Join us at noon CT (1 p.m. ET/10 a.m. PT) on Tuesday, July 19, for an hour-long chat about surviving childhood cancer, with Chicago Tribune health reporter Deborah L.Shelton and panelists Dr. Mary Lou Schmidt, Melinda Stolley, Ph.D., and Jessica Ittner, RN.

The cure rate for childhood cancers rose dramatically in the mid-1980s. Now, an estimated 270,000 Americans between the ages of 20 and 39 are childhood cancer survivors, about one in 640 adults in that age range. As many as 7,000 childhood cancer survivors live in the Chicago area. Despite that good news, research suggests that two-thirds of survivors develop a major medical disorder as a result, and about a quarter have three to four major health problems, one of which is considered life-threatening.

What do childhood cancer survivors need to know as they get older? Are survivors accessing the care that they need? And what research is underway to learn more survivors and the health problems that they face?

Experts:Dr. Mary Lou Schmidt is head of the division of pediatric hematology/oncology at Children's Hospital University of Illinois and head of the joint Children's Oncology Group Clinical Trials program at UIC, Rush University Medical Center and the John H. Stroger Medical Center (formerly Cook County Hospital). She has a strong clinical focus on infants, children, adolescents and young adults with cancer, and her research focus is on low and intermediate risk neuroblastoma clinical trials, late effects from childhood cancer and enrollment of under-represented minorities and adolescents and young adults onto COG clinical trials. She established and is the co-medical director of the UIC Cancer Survivorship Clinic and is a member of the UIC Cancer Center.

Melinda Stolley, Ph.D is a health psychologist with a specialization in oncology, as well as a portfolio in cancer survivor research and weight loss interventions with children and cancer survivors. She recently completed a National Cancer Institute Cancer Prevention Career Development Award that supported extensive training in health disparities and cancer survivorship. Stolley is currently conducting an NCI-funded multi-site study that examines health behaviors in a diverse cohort of childhood cancer survivors and healthy controls. Stolley is a fellow at UIC's Institute for Health, Research and Policy and a member of the UIC Cancer Center.

Jessica Ittner, R.N joined the staff at the University of Illinois at Chicago in 2008 and is project coordinator of Children's Oncology Group Studies at UIC and Rush University Medical Center. She is also nurse coordinator for the UIC Cancer Survivorship Clinic. Ittner has worked as a clinical scientist, a research assistant and clinical nurse during her career. As a child, Ittner was treated for a tumor with radiation, chemotherapy and surgery and often shares her personal experiences with other patients.

If you would like to submit a question in advance for Dr. Leventhal or Dr. Lynn Wegner, please e-mail Deborah L. Shelton at dshelton@tribune.com.

 Health Chat: Surviving childhood cancer(07/19/2011) 
11:49
Deborah Shelton: 
Welcome to today’s web chat on childhood cancer survivors. Please stay tuned; we will start at noon.
Tuesday July 19, 2011 11:49 Deborah Shelton
11:52
Deborah Shelton: 
Chatters, we will be taking your questions live. You can post at anytime. We will start at noon.
Tuesday July 19, 2011 11:52 Deborah Shelton
12:00
Deborah Shelton: 
Hi everybody! I am your moderator, Deborah Shelton, a health reporter at the Chicago Tribune. Thanks for joining us for this chat on childhood cancer survivors. We have three outstanding guest experts joining us.
Tuesday July 19, 2011 12:00 Deborah Shelton
12:00
Deborah Shelton: 
Dr. Mary Lou Schmidt is head of the division of pediatric hematology/oncology at Children's Hospital University of Illinois and head of the joint Children's Oncology Group Clinical Trials program at UIC, Rush University Medical Center and the John H. Stroger Medical Center (formerly Cook County Hospital). Dr. Schmidt established and is the co-medical director of the UIC Cancer Survivorship Clinic and is a member of the UIC Cancer Center.

