{"id":63,"date":"2019-12-12T15:54:09","date_gmt":"2019-12-12T15:54:09","guid":{"rendered":"https:\/\/lab.research.sickkids.ca\/nathan\/?page_id=63"},"modified":"2025-11-27T17:18:59","modified_gmt":"2025-11-27T17:18:59","slug":"research","status":"publish","type":"page","link":"https:\/\/lab.research.sickkids.ca\/nathan\/research\/","title":{"rendered":"Research"},"content":{"rendered":"

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Cancer Survivorship & Late Effects<\/h2>\n

Thanks to advances in the treatment and supportive care of children and adolescents with cancer, over 80% will become long-term survivors. Unfortunately, the therapies that lead to cure can also cause long-term side effects, also known as \u201clate effects\u201d. These late effects can include heart and lung problems, second cancers, problems with memory and attention, anxiety and depression, and infertility. As such, it is critical that all survivors of childhood and adolescent cancer receive lifelong follow-up care focused on their specific risks. Our research focuses on specific late effects that develop in survivors and how survivors interact with the health care system as they age. All of our projects have a common goal: to improve the health and quality of life of childhood and adolescent cancer survivors.[\/vc_column_text][vc_empty_space css=”.vc_custom_1599149826287{padding-top: 25px !important;}”][vc_separator][\/vc_column][\/vc_row][vc_row][vc_column offset=”vc_hidden-lg vc_hidden-md”][vc_column_text]<\/p>\n

Cancer Survivorship & Late Effects of Cancer Therapy<\/h2>\n

Thanks to advances in the treatment and supportive care of children and adolescents with cancer, over 80% will become long-term survivors. Unfortunately, the therapies that lead to cure can also cause long-term side effects, also known as \u201clate effects\u201d.These late effects can include heart and lung problems, subsequent cancers, problems with memory and attention, anxiety and depression, and infertility. As such, it is critical that all survivors of childhood and adolescent cancer receive lifelong follow-up care focused on their specific risks. Our research focuses on the specific late effects that develop in survivors, and how survivors interact with the health care system as they age. All of these projects have one common goal: to improve the health and quality of life of childhood and adolescent cancer survivors.[\/vc_column_text][\/vc_column][\/vc_row][vc_row gap=”30″ equal_height=”yes” css=”.vc_custom_1603205494419{background-color: #3a7ba6 !important;}”][vc_column width=”1\/4″ offset=”vc_hidden-sm vc_hidden-xs”][vc_empty_space][vc_column_text css=”.vc_custom_1603206014203{padding-top: 120px !important;}”]<\/p>\n

PCS\u00b2<\/span><\/h3>\n

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Preventing Cardiac Sequelae in Pediatric Cancer Survivors (PCS\u00b2)<\/span><\/h3>\n

Cancer therapy can place childhood cancer survivors at increased risk for heart disease, which can lead to significant illness or early death. We would like to identify those cancer survivors at highest risk as early as possible and find ways to prevent the progression of heart problems. In our PCS2 study, we used genomics, blood biomarkers, and echocardiography to determine which individuals are at highest risk.<\/span><\/p>\n

Study status<\/strong>: Recruitment complete, data analyses ongoing<\/em><\/span><\/p>\n

Analyses of our PCS\u00b2 data showed that many childhood cancer survivors who receive \u201cheart-toxic therapies\u201d have little to no evidence of heart problems during childhood and early adulthood. Other studies have shown that coronary artery disease can occur in survivors who have received specific chemotherapies or chest radiation. As such, we are carried out a study, Blood Vessel Health in Cancer Survivors<\/strong>, to see whether we can detect early signs of blood vessel changes (atherosclerosis) in childhood cancer survivors.<\/span><\/p>\n

Study status:<\/strong> Data analyses ongoing<\/em><\/span><\/p>\n

In addition, to assess long-term cardiovascular outcomes, we created the PCS\u00b2 Registry<\/strong>, which captures diagnosis, treatment, and cardiovascular data in patients who were treated with cardiotoxic therapies as children, many of whom are now adults.<\/span><\/p>\n

Study status:<\/strong> Recruitment and data collection ongoing<\/em><\/span><\/p>\n

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Preventing Cardiac Sequelae in Pediatric Cancer Survivors (PCS\u00b2)<\/span><\/h3>\n

