After training in Auckland and Melbourne, Scott started his paediatric career as general paediatrician and paediatric oncologist at Waikato Hospital in 1986. He moved to Starship in 1996 and has been clinical director of Paediatric Oncology and clinical leader for Starship. He has held several national and international roles in paediatric oncology and is a past continental president for Oceania of the International Society for Paediatric Oncology. Currently Scott works with the paediatric oncology team at Starship Blood and Cancer Centre and also holds an appointment as National Clinical leader; Child Cancer. In this role he is responsible for delivering on the national plan for child cancer services which combines the concept that every child in NZ will have the same access to best possible outcomes with the commitment that all children will be treated as close to home as safely possible. He was a member of the Clinical Guidelines working group which produced “Suspected Cancer in Primary Care”.
| Is Childhood Cancer a Specialist Game or Can GPs Play Too?
Main Session |
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| Saturday, 14 June 2014 | Start 8:30am | Duration: 25mins | Baytrust |
| Over the last 40 years, survival from a diagnosis of cancer in childhood has increased from under 50% to over 80%. This has occurred despite very few significant additions to the chemotherapeutic agents available. Several factors contribute to this improvement in outcome. • The emergence of paediatric oncology as a highly specialized field of practice with expertise being concentrated on centralized multidisciplinary teams. • Improvements in understanding of prognostic factors so that the most intensive therapy can be directed at those with the worst historical outcomes and those who are readily cured by less intensive therapy can avoid unnecessary late effects. • Improved diagnostics and therapeutics enabling improved supportive care resulting in less treatment related morbidity and mortality. • Sequential clinical trials, often enrolling internationally with evidence based treatment protocols. Centralised highly specialized delivery of child cancer care concentrates delivery on hospitals risking leaving the community family practitioner with either an ill-defined or extremely limited role. However there are a number of clear roles for the GP, some of which are highlighted. • Identification of the child presenting with symptoms and signs of a cancer and prompt referral to the nearest paediatric service. • Support of the family of a child receiving treatment for cancer, gradually picking up care of the child after cancer treatment is complete, often beginning with a catch-up immunization programme. • Being a part of the monitoring process for late effects of treatment and provision of long term care of the survivor. • Being a key part of the provision of palliative care for the child who is no longer being treated with curative intent. | |||
| Patient Stories About Managing Childhood
Cancer
Concurrent Workshop Repeated |
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| Saturday, 14 June 2014 | Start 11:00am | Duration: 55mins | Room 10 |
| Start 12:05pm | Duration: 55mins | Room 10 | |
| Scenario 1. Chickenpox is in the school. What is the response when the parent of a child on chemotherapy rings the practice? Scenario 2. The family presents a child on chemotherapy to the practice with a condition that is usually confidently managed by the GP. What additional aspects should be considered? Scenario 3. Participation by GP in management of dying child at home Scenario 4. Management of febrile neutropenias in a patient living a long distance from the nearest paediatric unit. GP as unusual first line in management of patient on treatment Scenario 5. GP reluctance to be involved in the process of reimmunisation because of time involved, uncertainty about access to immunization benefits and lack of clarity about vaccines on the schedule. GPs inadequately informed and unsupported by a system currently in process of changing. (July 1st 2014) Scenario 6. Successful integration in the workforce and community after diagnosis with poor prognosis cancer and extreme morbidity during treatment which needed to be truncated . GP involvement in late effects monitoring using the personalized health passport. Scenario 7. Compromise of quality of life by treatment limiting side effects and impact on loss of potential. GP involvement in managing metabolic syndrome. Scenario 8. Stage 4 disease with low chance of cure following late presentation to GP. Scenario 9. Parental refusal to engage in therapy and the resulting court process. Could we have integrated the General Practice and knowledge of the patient’s community links better? | |||