By Bernard S. Little
The John P. Murtha Cancer Center at Walter Reed Bethesda hosted
its inaugural Childhood Cancer Summit Sept. 20.
Families, caregivers and others observe Childhood Cancer
Awareness Month during September, focusing on the nearly 70,000 young adults 15
to 39 years of age diagnosed with cancer in the United States annually,
according to Dr. Amin Herati, a urologist from Johns Hopkins University. Herati
served as one of the speakers during the day-long summit at WRB.
“Advances in detection, treatment and survivorship have
shifted the focus of survivorship care plans towards quality of life,” Herati
Army Lt. Col. (Dr.) Dina Parekh, chief of Pediatric
Hematology Oncology at Walter Reed National Military Medical Center, agreed,
crediting the multi-disciplinary family approach to care and holistic effort in
cancer detection and treatment to advances survivorship.
“What we do as oncologists, and the medicine of it, is not
hard. We take a diagnosis, we follow a recipe, [and] we come up with a plan.
Much of the time it can be pretty unremarkable. But what we can do as a team
with social workers, nurses, surgeons, oncologists, urologists, gynecologists, patient
navigators and the patients, all talking together, is truly phenomenal,” Parekh
added. “[Although] pediatric survivorship is growing day-by-day, we can always
strive for better,” she furthered.
Annually, more than 1,000 active duty service members
receive a cancer diagnosis, said retired Army Col. (Dr.) Craig D. Shriver, director
of the Murtha Cancer Center, which is the only Cancer Center of Excellence in
the Department of Defense. He said many of those diagnosed are young adults.
“From a childhood cancer perspective, survey after survey
show that for service members deployed and not deployed, care of their family
members is the No. 1 morale issue. If you’re over in a theater of conflict and
your child gets a diagnosis, you’re probably not going to be fully mission
ready unless you feel comfortable your family is being taken care of in the
best possible way,” Shriver continued.
He stressed the importance of hearing from cancer survivors
who shared their stories during the summit at WRNMMC. One of those survivors,
Carly Allphin, was diagnosed with Stage 4 Ewing’s sarcoma about two and half
years ago. She was 14. An MRI found nine tumors throughout her spine.
Krista Allphin, Carly’s mother, said that day in April 2016
when her daughter was diagnosed “is sealed in her brain. It was probably the
worst day of my life.” Krista added the bright spot was the staff at WRNMMC,
who helped her family understand what to expect, treatment options and side
effects regarding Carly’s care. “It was a major whirlwind,” she recalled.
Carly admits that fertility preservation wasn’t at the
forefront of her mind when she received her diagnosis. However, an important
part of cancer treatment is to carefully evaluate each person’s medical
situation, goals for parenthood and cancer treatment plan, speakers at the
summit stressed. Sperm and egg cells are vulnerable to cancer treatment such as
chemotherapy and radiation, which Carly received. Fertility preservation calls
for collecting and protecting sperm or egg cells prior to cancer treatment so
they are not damaged, and Carly underwent the procedure prior to her treatment.
“We now have this hope for these frozen follicles that are
[stored] in Baltimore, and we’re thankful for our doctors who didn’t give up,”
said Krista. Carly agreed.
Erin Craig shared similar sentiments. On Dec. 22, 2017, she was
diagnosed with acute myeloid and monocytic leukemia. She was 20.
“Children were not on my mind at the time, but I knew that I
wanted to have that choice down the road. It is a shock to hear that there’s a
very large chance that I will never regain function in my ovaries after going
through the amount of chemotherapy I went through, total body radiation and the
bone marrow transplant,” Craig continued.
“What’s so jarring about that from the patient side is
you’re not only hearing about how this is going to affect you right now, but
this is going to have effects on the rest of your life. This is going to
completely change how you move forward,” said Craig.
“I’m grateful my doctors said, ‘We’re not only going to look
at the next six months, but we’re going to look at this holistically, not just
how this is going to affect you medically and emotionally, but how this is
going to affect your life going forward, and the importance that fertility
might have to you one day. I’m really incredibly appreciative of that focus and
foresight to see what I might need down the line. It was a discussion we had
and it came down to [providers saying] ‘This is your decision.’ I was given the
choice and I think that was the really important part,” Craig explained.
Dr. Veronica Gomez-Lobo, director of Washington Hospital
Center Pediatric and Adolescent Ob/Gyn, discussed the current state of
oncofertility, adding that children born after fertility preservation don’t
have a higher rate of cancer birth defects.
In addition to Herati, Navy (Dr.) Lt. Cmdr. Janelle Fox also discussed cancer
and young males. Fox addressed prepubertal oncofertility while Herati focused
on the postpubertile male. As with other speakers at the summit, both agreed
that fertility preservation should be addressed with patients and their
families as early after diagnosis as possible. Fox recommended people visit the Save
My Fertility site at http://www.savemyfertility.org/ for more information regarding fertility
Stacee Springer and Meghan Fitzgibbon, licensed clinical
social workers at WRNMMC who work with adolescent and young adult beneficiaries
as part of the Adolescent Young Adult Oncology Team at the medical center,
explained the Murtha Cancer Center Fertility Preservation Policy.
Implemented in February 2017 with a goal of standardizing
the initiation of the fertility preservation discussion, Springer and
Fitzgibbon explained the purpose of the fertility preservation policy at WRNMMC
is to “ensure a consistent approach to addressing fertility preservation
throughout the Murtha Cancer Center.” In addition, the policy provides “minimum
standards for addressing infertility risk in cancer patients.”
The summit also included a question and answer session with
participants, as well as a family break-out session.