Pediatric Oncology
Education Materials

• Level of energy, general health
• Vision
• Neurological symptoms (for example headaches, seizures and TIA type episodes)
• Change in short term memory
• Depression
• Social/employment situation
• Smoking, alcohol ingestion and recreational drug use
• Exercise
• Current medications

Check:

• Blood pressure
• Visual acuity, visual fields and fundoscopy
• Weight and height to calculate Body Mass Index (BMI)
• Examine neck to exclude thyroid nodules
• General examination

• If there are memory problems, it is important to formally document cognitive impairment in order to obtain vocational or recreational rehab & to apply for a disability pension

• Routine blood work (CBC, lytes, LFTs and creatinine)
• Assessment of pituitary function should be supervised by an endocrinologist (GH deficiency is very common & problems like ACTH deficiency may develop many years after therapy)
• Thyroid function tests (at least free T4 and TSH)
• Hepatitis C testing if blood product transfusion prior to 1994
• Testing for metabolic syndrome: Fasting blood glucose & lipids

• MR of the head at least every 3 years or so to exclude RT induced meningioma
• Also excludes late recurrence of OPG
• Ultrasound scan of the thyroid every 3 years to exclude nodules and thyroid carcinoma

Specialist

follow-up

Assessment by the following specialists every 1 - 2 years:

• Endocrinology
• Ophthalmology or Neuro-ophthalmology

• Family counselling
• Psychology
• Psychiatry

Lifestyle:

• Advise about diet, exercise and lifestyle choices (such as smoking) which may further increase the risk of vascular disease.

ACTH Deficiency:

• During infection, surgery and illness OPG survivors with pituitary dysfunction are very likely to need support with extra steroid medication
• Medic Alert bracelets are advised to warn about ACTH deficiency

• Educational issues
• Emotional issues
• Eye health
• Cataracts
• Hearing loss
• Growth hormone deficiency
• Central adrenal insufficiency
• Hypopituitarism
• Thyroid problems
• Reducing the risk of second cancers