Thanks for being here.
Tuesday July 19, 2011 12:00 Deborah Shelton
12:00
Mary Lou Schmidt: 
I am very excited to discuss questions about and from survivors of childhood cancer. With all of the success in treatment and care for children with cancer over the last 30 years, new issues are arising and we are here to help the public understand the issues so we can all support and promote survivors to lead healthy lives.
Tuesday July 19, 2011 12:00 Mary Lou Schmidt
12:04
Deborah Shelton: 
Melinda Stolley PhD, is a clincial psychologist who researches behavioral and psychological aspects of childhood cancer survivroship.

Welcome!
Tuesday July 19, 2011 12:04 Deborah Shelton
12:04
Melinda Stolley: 
I am delighted to have the opportunity to be here today and to talk with you all about childhood cancer survivorship.
Tuesday July 19, 2011 12:04 Melinda Stolley
12:05
Deborah Shelton: 
Last but not least is Jessica Ittner, a registered nurse who joined the staff at the University of Illinois at Chicago in 2008 and is project coordinator of Children's Oncology Group Studies at UIC and Rush University Medical Center. She is also nurse coordinator for the UIC Cancer Survivorship Clinic. Ms. Ittner has worked as a clinical scientist, a research assistant and clinical nurse during her career. As a child, Ittner was treated for a tumor with radiation, chemotherapy and surgery, and often shares her personal experiences with other patients.

Thanks for joining us.
Tuesday July 19, 2011 12:05 Deborah Shelton
12:05
Jessica Ittner RN: 
Thanks for inviting me to participate! I'm excited to answer any questions about survivorship.
Tuesday July 19, 2011 12:05 Jessica Ittner RN
12:06
[Comment From Giovanni Giovanni : ] 
What percentage of childhood cancer survivors have a chronic health condition?
Tuesday July 19, 2011 12:06 Giovanni
12:06
Deborah Shelton: 
Thanks for the question Giovanni!
Tuesday July 19, 2011 12:06 Deborah Shelton
12:06
Mary Lou Schmidt: 
Much of what we know about childhood cancer survivors in the US comes from the Childhood Cancer Survivors Study (Oeffinger, et al, NEJM 2006): which is a telephone survey of approximately 14,000 survivors and their siblings. These survivors were treated for cancer in the 1970s-1990s, they are cured from their first cancer and at the time of their interview they were on average 27 years old.

There are 270,000 adults who have survived childhood cancer, 2/3 of whom have at least one chronic health condition. Many of the late effects are mild however approximately 30-40% of survivors have a severe health condition and this risk increases with increasing time from end of therapy.

Tuesday July 19, 2011 12:06 Mary Lou Schmidt
12:07
[Comment From Candy Candy : ] 
My daughter had ALL when she was 9, treated with chemo and cranial radiation. She's now almost 21 and will be graduating college next year. Is there any new research on any ongoing problems -- emotionally or physically -- for survivors like her? She was told she would be at increased risk forbreast cancer and should be monitored forheart problems if she gets pregnant
Tuesday July 19, 2011 12:07 Candy
12:08
Mary Lou Schmidt: 
The most common chronic health conditions include: major joint replacement,heart disease, second cancer, brain/thinking/memory problems, stroke, kidney failure and/or need fordialysis, hearing loss, loss of vision,hormone problems and infertility.
The exact risk for any survivor of childhood cancer is dependent on the exact cancer that they had, the age they were when they were diagnosed, the exact treatment that they received and any complications that they may have had during their treatment.

