DHC Pediatric Webinar - Caring for Childhood Cancer Survivors: Helping Children Thrive After Cancer Care

This Pediatric Lecture Series will discuss important pediatric topics that may lead to the improvement of child health from an individual, health care system and/or societal level. This presentation provides information on screening, reporting, diagnosis, and treatment referral options for childhood cancer survivorship.

Presenter

Angela Ricci, MD
Assistant Professor of Pediatrics
Section Chief Pediatric Hematology Oncology
Dartmouth Hitchcock Medical Center

Dr. Angela Ricci completed her undergraduate education at Princeton University and medical school at Columbia University College of Physicians and Surgeons. She did her pediatric residency training at the Boston Combined Residency Program before returning to Columbia for fellowship in Pediatric Hematology/ Oncology/ Stem Cell Transplant. She came to Dartmouth after completing training in 2018. Working with NH Cancer Registry, she was a core faculty member on large NH State Grant working on a series of Childhood Cancer Projects including a survivorship study, childhood cancer conference and comprehensive review of literature of causes of childhood cancer. She has also taken on leadership roles at DH and within regional and national organizations. She is the director of the Dartmouth Pediatric Oncology Long Term Survivor Program and is the Co-Chair of the Consortium for New England Childhood Cancer Survivors. She is the institutional principal investigator for Children’s Oncology Group research studies and clinical trials. She has recently been elected to serve on the American Academy of Pediatrics Section on Pediatric Hematology/ Oncology Executive Council. Dr. Ricci loves living in the Upper Valley, enjoying spending as much time outside with her family as possible, and she also especially values getting to feel part of the community with her patients and their families.

1. Identify treatments associated with long term health effects for childhood cancer survivors.
2. Recognize issues faced by childhood cancer survivors in our region in particular.
3. Describe personalized care planning including essential aspects of long term follow care for childhood cancer survivors.

In support of improving patient care, Dartmouth Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

American Medical Association (AMA)

Dartmouth Health designates this Enduring Material for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

American Nurses Credentialing Center (ANCC)

Dartmouth Health designates this Enduring Material for a maximum of 1.00 ANCC contact hours.

Association of Social Work Boards (ASWB)

As a Jointly Accredited Organization, Dartmouth Health is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. Regulatory boards are the final authority on courses accepted for continuing education credit. Social workers completing this course receive 1.0 general continuing education credits.

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Bibliographic Material

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• Bitsko, M.J., Cohen, D., Dillon, R., Harvey, J., Krull, K. and Klosky, J.L. (2016), Psychosocial Late Effects in Pediatric Cancer Survivors: A Report From the Children's Oncology Group. Pediatr Blood Cancer, 63: 337-343. https://doi-org.dartmouth.idm.oclc.org/10.1002/pbc.25773.

• Boman, K.K., Lindblad, F. and Hjern, A. (2010), Long-term outcomes of childhood cancer survivors in Sweden: A population-based study of education, employment, and income. Cancer, 116: 1385-1391.

• Dinan MA, Stratton KL, Leisenring WM, Yasui Y, Chow EJ, Tonorezos ES, Moskowitz CS, Yeh JM, Noyd D, Armstrong GT, Oeffinger KC. Treatment exposure-based risk-stratification for care of survivors of childhood cancer: a report from the childhood cancer survivor study. J Natl Cancer Inst. 2025 Dec 1;117(12):2580-2590. https://doi.org/10.1093/jnci/djaf268. PMID: 40971674; PMCID: PMC12682367.

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• Freyer, D. (2010). Journal of Clinical Oncology, 28 (32), 4810-4818. https://doi.org/10.1200/JCO.2009.23.4278.

