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How Is Childhood Cancer Different from Adult Cancer? · Flourish- A Prisma Health Podcast

• 0:03
  Melanie Cole, MS (Host): Welcome to Flourish, a Prisma Health podcast.
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  I'm Melanie Cole.
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  And today, we're talking about childhood cancer and health disparities.
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  Joining me is Dr.
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  Anna Hoppman.
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  She's a pediatric hematologist-oncologist at Prisma Health.
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  Dr.
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  Hoppman, thank you so much for joining us today.
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  As we talk about this topic, which is not always easy to talk about
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  or hear about, it's every parent's worst nightmare, how is childhood
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  cancer different from adult cancer?
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  And what should South Carolina families understand about that difference?
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  Dr. Anna Hoppman:
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  Thank you, Melanie.
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  I'm happy to be here today.
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  One of the main differences between childhood cancer and adult-onset
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  cancers is that you cannot screen for or prevent childhood cancers.
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  We think about screenings for adult-onset cancers, for example, mammography for
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  breast cancer or colonoscopy for colon cancer, but there are no known ways to
• 1:03
  screen for or prevent cancer in children.
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  Melanie Cole, MS: That's an interesting distinction.
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  Thank you for clarifying that.
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  Now, what kinds of cancers are we talking about?
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  Dr. Anna Hoppman:
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  The most common types of cancers in children are leukemias,
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  lymphomas, and brain tumors.
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  Melanie Cole, MS: Tell us a little bit about survival rates for childhood cancer.
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  Are they improving?
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  And if so, what factors are we looking at that could be driving that progress?
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  Dr. Anna Hoppman:
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  Thankfully, we've seen tremendous improvement in childhood
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  cancer survival over time.
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  When you look back, you know, 50, 60 years ago, there was a very dismal
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  prognosis for childhood cancers and many children did not survive.
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  But through incremental improvements in our treatments and the ways we support
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  children during cancer treatments, those cure rates have risen dramatically.
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  For some of the most common types of cancers, including acute
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  lymphoblastic leukemia, the cure rate is over 90% today, and we're
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  very grateful for those advancements.
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  Melanie Cole, MS: That's such a hopeful statistic, Dr.
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  Hoppman.
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  Thank you for sharing that.
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  Now, do children in South Carolina experience disparities in cancer outcomes?
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  And what are some of the biggest reasons behind those gaps?
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  Explain a little bit about what disparities mean and
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  why there are those gaps.
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  Dr. Anna Hoppman:
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  Disparities means differences.
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  So, it could be differences in the number of cancer cases, differences in
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  the survival over time, or differences in access to certain resources or care.
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  In South Carolina and in the United States as a whole, there's a higher
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  incidence of cancer in non-Hispanic White children, meaning they're more
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  likely to have childhood cancer.
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  But there are lower survival rates among non-Hispanic, Black children,
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  meaning if they get childhood cancer, they have lower odds of surviving
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  compared to other races and ethnicities
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  Melanie Cole, MS: Well, Dr.
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  Hoppman, based on these disparities or differences, how do those factors,
• 3:13
  like where a family lives, their income, or access to transportation,
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  impact a child's ability to receive that timely, high-quality cancer care?
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  Dr. Anna Hoppman:
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  So, cancer care, depending on the type of cancer, can be a long treatment journey,
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  kind of ranging from months to years.
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  For acute lymphoblastic leukemia, one of our most common types of cancer, the
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  treatment is around two and a half years.
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  And so when families face challenges with things like transportation,
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  with their insurance continuity, it places this repetitive burden on
• 3:48
  the patient and the family over time because the treatment is so long.
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  And it can make it difficult to get the treatment and services they need.
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  Melanie Cole, MS: While you're talking about that then, can you
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  expand on some of those challenges that families and caregivers face?
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  So, you mentioned transportation and certainly insurance and finances
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  and dealing with all the red tape of insurance, that is just a
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  dizzying situation for families.
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  But when we think of medically and emotionally—and medically, even
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  understanding what you're saying, what the doctors are saying, what
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  the treatment involves, what the side effects and complications could be, and
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  then the emotional toll that it's going to take on the family, the child, the
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  parents, any outside family community.
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  I mean, it can really spread out pretty far and wide when a
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  child is suffering from cancer.
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  So, speak about what you see, Dr.
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  Hoppman, and really how you help families in that way.