It will be important to share all of the information of her prior treatments with her current physicians to optimize her health.
Tuesday July 19, 2011 12:08 Mary Lou Schmidt
12:08
Melinda Stolley: 
The majority of childhood cancer survivors do not suffer any long term psychological consequences. In fact, many report high levels of quality of life and relate that they have a greater appreciation for what is good in their lives and feel somewhat resilient and better able to deal with stressful situations than their non-cancer affected peers. However, there is a subset that do face psychological challenges including depression, anxiety and post-traumaticstress syndrome. There are many factors that contribute to long term psychological struggles including stage at diagnosis, treatment, age at diagnosis, family cohesion, social support and other medical and social conditions. As in most situations, those faced with the most difficult conditions such as poverty, family conflict, long treatments, etc. are at higher risk for struggling psychologically.
Tuesday July 19, 2011 12:08 Melinda Stolley
12:09
[Comment From Michele Michele : ] 
I am in S.Florida and am searching for a late effects clinc.
Tuesday July 19, 2011 12:09 Michele
12:09
Mary Lou Schmidt: 
There are approximately 100 Longterm Survivors of Childhood Clinics in the US at this time. These are specialized clinics that have medical specialists who understand the medical details and the experience that survivors of childhood cancer went through. The staff usually includes primary care physicians, pediatric oncologists, survivorshipnurses and psychologists/social workers. These clinics also have access to specialists who can evaluate these patients if necessary. Specialists include doctors who evaluatethe heart,lungs,brain, hormone systems, kidneys, gait,ears, eyes,skin just to name a few.

The 100 Childhood Cancer Survivors Clinics are generally placed at the major medical centers and are associated with the Children's Oncology Group Pediatric Cancer programs. Here is a link to these programs:
List of Childhood Cancer Survivors Clinics in the US: http://www.childrensoncologygroup.org/Surveys/lateEffects/lateEffects.PublicSearch.asp
Tuesday July 19, 2011 12:09 Mary Lou Schmidt
12:10
[Comment From Erica Neufeld Erica Neufeld : ] 
At CureSearch for Children's Cancer, we've recently launched our updated website (www.curesearch.org) and it now contains a wealth of information about the late effects of cancer. If you select a cancer type from the home page and then go to After Treatment, you can read about the late effects information specifically related to that cancer type.
Tuesday July 19, 2011 12:10 Erica Neufeld
12:11
Mary Lou Schmidt: 
To clarify, CureSearch is the website and Foundation for the Children's Oncology Group.
Tuesday July 19, 2011 12:11 Mary Lou Schmidt
12:12
Deborah Shelton: 
Thanks for the clarification.
Tuesday July 19, 2011 12:12 Deborah Shelton
12:13
[Comment From Torre Torre : ] 
Is it common for those in the first generation of survivors who have no medical record history?
Tuesday July 19, 2011 12:13 Torre
12:18
Jessica Ittner RN: 
Thanks for the question Torre. We have had some survivors who can't locate their medical records.
If written records from the hospital can't be found, if possible you can ask your parents or adults that were present when you were treated if they remember details from your therapy. At the very least, if you received radiation or if they remember the names of chemotherapy agents you received.