• Todd M Gibson, Sogol Mostoufi-Moab, Kayla L Stratton, Wendy M Leisenring, Dana Barnea, Eric J Chow, Sarah S Donaldson, Rebecca M Howell, Melissa M Hudson, Anita Mahajan, Paul C Nathan, Kirsten K Ness, Charles A Sklar, Emily S Tonorezos, Christopher B Weldon, Elizabeth M Wells, Yutaka Yasui, Gregory T Armstrong, Leslie L Robison, Kevin C Oeffinger, Temporal patterns in the risk of chronic health conditions in survivors of childhood cancer diagnosed 1970–99: a report from the Childhood Cancer Survivor Study cohort, The Lancet Oncology, Volume 19, Issue 12, 2018, Pages 1590-1601, ISSN 1470-2045, https://doi.org/10.1016/S1470-2045(18)30537-0.

• Howlader N, Noone AM, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975–2018, National Cancer Institute. Bethesda, MD, https://seer.cancer.gov/csr/1975_2018/, based on November 2020 SEER data submission, posted to the SEER web site, April 2021.

• Kenney, LB, Vrooman, LM, Lind, ED et al. Virtual visits as long-term follow-up care for childhood cancer survivors: Patient and provider satisfaction during the COVID-19 pandemic. Pediatr Blood Cancer. 2021; 68:e28927. https://doi.org/10.1002/pbc.28927.

• Kirchhoff, A.C., Krull, K.R., Ness, K.K., Park, E.R., Oeffinger, K.C., Hudson, M.M., Stovall, M., Robison, L.L., Wickizer, T. and Leisenring, W. (2011), Occupational outcomes of adult childhood cancer survivors. Cancer, 117: 3033-3044. https://doi-org.dartmouth.idm.oclc.org/10.1002/cncr.25867.

• Kirchhoff AC, Waters AR, Liu Q, Ji X, Yasui Y, Yabroff KR, Conti RM, Huang IC, Henderson T, Leisenring WM, Armstrong GT, Nathan PC, Park ER. Health insurance among survivors of childhood cancer following Affordable Care Act implementation. J Natl Cancer Inst. 2024 Sep 1;116(9):1466-1478. https://doi.org/10.1093/jnci/djae111. PMID: 38741226; PMCID: PMC11378313.

• Lehmann V, Chemaitilly W, Lu L, Green DM, Kutteh WH, Brinkman TM, Srivastava DK, Robison LL, Hudson MM, Klosky JL. Gonadal Functioning and Perceptions of Infertility Risk Among Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study. J Clin Oncol. 2019 Apr 10;37(11):893-902. https://doi.org/10.1200/JCO.18.00965. Epub 2019 Feb 27. PMID: 30811296; PMCID: PMC6455717.

• Mikulska M, Cesaro S, de Lavallade H, Di Blasi R, Einarsdottir S, Gallo G, Rieger C, Engelhard D, Lehrnbecher T, Ljungman P, Cordonnier C; European Conference on Infections in Leukaemia group. Vaccination of patients with haematological malignancies who did not have transplantations: guidelines from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019 Jun;19(6):e188-e199. https://doi.org/10.1016/S1473-3099(18)30601-7. Epub 2019 Feb 8. Erratum in: Lancet Infect Dis. 2019 Apr;19(4):e109. https://doi.org/10.1016/S1473-3099(19)30100-8. PMID: 30744964.

• Moskowitz CS, Chou JF, Neglia JP, Partridge AH, Howell RM, Diller LR, Novetsky Friedman D, Barnea D, Morton LM, Turcotte LM, Arnold MA, Leisenring WM, Armstrong GT, Robison LL, Oeffinger KC, Henderson TO. Mortality After Breast Cancer Among Survivors of Childhood Cancer: A Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2019 Aug 20;37(24):2120-2130. https://doi.org/10.1200/JCO.18.02219. Epub 2019 Jul 1. PMID: 31260644; PMCID: PMC6698921.

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• Rees JR, Weiss JE, Riddle BL, Craver K, Zens MS, Celaya MO, Peacock JL. Pediatric Cancer By Race, Ethnicity and Region in the United States. Cancer Epidemiol Biomarkers Prev. 2022 Oct 4;31(10):1896-1906. https://doi.org/10.1158/1055-9965.EPI-22-0317. PMID: 35861625; PMCID: PMC9578755.

