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Current Cancer Research 

Development and validation of a pediatric cancer-specific symptom screening and assessment tool

Giving children with cancer a better way to describe their symptoms

The good news is cure rates for children with cancer are nearly at 82% but with this progress comes some bad news: Many children bear a heavy burden of symptoms during treatment and have chronic health conditions following treatment. This multi-centre study, led by investigators from The Hospital for Sick Children in Toronto, gives children with cancer their say on the symptoms that matter the most to them by seeking their views on a symptom screening and assessment tool, known as the Symptom Screening in Pediatrics Tool (SSPedi). Knowing more about how children with cancer feel about symptoms such as mood swings, nausea, headaches, fatigue or feeling scared or worried is key to maximizing their well-being, improving management of those symptoms and reducing morbidity. Previous research has found that getting children to self-report their symptoms made them feel more in control. This study aims to develop and evaluate an electronic version of the SSPedi so that children can self-report their symptoms on electronic devices such as iPads and Android tablets.

CHEO is one of 9 sites in Canada and the United States evaluating the reliability and validity of the electronic version of the SSPedi. Dr. Donna Johnston is site principal investigator for CHEO, where an estimated 30 children between the ages of 8-18 with cancer or undergoing hematopoietic stem cell transplantation (HSCT) will participate. In total, 870 children are expected to participate at all sites over two years, including 300 child-parent paired assessments.

Status update: CHEO recruited 49 patients to this study, and it completed accrual in June. A manuscript is underway, with plans to implement this assessment tool in pediatrics.

CanDECIDE: Canadian study of determinants of endometabolic health in children

Studying the impact of obesity on childhood survivors of brain cancer tumours

Rising rates of obesity are having an impact on childhood cancer and a range of other diseases. In Canada, childhood obesity has tripled over the past two decades and 25% of children are overweight or obese. This study examines patterns of obesity in brain tumor survivors as well as non-cancer controls, and define the biological and psychosocial determinants of these adiposity patterns. As success in treating childhood cancer increases, it is important to understand the endocrine and metabolic complications linked with obesity, including Type 2 diabetes and early cardiovascular disease. It’s also important to minimize the burden to survivors of childhood cancer: virtually nothing is known about survivors of brain tumours in terms of the inflammatory status associated with the tumour or its treatment and the impact of obesity. This cohort study involving children with a diagnosis of brain tumour will enroll patients who are 6 months off therapy and assess markers for obesity as well as other data. A total of 200 patients and 200 controls will be recruited. Patients have been recruited from clinics at McMaster Children’s Hospital and other participating centres, including CHEO. Dr. Donna Johnston is CHEO’s co-investigator.

Status update: The study is now up and running at CHEO.

Teens Taking Charge: A pilot randomized controlled trial of an online self-management and transitional care program for youth with cancer

Helping teenagers with cancer to take the reins of control for their aftercare

Adolescents between the ages of 12-18 with cancer are at risk of missing out on crucial follow-up care for the late effects of their treatments as they transition between pediatric and adult health care. Self-management is especially important for this unique patient group because improvements in their health outcomes have lagged behind younger children and older adults. An estimated one-third of youths with cancer do not successfully transfer to aftercare or adult health care services in Ontario. To tackle this problem, CHEO is one of four university-affiliated pediatric tertiary care centres involved in the development and evaluation of Teens Taking Charge: Managing Cancer Online, an English-French bilingual tool designed to provide adolescent-focused health information, disease management skills and social support. The website’s content, developed by SickKids’ About Kids Health program, includes animations, video clips, a monitored discussion board, an ‘Ask the Expert’ feature, goal-setting, weekly-knowledge quizzes and ‘My Journal’. The study is led by SickKids with interviews of kids and parents taking place at CHEO, McMaster Children’s Hospital and the Centre Hospitalier Universitaire Sainte-Justine. A total of 60 English- and 60 French-speaking adolescents with cancer and one of their parents/caregivers have been recruited across all sites. Dr. Donna Johnston is CHEO’s co-investigator.

Status update: This study is actively recruiting patients at CHEO.

Novel Approaches to the Prediction, Diagnosis and Treatment of Cardiac Late Effects in Survivors of Childhood Cancer (PCS2 study)

Investigating ways to limit chemo complications before the damage is done

Chemotherapy kills cancer cells but can also damage healthy cells. Complications can appear years after treatment is completed. The ‘late effects’ of anthracycline chemotherapy treatment can include heart damage that affects the heart’s ability to pump blood through the body. It is difficult to predict which children or teens with cancer are at greatest risk. This study involving 920 participants aims to develop tools such as blood tests, heart imaging and genetic testing that can detect heart damage early in its course and determine whether differences in genes between individual children and teens with cancer can predict who is at greater risk of heart damage. Research is taking place at the Children’s Hospital of Eastern Ontario, SickKids (Toronto), McMaster Children’s Hospital (Hamilton) and the London Health Sciences Centre (London). CHEO staff pediatric oncologist Dr. Mylène Bassal and CHEO staff pediatric cardiologist Dr. Jane Lougheed are site investigators at CHEO.

This study is led by Dr. Paul Nathan at The Hospital for Sick Children (Toronto) and funded by the Canadian Institutes for Health Research (CIHR), the Garron Family Cancer Centre at SickKids, the Pediatric Oncology Group of Ontario (POGO), the Canadian Cancer Society, C17 and the Ontario Institute for Cancer Research (OICR).

Status update: The study is actively recruiting patients at CHEO.
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