Most hospitals currently have electronic medical records, so people who are receiving cancer therapy at this time can easily obtain their records from their healthcare provider. However, I was treated for my tumor in the 1990s when hospitals did not yet have this technology. Many of my patients have a difficult time finding their records, and unfortunately I've had a few patients who have not been able to locate records.
If you've requested your medical records and haven't heard anything back from the hospital, don't give up. It may take a few phone calls or even a visit in person (if possible) to obtain your records. If the medical records department isn't helpful, call your Oncologist's office and ask for a copy of your healthcare records. Instead of asking for the entire record, ask for a “cancer treatment summary” or a letter that summarizes your cancer treatment. Pediatric Oncology patients may want to ask for their "roadmaps," surgery reports and radiation records (if applicable). If you're currently receiving treatment for cancer, make sure your Oncologist provides you with this information when you are finished with your cancer therapy.
Tuesday July 19, 2011 12:18 Jessica Ittner RN
12:19
Jessica Ittner RN: 
For other survivors:
At the very minimum, you need to know basic details about your cancer and your cancer treatment history. Make sure you know the answers to these questions:
1. What was the name of your diagnosis? (including stage, site)
2. Did you receive surgery for your cancer? If so, what are the names of the surgeries (and dates)
3. Did you receive radiation for your cancer? If so, what was the site of radiation and what was the dose?
4. Did you receive chemotherapy for your cancer? If so, what were the names of the chemotherapy agents you received? What was the dose? At the very minimum, ask for the CUMULATIVE DOSE for anthracyclines received (important to screen for late effects tothe heart)
5. Did you receive a bone marrow transplant? If so, what kind of transplant? What was the conditioning regimen for the transplant? Did you have any type of GVHD after your transplant?
6. Did you have any major complications during your cancer therapy that other healthcare practitioners should know about?
Tuesday July 19, 2011 12:19 Jessica Ittner RN
12:21
Melinda Stolley: 
It is very important that your child have documentation of their diagnosis and treatment history. this will allow them to get the best follow-up treatment possible. Many pediatric hospitals have follow-up program so be sure to ask about transitioning their care from the pediatric hem/onc to the follow-up program and then transition from there to an adult long-term follow-up program. the transition from pediatric care to adult care can be bumpy, but you can help your child make that a smooth transition.
Tuesday July 19, 2011 12:21 Melinda Stolley
12:22
[Comment From Amber Masso-ACCO Amber Masso-ACCO : ] 
What advice would the panel give to parents in regard for preparing their child to handle their follow-up as they get older- specifically teen patients and teenaged survivors.
Tuesday July 19, 2011 12:22 Amber Masso-ACCO
12:23
Melinda Stolley: 
My comment was in response to Amber's excellent question....
Tuesday July 19, 2011 12:23 Melinda Stolley
12:23
[Comment From Debra Debra : ] 
Do childhood cancer survivors tend to have weaker immune systems than non-survivors?
Tuesday July 19, 2011 12:23 Debra
12:23
Mary Lou Schmidt: 
As I mentioned earlier, the exact risk of a late complication for any survivor of childhood cancer is dependent on the exact cancer that they had, the age they were when they were diagnosed, the exact treatment that they received and any complications that they may have had during their treatment. For example:

a) A survivor of childhood leukemia diagnosed at age 3 and receive approximately 10 chemotherapy drugs over a 2-3 year period including chemotherapy infused into their spinal fluid. These survivors need to to have their heart function, blood system, kidney function and learning assessed.
b) A survivor who was diagnosed with Hodgkin's lymphoma as a teenager needs to be screened for heart disease and very earlybreast cancer.
c) A survivor diagnosed with a brain tumor at any age who received radiation to the brain needs to be assessed for problems involving their learning, thinking, memory and hormone levels.
d) A survivor who had a bone or muscle tumor needs to have their gait,joints, hearing, kidney and heart function assessed.

Importantly, many survivors have a very strongimmune system and aren't more susceptible to infections but this is not true for all survivors.

Tuesday July 19, 2011 12:23 Mary Lou Schmidt
12:23
[Comment From George George : ] 
What do I need to know going into my first appointment?
Tuesday July 19, 2011 12:23 George
12:25
Jessica Ittner RN: 
Before your first appointment, make sure you provide the survivor clinic with a copy of your cancer treatment history. Clinics can help you find this information if you don't have a copy in your records.