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• Siegel et al, MMWR 2018; 67(25); p707

• Singh P, Shah DA, Jouni M, Cejas RB, Crossman DK, Magdy T, Qiu S, Wang X, Zhou L, Sharafeldin N, Hageman L, McKenna DE, Armenian SH, Balis FM, Hawkins DS, Keller FG, Hudson MM, Neglia JP, Ritchey AK, Ginsberg JP, Landier W, Bhatia R, Burridge PW, Bhatia S. Altered Peripheral Blood Gene Expression in Childhood Cancer Survivors With Anthracycline-Induced Cardiomyopathy - A COG-ALTE03N1 Report. J Am Heart Assoc. 2023 Oct 3;12(19):e029954. https://doi.org/10.1161/JAHA.123.029954. Epub 2023 Sep 26. PMID: 37750583.

• Snyder C, Smith KC, Leisenring WM, Stratton KL, Boyd CM, Choi Y, Dean LT, Hudson MM, Chow EJ, Oeffinger KC, Park ER, McDonald AJ, Armstrong GT, Nathan PC. Continuity and coordination of care for childhood cancer survivors with multiple chronic conditions: Results from the Childhood Cancer Survivor Study. Cancer. 2024 Dec 15;130(24):4347-4359. https://doi.org/10.1002/cncr.35522. Epub 2024 Aug 18. PMID: 39154228; PMCID: PMC11585447.

• Turcotte LM, Liu Q, Yasui Y, Henderson TO, Gibson TM, Leisenring W, Arnold MA, Howell RM, Green DM, Armstrong GT, Robison LL, Neglia JP. Chemotherapy and Risk of Subsequent Malignant Neoplasms in the Childhood Cancer Survivor Study Cohort. J Clin Oncol. 2019 Dec 1;37(34):3310-3319. https://doi.org/10.1200/JCO.19.00129. Epub 2019 Oct 17. PMID: 31622130; PMCID: PMC7001784.

• Wengenroth, L., Rueegg, C.S., Michel, G., Gianinazzi, M.E., Essig, S., von der Weid, N.X., Grotzer, M., Kuehni, C.E. and (2015), Concentration, working speed and memory: Cognitive problems in young childhood cancer survivors and their siblings. Pediatr Blood Cancer, 62: 875-882. https://doi.org/10.1002/pbc.25396.

• NCCR*Explorer: An interactive website for NCCR cancer statistics [Internet]. National Cancer Institute; 2023 Sep 7. [updated: 2023 Sep 8; cited 2023 Oct 27]. Available from: https://nccrexplorer.ccdi.cancer.gov.

• Yeh JM, Ward ZJ, Stratton KL, McMahon MV, Taylor CS, Armstrong GT, Chow EJ, Hudson MM, Morton LM, Oeffinger KC, Diller LR, Leisenring WM. Accelerated Aging in Survivors of Childhood Cancer-Early Onset and Excess Risk of Chronic Conditions. JAMA Oncol. 2025 May 1;11(5):535-543. https://doi.org/10.1001/jamaoncol.2025.0236. PMID: 40111318; PMCID: PMC11926734.

• Zamani SA, Karyadi DM, Hartley SW, Gibson TM, Sampson JN, Kraft P, Chanock SJ, Morton LM. Germline rare variants in cancer susceptibility genes and subsequent neoplasm risk after childhood cancer. J Natl Cancer Inst. 2025 Dec 1;117(12):2545-2555. https://doi.org/10.1093/jnci/djaf260. PMID: 40924783; PMCID: PMC12628269.
  
  

Provider Contact Information
Provider contact information for questions regarding accreditation of the activity:

Center for Learning and Professional Development
ACE Office
Dartmouth Health
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