title: The Late Effects Clinic in action: for survivors of childhood malignancy.
abstract: Long-term survivors of childhood malignancy are a newly emergent patient group with a unique but wide range of survivorship issues. There are rising demands for long-term, medical follow-up and social support for this potentially vulnerable group. These demands stem from improving survival rates and the progressively increasing incidence of late physical, psychological and social sequelae. CASE-STUDIES AND DISCUSSION: The ideal method to facilitate this long-term followup is unclear, and faces the problems of health-care system limitations coupled with the paucity of outcomes-based research to guide evidence-based, clinical practice. We discuss how the Late Effects Clinic operates in our institution: optimising the involvement of the multi-disciplinary medical and allied health care teams to meet the physical and psychological needs of long-term survivors, and to assist with the social issues surrounding survivorship. This model involves a co-operative team approach, thereby alleviating the sole responsibility from general practitioners or individual physicians with a restricted realm of expertise. We present three case reports illustrating the value of a formal late effects follow-up programme, and demonstrating the integration of the Late Effects Clinic into medical practice.
authors.affiliation: Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
authors.forename: Belinda A
authors.initials: BA
authors.lastname: Campbell
authors.forename: Greg
authors.initials: G
authors.lastname: Wheeler
authors.forename: John F
authors.initials: JF
authors.lastname: Seymour
authors.forename: David
authors.initials: D
authors.lastname: Ritchie
authors.forename: Natalie
authors.initials: N
authors.lastname: Goroncy
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000554:Ambulatory Care Facilities; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000534:rehabilitation* / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000453:epidemiology / Q000473:pathology; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D017741:Survivors