I find that many of my patients don't know exactly what to expect at their first clinic visit. The first visit may take some time, usually from one to two hours. During that time, you can expect to discuss your cancer treatment history in detail, patient education to build your knowledge of your health history and risk for late effects, and a detailed history and physical from a Nurse Practitioner or a Physician. Sometimes these visits will include discussions with social workers, psychologists, nutritionists, physical therapists or other healthcare professionals to ensure that all aspects of your life are going well.
My first visit to a cancer survivor clinic was a little overwhelming. I received a lot of information, and I had not heard much of the information before. Ask for a written copy of the information you receive so you can share it with other healthcare providers, and go over it once you get home and can take in more information.
Tuesday July 19, 2011 12:25 Jessica Ittner RN
12:26
[Comment From Tonya Tonya : ] 
Are there any problems associated with a childhood cancer survivor acquiring health or life insurance once they reach adulthood?
Tuesday July 19, 2011 12:26 Tonya
12:29
Melinda Stolley: 
tonya,
There is a great resource for learning about what your rights are in terms of insurance....the cancer legal resource center at www.CancerLegalResourceCenter.org
Hope this helps.
Tuesday July 19, 2011 12:29 Melinda Stolley
12:29
Jessica Ittner RN: 
Thanks Tonya-sometimes people do have issues with insurance associated with their childhood cancer diagnosis and treatment history, I would suggest if you are having issues to find a survivor clinic and ask to speak with their social worker. The social worker at your survivor clinic will be able to help you with insurance issues.
Tuesday July 19, 2011 12:29 Jessica Ittner RN
12:30
[Comment From Agatha Agatha : ] 
You've mentioned survivor clinics, do you have any ideas what percentage of survivors are actually utilizing those clinics?
Tuesday July 19, 2011 12:30 Agatha
12:30
Mary Lou Schmidt: 
According to the Childhood Cancer Survivor Study, only about 30% of survivors reported that they went to a specialized Survivor Clinic and only 18% said that they had any special screening or advice about how to living healthier lives to avoid developing chronic health conditions. We have a big health education problem. Many survivors don't understand that they need to go to a specialized clinic. Maybe their oncologist didn't tell them or they were told but they just wanted to put "cancer behind them" and forget about it. Many survivors may not be telling their primary care physicians that they survived cancer. If they tell their primary care physician, these doctors may not understand that all patients who survived childhood cancer need a comprehensive assessment according to the Children's Oncology Group Long Term Follow-up Guidelines. This can be done by the primary care doctor but it takes a lot of time and they may not have all of the medical details for their patient such as their original cancer diagnosis, age at the time of diagnosis, and information about all surgeries, radiation and chemotherapy medicines.
Tuesday July 19, 2011 12:30 Mary Lou Schmidt
12:31
[Comment From Tammy Pate Tammy Pate : ] 
is there a new survivor study that we could participate in?
Tuesday July 19, 2011 12:31 Tammy Pate
12:31
Melinda Stolley: 
The Childhood cancer survivor study is the largest and longest running study. It examined survivors who had been treated from 1976-1984 and they now have a second group they are following who were treated in the 80's and 90's. This study involves 26+ institutions. You may be able to become involved in the study if it involves your institution. You can learn more about this study at http://ccss.stjude.org
Also, I am conducting a study in chicago with minority cancer survivors. We appreciate your willingness to volunteer for research!! I would also ask your physician if they know of any studies.
Tuesday July 19, 2011 12:31 Melinda Stolley
12:34
[Comment From Torre Torre : ] 
I had cancer back in the mid-80's and early 90's and there was little no no follow-up after year 5. I hope today's survivors are better taken care of.
Tuesday July 19, 2011 12:34 Torre
12:35
Mary Lou Schmidt: 
Torre, I agree. Pediatric Oncology teams were so happy to see more and more children survive their cancer but we really didn't appreciate the high incidence of long term chronic health conditions. We are doing a better job now in training these teams to refer all of our survivors to Long Term Follow-up Clinics.

The UIC Cancer Survivors Clinic accepts any age survivor and we've evaluated patients ages 6-50. Survivors from the '80's and '90's need and deserve these specialized clinics.

