Endocrine Abstracts

The number of childhood cancer survivors is ever increasing and as this population continues to grow, the long term physical and psychological impact of having cancer treatment in childhood becomes ever more apparent. Childhood cancer survivors are moving into adulthood with significant health needs secondary to their cancer treatment. Acknowledging and addressing these needs is crucial in supporting them on their continued health journey. Patients attending the ‘late effects’ clinics for childhood cancer survivors were asked to complete a holistic needs assessment questionnaire prior to their clinic appointment, in an attempt to identify their concerns and ensure the appointment was fulfilling the patients’ needs as well as the clinicians. The questionnaire listed nineteen potential topics for discussion. Patients were then invited to bring the completed form into clinic where the health needs they had identified could be discussed further. 35 patients completed the assessment. Most frequently reported health needs were concentration (40%), fatigue (40%), fertility (37%), weight (37%) and psychological (31%). Body Mass Index (BMI) of patients who identified weight as a health need revealed 38% to be underweight, 31% overweight, 23% obese and 8% severely obese. The brain tumour and bone marrow transplant survivors were reporting these problems most frequently, who were all treated with cranial irradiation, and will all require lifelong endocrine follow-up. Use of the holistic needs assessment questionnaire enabled patients to ensure that their concerns were discussed in clinic, often directing the discussion away from traditional ‘medical’ priorities. When needs could not be met by the clinic team, resources could be provided (for example, information leaflets about managing fatigue) and onward referrals made (for example, for neuropsychological assessments or to specialist fertility services). The results also illustrate the complex multi-faceted on-going needs of childhood cancer survivors, particularly those who have been treated with cranial irradiation.