University of Pennsylvania School of Nursing, Philadelphia, PA
Theresa C Disipio , Frances Zappalla , Joanne Quillen
Background: Many adult childhood cancer survivors are at risk of developing adverse health outcomes as a result of their previous diagnosis and treatments. Cardiac events are the most common cause of non-malignant mortality among pediatric cancer survivors; one in eight will develop severe cardiac disease (Lipshultz et al, 2012). The use of integrative therapies in the survivorship setting has the potential to reduce risk of developing late effects and assist with positive coping mechanisms (Kelly, 2009). Early exposure to anti-inflammatory nutrition, yoga and relaxation techniques in combination with thorough cardiac monitoring has the potential to reduce feelings of anxiety and fear of recurrence while catalyzing positive lifestyle modifications and improving overall wellness. Methods: In partnership with the Department of Cardiology at AIDHC, childhood cancer survivors at moderate-to-high risk were identified and referred for integrative cardiology consults (ICC) with a goal of providing an introduction to integrative medicine approaches, and a long-term emphasis on decreasing the incidence of future adverse cardiac events. Patients were approached during their routine post-therapy follow-up appointments. Cardiology consult orders were placed by the oncology provider through the electronic medical record (EPIC) via smart phrasing. Results: A total of 15 patients and families were approached. All 15 complied to ICC in conjunction with their routine ECHO/EKG testing. 47% of the referred patients were exposed to both anthracycline chemotherapy and radiation. 17% presented with significant cardiac related family medical history and 40% had existing comorbidities or lifestyles that may affect future cardiac health. Conclusions: Implementing an ICC standard for childhood cancer survivors at moderate-to-high risk for cardiac late-effects has been successful for AIDHC’s Cancer Survivorship Clinic and shows promise as a preventative intervention. Efficacy will be assessed by measuring patient and family knowledge pre and post ICC in the future.
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