Tuesday July 19, 2011 12:35 Mary Lou Schmidt
12:36
[Comment From Ellie Ellie : ] 
As a 10-year survivor who's doing well in school, I really don't see the benefit in going to a survivor clinic. I want to leave all that in my past and make the most of my current life. It makes me anxious just thinking about reliving those three years again by talking about at a clinic.
Tuesday July 19, 2011 12:36 Ellie
12:37
Deborah Shelton: 
Thanks for your honesty Ellie.
Tuesday July 19, 2011 12:37 Deborah Shelton
12:38
Jessica Ittner RN: 
Thanks for your comment and honesty Ellie. I understand how you feel. However, it's important for survivors, even if they're doing well, to get long term follow up care.
Getting through diagnosis and treatment is hard. It's the most difficult thing I've had to do in my life. When you're done with therapy, you just want to get on with your normal life and routine. It's difficult to adjust to a "new normal." Sometimes being diagnosed with a late effect can cause a survivor to be angry, in denial, fearful or depressed.
Discuss your concerns with your healthcare team. Don't let denial or fear about your situation prevent you from receiving the care that you need. The earlier problems are diagnosed and treated, the better the outcome. And not all survivors have late effects, and it's relief to find out that you're completely healthy!
Tuesday July 19, 2011 12:38 Jessica Ittner RN
12:39
[Comment From Michele Michele : ] 
Is there a social network for young adult cancer survivors?
Tuesday July 19, 2011 12:39 Michele
12:39
Melinda Stolley: 
Michele,
there are a couple resources....Try these out.

http://stupidcancer.com/community/i2y-orgs.shtml

http://www.cancersurvivorsunite.org/csuresources.htm

http://csn.cancer.org/node/211233 - this describes an annual conference sponsored by ACS for young adult survivors
Tuesday July 19, 2011 12:39 Melinda Stolley
12:40
[Comment From Monica Marcelis Fochtman Monica Marcelis Fochtman : ] 
I am wondering if you might comment on the "late effects" fo siblings. Although cancer was in our son's body, it happened to our entire family. We all dealt with it, and continue to address it in different ways. Any research out there about the trauma to siblings?
Tuesday July 19, 2011 12:40 Monica Marcelis Fochtman
12:43
Melinda Stolley: 
Monica,
Cancer does indeed impact the entire family. In some ways, the siblings are often the forgotten survivors. It is great that you recognize that...this is so important, especially since your other children will see that you understand that they are dealing with this difficult and painful situation. There is an organization called, "Super Sibs" that has done tremendous work in this area. they offer different programs and also have a lot of information on their website. Talking with your other children about their experience and doing what you can to have special time with them will go a long way. it can sometimes also help to have them talk to a counselor or psychologist. Or many cancer support centers also offer sibling programs. There is a lot of research in this area and basically they say, that as you observe, everyone deals with it in their own way. the more the family talks, the better.
Tuesday July 19, 2011 12:43 Melinda Stolley
12:44
[Comment From AJs Dad AJs Dad : ] 
If there was one thing you could communicate about survivorship to the broad childhood cancer community, what would that be?
Tuesday July 19, 2011 12:44 AJs Dad
12:45
Mary Lou Schmidt: 
The most important message we want the public to know is that EVERY survivor of childhood cancer should be evaluated by a Long Term Follow-up Clinic if at all possible so that they can understand their current health challenges, manage these the best they can and they can understand what specialized screening should be done.

Interestingly, I was just speaking to a local pediatrician about his 10 year old patient with a newly diagnosed abdominal tumor. He mentioned to me that he (the pediatrician) had had cancer when he was 21 years old. This gave me a great opportunity to educate him about his need for long term follow-up in a Cancer Survivors Clinic. He had NO IDEA that this was even a possibility or could benefit him.

Likewise, we recently diagnosed a 4 day old baby with retinoblastoma. Her father had the same diagnosis 27 years ago and carries the samegenetic mutation. Both father and daughter have an increased risk of second cancers. I asked him if he was going for follow-up and he had never heard of this. He now has been evaluated and is grateful for the knowledge the visit brought him although he too was very nervous to do this beforehand.

