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Objective 7:

Causes of cancer

To understand the causes of paediatric

cancers and to address prevention

wherever possible.

“Why does my child have cancer?” is a crucial question for parents, which most of the time

receives no answer. Relatively few causative factors have been identified so far for childhood



To run prospective clinical research to reduce the likelihood of long-term side effects in

patients who have a good prognosis malignancy.


1. Establish guidelines for follow-up that cover all possible late-occurring side effects of

current treatments;

2. Create and provide a ‘Survivorship Passport’ for each child and adolescent treated for

cancer that will include:


History and summary of the patient’s disease as well as treatments received;


Relevant follow-up measures, including precautionary measures to improve their

quality of life;


A database to store the patient’s clinical data and help monitoring and research;

3. Set up a relevant model of care to allow for a smooth transition to adult medicine (such as

‘long-term follow-up clinics’);

4. Increase research on late-occurring side effects (for example cardiac toxicity, secondary

tumours and infertility) and on quality of survival, including societal and psychological


5. Anticipate long-term toxicities of innovative therapies, such as targeted therapies, that will

be introduced in standard treatments;

Two ongoing FP7 European projects, PanCareSurFup and PanCareLIFE, carry out research

on late-occurring side effects [17]. The pilot initiative of the ‘Survivorship Passport’ is being

developed thanks to the support of ENCCA and PanCareSurFup, and the organisation of care

including a virtual late-effects advisory centre, will be also addressed within the ExPO-r-NET




Credit Czech Working Group for Paediatric Oncology, Czech Republic

“Survivors of childhood cancer want a normal life.”

(Sabine Karner, PPAC/CCI/PanCare, Austria)