 40% Leukemia/Lymphoma, 20% Solid tumors, 20% CNS tumors, 20% Unknown. Mean steps/day increased during camp by 7709 (p < .001; 95% CI; 6209 to 9210). Fatigue (p=0.47), anxiety (p=.021) and depression (p=.005) all decreased during camp. Weak non–significant negative correlation, in first 24 samples, between change in oxidative stress and physical activity (r = –.144; p=.50).

Disclaimer: [1 CH] will be awarded for attending all three paper presentations presented during this timeslot. Partial credit is not available.

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5:05 – 5:25 pm Thursday, September 13

Paper Presentation: Engaging Patients and Providers in the Research Process — KAM: Kids are Moving—An Exercise Program for Children with Cancer (210-2)

1CNE  Basis of inquiry: During cancer treatment, children are significantly less active than their healthy peers. Inactivity persists into survivorship, negatively influencing health and quality of life. Children with cancer report that fatigue is one of the most distressing, treatment-related symptom impacting their quality of life; yet children with increased physical activity (PA) have less fatigue. In this study, we sought to evaluate if children could decrease their level of fatigue over the trajectory of treatment by increasing their physical activity.

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