Tuesday July 19, 2011 12:45 Mary Lou Schmidt
12:45
Jessica Ittner RN: 
Thanks for the comment AJs Dad. In addition to Dr. Schmidt's comments:

Being your own advocate is very important as a cancer survivor. In the world of adult medicine, it's up to the patient to make their own appointments and coordinate their care. Healthcare practitioners may not be familiar with how to take care of cancer survivors or what late effects they are at risk for. I've had to educate mynurses and physicians and let them know what I'm at risk for and what screening I need. A doctor at a clinic that specializes in cancer survivors will know this information, but your general family doctor, radiologist etc. probably won't know these details. YOU are the expert on your cancer treatment history and your risk for late effects, so share that with your healthcare providers. If they are not listening to you or are unwilling to talk about your cancer treatment history and late effects, find another provider who is willing to discuss these issues.
Tuesday July 19, 2011 12:45 Jessica Ittner RN
12:46
[Comment From Carla Hood Carla Hood : ] 
I was diagnosed back with Stage IV High Risk Neuroblastoma in 1968 @ 8 1/2 MONTHS of age; as a 43 YEAR + Survivor, I think it's important not so much sharing at a clinic but sharing with the public at large. We, the Survivors, are what brings HOPE to those children & families just stepping onto the battlefield called Childhood cancer! We NEED to be a voice for them!
Tuesday July 19, 2011 12:46 Carla Hood
12:46
Deborah Shelton: 
Thanks for the comment Carla.
Tuesday July 19, 2011 12:46 Deborah Shelton
12:47
[Comment From Agatha Agatha : ] 
Are medical students taught to specifically inquire about childhood cancer history from their patients?
Tuesday July 19, 2011 12:47 Agatha
12:51
Mary Lou Schmidt: 
Medical students are trained to take a detailed family history. However as Melinda and Jessica have emphasized, it is really important for survivors of childhood cancer to provide every health care practitioner with a detailed medical history which should include your diagnosis, your age at the time of diagnosis, and the details related to your treatment history.

Medical students need your input and your teaching. This will make them better doctors.
Tuesday July 19, 2011 12:51 Mary Lou Schmidt
12:51
[Comment From Jessica Jessica : ] 
Michelle, I am a nurse practitioner in Miami, and we are starting a survivor clinic at the UM Medical Campus
Tuesday July 19, 2011 12:51 Jessica
12:52
Jessica Ittner RN: 
That's great Jessica! I'm sure you're familiar with this website, but a great resource for healthcare providers is http://www.survivorshipguidelines.org/

Good luck with the new clinic!
Tuesday July 19, 2011 12:52 Jessica Ittner RN
12:56
[Comment From Amber Masso-ACCO Amber Masso-ACCO : ] 
What advice would you give parents for informing school about a child's needs as a survivor?
Tuesday July 19, 2011 12:56 Amber Masso-ACCO
12:56
Mary Lou Schmidt: 
This is a great question.

I believe that being as open as possible and sharing the challenges of your child's history and connecting up your Cancer Survivors Clinic with your school may lead to a better educational experience.

Tuesday July 19, 2011 12:56 Mary Lou Schmidt
12:57
Deborah Shelton: 
Wow! I think we squeezed a lot into this chat. Thank you guest experts for sharing your expertise.
Tuesday July 19, 2011 12:57 Deborah Shelton
12:58
Mary Lou Schmidt: 
It has been a great pleasure to interact with the public related to issues of survivors who we celebrate every day.
Tuesday July 19, 2011 12:58 Mary Lou Schmidt
12:58
Melinda Stolley: 
What a great chat! Thanks for including me, I enjoyed talking with you all and hope that you all learned some new tidbit today.
Melinda
Tuesday July 19, 2011 12:58 Melinda Stolley
12:58
Jessica Ittner RN: 
Thanks again for inviting me to participate Deborah. I hope this information was helpful!
Tuesday July 19, 2011 12:58 Jessica Ittner RN
12:58
Deborah Shelton: 
This chat will be permanently archived for future reading. Feel free to share this link.
Tuesday July 19, 2011 12:58 Deborah Shelton
12:58
Deborah Shelton: 
Join Judy Graham next week for a web chat on keeping out of thenursing home. What older people need to know and do to stay independent at home as they become more frail.
Tuesday July 19, 2011 12:58 Deborah Shelton
12:59
Deborah Shelton: 
Thanks everybody!
Tuesday July 19, 2011 12:59 Deborah Shelton
12:59