Cancer therapy can place childhood cancer survivors at increased risk for heart disease, which can lead to significant illness or early death. We would like to identify those cancer survivors at highest risk as early as possible and find ways to prevent the progression of heart problems. In our PCS2 study, we used genomics, blood biomarkers, and echocardiography to determine which individuals are at highest risk.<\/span><\/p>\n

Study status<\/strong>: Recruitment complete, data analyses ongoing<\/em><\/span><\/p>\n

Analyses of our PCS\u00b2 data showed that many childhood cancer survivors who receive \u201cheart-toxic therapies\u201d have no evidence of heart problems during childhood and early adulthood. Evidence from other studies has shown that coronary artery disease can occur in survivors who have received specific chemotherapies or chest radiation. As such, we are currently recruiting participants for a Blood Vessel Health in Cancer Survivors<\/strong> study to see whether we can detect early signs of blood vessel changes (atherosclerosis) in childhood cancer survivors.<\/span><\/p>\n

Study status:<\/strong> Recruitment ongoing, preliminary analyses have begun<\/em><\/span><\/p>\n

In addition, to assess long-term cardiovascular outcomes, we created the PCS\u00b2 Registry<\/strong>, which captures diagnosis, treatment, and cardiovascular data in patients who were treated with cardiotoxic therapies as children, many of whom are now adults.<\/span><\/p>\n

Study status:<\/strong> Recruitment ongoing<\/em><\/span><\/p>\n

[\/vc_column_text][\/vc_column][\/vc_row][vc_row gap=”30″ css=”.vc_custom_1597780457041{background-color: #ffffff !important;}”][vc_column width=”1\/4″ offset=”vc_hidden-sm vc_hidden-xs”][vc_column_text css=”.vc_custom_1764261765817{padding-top: 90px !important;}”]\"ONLOOP[\/vc_column_text][vc_empty_space][\/vc_column][vc_column width=”3\/4″ offset=”vc_hidden-sm vc_hidden-xs”][vc_column_text css=”.vc_custom_1680015379210{margin-right: 25px !important;margin-bottom: -15px !important;padding-right: 100px !important;}”]<\/p>\n

Childhood Cancer Surveillance Program (ONLOOP)<\/h3>\n

There are over 14,000 survivors of childhood cancer in Ontario. Unfortunately, the therapy needed to cure their cancer leads to a higher risk for health problems during adulthood, such as new cancers and heart problems. Most adult survivors of childhood cancer do not complete the recommended screening tests to check for these problems. Once these survivors become young adults, most of them are \u2018lost\u2019 to the cancer system. Our team is building a surveillance system to ensure that childhood cancer survivors continue to get the follow-up care they need when they transition from the intensive childhood cancer care system to the routine health care system in adulthood.<\/p>\n

Study status:<\/strong> In development, recruitment to begin soon<\/em><\/p>\n

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Ontario’s Late Effects Surveillance Program (ONLOOP)<\/h3>\n

There are over 14,000 survivors of childhood cancer in Ontario. Unfortunately, the therapy needed to cure their cancer leads to a high risk for health problems during adulthood, such as new cancers and heart problems. Most adult survivors of childhood cancer do not complete the recommended screening tests to check for these problems. Once these survivors become young adults, most of them are \u2018lost\u2019 to the cancer system. Our team is building a surveillance system that can ensure that childhood cancer survivors continue to get the follow-up care they need when they transition from the intensive childhood cancer care system to the routine health care system in adulthood.<\/p>\n

Study status:<\/strong> In development; recruitment to begin soon<\/em><\/p>\n

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ROCCA (Real-world Outcomes of Cancer In Children and Adolescents)<\/span><\/a><\/h3>\n

ROCCA<\/span><\/a> leverages Ontario’s and Canada\u2019s unique administrative data to evaluate health and socioeconomic outcomes across the paediatric and adolescent\/young adult (AYA) cancer journey, from diagnosis through treatment to survivorship or palliative care.<\/span><\/p>\n

By conducting innovative and rigorous population-level research, we aim to inform efforts that increase equitable access to high-quality and cost-effective cancer care for children and AYAs in Canada and beyond.<\/span><\/p>\n

Our research program has three pillars: real-world outcomes, health economics, and data creation and linkage<\/span><\/p>\n