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  Dr. Anna Hoppman:
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  I think one of the things that makes our field very gratifying to work in,
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  though it can be challenging at times or emotionally challenging for us even
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  as the clinicians, one of the most gratifying things is the resilience of
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  the patients and families that amidst this diagnosis or amidst the challenges with
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  treatment, that they're very resilient.
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  That the kids are bright and cheerful and playing games in our clinic even when we
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  can tell that they don't feel their best.
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  And I think it's really that resiliency of the family and the people around
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  the family and the neighborhood and the community that lift our patients and
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  families up to get them through these long durations of cancer treatment and allows
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  them to get the medical care they need.
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  Melanie Cole, MS: Well, it certainly is community-wide and felt by the friends
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  and the schools and everybody when a child is going through these kinds
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  of treatment, which can be brutal.
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  So, South Carolina's developing a comprehensive pediatric cancer plan.
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  What does that mean, Dr.
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  Hoppman?
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  And how could it improve care for children across the state?
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  Dr. Anna Hoppman:
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  When you look around the United States, all states and territories develop
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  comprehensive cancer control plans.
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  And it's a roadmap for that state to look at their cancer statistics
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  and see where things are going well, what they can improve over
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  time to make things even better.
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  But what we don't like about this is that only about 30% of plans include
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  children with a dedicated section.
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  We started talking to public health leaders and cancer coalition members in
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  the state of South Carolina, and everybody was united in this vision that we should
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  elevate the issues of children with cancer and their families to the highest level in
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  South Carolina and give them a dedicated section in our comprehensive cancer plan.
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  For us, the comprehensive cancer plan will have four areas that we'll
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  focus on over a five-year period.
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  They include pediatric cancer awareness, quality care, ensuring we have all the
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  needed services and support right here in South Carolina, educational support
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  to make sure our patients, who are also students, many of them in elementary,
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  middle, and high school, have the support they need to be in the classroom when it's
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  safe or remote learning during treatment.
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  And the final section of the cancer plan is survivorship to maintain support for
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  our patients and families in that long period of survivorship after pediatric
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  cancer treatment and to make sure they have the support they need, both medically
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  and in terms of their vocational support.
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  That if they have some late effects or challenges after cancer treatment, that we
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  help them to find resources for vocational support in addition to their medical care
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  Melanie Cole, MS: What a great initiative that is.
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  Dr.
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  Hoppman, thank you for sharing that with us.
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  And as we get ready to wrap up, what kinds of experiences, challenges, or ideas do
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  you think, and in your vast experience, would be most helpful for parents and
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  caregivers to share as we build this plan?
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  What would you like to hear from them?
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  Dr. Anna Hoppman:
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  The state plan is for them and is informed by them.
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  You know, we care for these patients every day and their families, and
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  we listen to them, to what's going well, to what can be improved.
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  And we have several parent advocates on our state task force
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  to help make sure that their opinions are reflected in the plan.
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  As we launch the plan for South Carolina, we want parents
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  to be engaged and involved.
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  We would love to hear from parents that want to join our state work
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  group or help with implementing the plan over the five-year cycle.
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  It's going to take a lot of volunteers and be a real team
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  effort to make the plan a reality.
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  Melanie Cole, MS: Dr.
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  Hoppman, you've given us so much great information and things to think about.
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  As a final thought, please tell us about your team and the people that you work
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  with at Prisma Health, because really, as we were saying before, and it takes
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  the community and caregivers, but it also takes this multidisciplinary,
• 9:04
  very caring, comprehensive team.
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  Dr. Anna Hoppman:
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  I'm part of a wonderful team of doctors, advanced practice providers,
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  nursing, pharmacists, social work, and our psychosocial care team.
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  And we couldn't do it without any one of these members.
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  They support our patients from the time they check into the clinic, take their
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  vital signs, come back to the clinic room.
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  They give them things to eat, things to do, support their mental health needs.
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  And without them, it would be very difficult to provide the medical
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  care we provide to treat cancer.
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  With the aspects of the team, we're able to support the whole patient and family
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  to get them through treatment and beyond.
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  Melanie Cole, MS: What a great way to end and such important points that you made.
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  Thank you again for joining us and sharing your incredible expertise
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  for listeners on this topic.
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  And to hear more podcasts from our experts, please visit our website
• 9:59
  at prismahealth.org/podcast.
• 10:02
  I'm Melanie Cole.
• 10:03
  And we'd like to invite our audience to download, subscribe, rate, and review
• 10:07
  Flourish: A Prisma Health Podcast on Apple Podcasts, Spotify, iHeart, and Pandora.
• 10:13
  Thank you so much for joining us on Flourish: A Prisma Health Podcast.