Staying healthy after cancer: The STAR program

All cancer survivors want to live long, productive lives. Consequently, after their initial diagnosis and treatment, they need specialized long-term care with continued monitoring of risk factors, relevant health guidance, ongoing support and occasional further treatment. Thanks to more aggressive and effective protocols, advanced research and an ever-increasing number of clinical trials, it is estimated that by the year 2010, as many as 1 in every 250 young adults will be a childhood cancer survivor.

Thanks to current treatment strategies, approximately 75 percent of children diagnosed with cancer become long-term survivors.

As a result of the more aggressive treatment, however, there is also greater risk of cancer survivors developing late-appearing, long-term side effects. To minimize this risk and to ensure early diagnosis of any potential problems, Children's Memorial Hospital encourages active participation in long-term care specifically designed for cancer survivors. The transition to this care begins initially in the successful, safe environment of Children's Memorial.

At Children's Memorial, the survivor who already feels connected with the medical team, learns that annual check-ups are an important part of ongoing care for several reasons.

• Moving the details of long-term care from the former caregiver to the survivor.
• Reinforcing the concept that early diagnosis of any potential problem is the best preventive medicine.
• Staying connected with the hospital, the survivor remains part of a broad-spectrum database, which is critical both to good outcomes and the evolution of cancer research and clinical trials.

Thanks to current treatment strategies, approximately 75 percent of children diagnosed with cancer become long-term survivors. This success is a major feat of pediatric medicine, surgery, radiation oncology and stem cell transplantation. Nevertheless, survivors need continued monitoring and care to minimize any possible late negative effects of these diseases and treatments. This monitoring and care needs to be organized, systematic and comprehensive, addressing both the physiologic and psychosocial effects of treatment. This is the focus of the STAR Program sponsored jointly by Children's Memorial and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

Patients are referred to the program five years after diagnosis. With more than 1,200 long-term survivors in our database, we see approximately 360 patients annually. In 2002, the STAR program expanded its hours and increased nursing participation to accommodate more survivors. Barbara Lockart, RN, PNP, and Karina Danner-Koptik, RN, MSN, share the program's nursing responsibilities for patient evaluations and patient education. They also provide expertise to instruct nursing colleagues and participate in the program's research protocols.

In 2002, an advisory board to the STAR Program, comprised of survivors, parents of survivors, STAR clinic staff and medical consultants, was created to serve as a conduit for consumer input. To help share information on long-term survivorship at diagnosis, board members developed a new section about the program for the Parent's Handbook, a section that parents find inspirational during an otherwise difficult time. Sessions are held Wednesday morning and afternoons and alternate Tuesday mornings.