We strive to communicate our findings to patients and their families, policymakers, and advocacy groups, so they can be used to improve the care provided to children and AYA with cancer and better understanding the long-term impacts of cancer.<\/span>[\/vc_column_text][vc_empty_space][\/vc_column][\/vc_row][vc_row gap=”30″ equal_height=”yes” css=”.vc_custom_1603205494419{background-color: #3a7ba6 !important;}”][vc_column offset=”vc_hidden-lg vc_hidden-md”][vc_column_text]<\/p>\n

ROCCA (Real-world Outcomes of Cancer In Children and Adolescents)<\/span><\/h3>\n

ROCCA leverages Ontario’s and Canada\u2019s unique administrative data to evaluate health and socioeconomic outcomes across the paediatric and adolescent\/young adult (AYA) cancer journey, from diagnosis through treatment to survivorship or palliative care.<\/span><\/p>\n

By conducting innovative and rigorous population-level research, we aim to inform efforts that increase equitable access to high-quality and cost-effective cancer care for children and AYAs in Canada and beyond.<\/span><\/p>\n

Our research program has three pillars: real-world outcomes, health economics, and data creation and linkage.<\/span><\/p>\n

We strive to communicate our findings to patients and their families, policymakers, and advocacy groups, so they can be used to improve the care provided to children and AYA with cancer and better understanding the long-term impacts of cancer.<\/span><\/p>\n

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IMPACT<\/span><\/h3>\n

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IMPACT Study\/ ICES Data Linkage Studies<\/h3>\n

Compared to children and older adult cancer patients, much less is known about the cancer care that adolescents and young adults (AYA) receive. Through the IMPACT study, we have created a database that includes over 5,000 AYA aged 15\u201321 diagnosed between 1992\u20132011 at one of five paediatric cancer centres or at an adult cancer centre (i.e. regional cancer centre or community hospital) in Ontario.<\/span><\/p>\n

Patients are identified through the Ontario Cancer Registry. Diagnosis, treatment, and outcome data are obtained through POGONIS (Ontario childhood cancer survivor registry) for those treated at a paediatric centre, and medical records are reviewed for those treated at an adult cancer centre. Linking these data to population-based administrative health databases stored at ICES is allowing our team to address questions related to the care and health outcomes in survivors of AYA cancers.<\/span><\/p>\n

Study status:<\/strong> Data collection and analyses ongoing<\/em><\/span><\/p>\n

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IMPACT Study\/ ICES Data Linkage Studies<\/h3>\n

Compared to children and older adult cancer patients, much less is known about the cancer care that adolescents and young adults (AYA) receive. Through the IMPACT study, we have created a database that includes over 5,000 AYA aged 15\u201321 diagnosed between 1992\u20132011 at one of five paediatric cancer centres or at an adult cancer centre (i.e. regional cancer centre or community hospital) in Ontario.<\/span><\/p>\n

Patients are identified through the Ontario Cancer Registry. Diagnosis, treatment, and outcome data are obtained through POGONIS (Ontario childhood cancer survivor registry) for those treated at a paediatric centre, and medical records are reviewed for those treated at an adult cancer centre. Linking these data to population-based administrative health databases stored at ICES is allowing our team to address questions related to the care and health outcomes in survivors of AYA cancers.<\/span><\/p>\n

Study status:<\/strong> Data collection and analyses ongoing<\/em><\/span><\/p>\n

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CCSS<\/h3>\n

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Childhood Cancer Survivor Study (CCSS)<\/span><\/h3>\n

To evaluate the long-term health outcomes of childhood cancer survivors, we collaborate with The Childhood Cancer Survivor Study (CCSS), a U.S.-led study that has established a large cohort (>24,000) of long-term survivors and sibling controls from 31 centres across North America.<\/p>\n

The CCSS cohort allows us to analyze clinical and self-reported data as well as biospecimens from childhood cancer survivors. These data allow us to characterize individuals who are at highest risk for late effects as well as how survivors access the healthcare system.<\/p>\n

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Childhood Cancer Survivor Study (CCSS)<\/span><\/h3>\n

 <\/p>\n

To evaluate the long-term health outcomes of childhood cancer survivors, we collaborate with The Childhood Cancer Survivor Study (CCSS), a U.S.-led study that has established a large cohort (>24,000) of long-term survivors and sibling controls from 31 centres across North America.<\/p>\n

The CCSS cohort allows us to analyze clinical and self-reported data as well as biospecimens from childhood cancer survivors. These data allow us to characterize individuals who are at highest risk for late effects as well as how survivors access the healthcare system.<\/p>\n

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Selected Publications<\/h2>\n

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