For most children being diagnosed with cancer, it is no longer a death sentence, says Dr. Jackie Casillas of UCLA’s Life After Cancer Clinic.
In fact, nearly 80 percent of all pediatric cancer patients will survive past five years and beyond, thanks to remarkable advances in treatment. But doctors now must help childhood cancer survivors deal with a host of special issues related both to their young age, their treatment and the disease itself.
Casillas is one of those doctors, a leader in the movement to address the late effects of cancer. As an assistant professor in the hematology/oncology division, Casillas is dedicated to this relatively new field of specialized follow-up care for childhood cancer survivors.
Although it has only officially been operational for a little more than a year, the Life After Cancer Clinic provides patients with a wide range of services that address problems encountered by those who battled cancer as children. As director, Casillas is instrumental in its operation.
As many as two-thirds of childhood cancer survivors may face a variety of challenges known as late effects: cardiac problems, learning disabilities, growth and fertility problems, psychosocial difficulties and even a second cancer. Currently, the clinic primarily cares for patients treated at UCLA. But thanks to networking efforts by Casillas and others, it now draws patients from throughout the Los Angeles community and nationwide.
According to Casillas, long-term follow-up care usually begins five years after diagnosis and two years after completing therapy. The clinic continues to monitor patients well into young adulthood. In addition to receiving screening for physical late effects and subsequent necessary medical treatment, the survivors receive support for any psychosocial problems that may arise as well as screening and referrals for any academic difficulties they may have. In addition, there is an educational component designed to empower patients to take charge of their own health, practice health-promoting behaviors and address their unique health needs related to their history of cancer, especially as they near adulthood. Casillas says she is especially committed to this aspect of care because, as she puts it, “cancer doesn’t stop with the person that has it.”
“It affects the whole family,” she said.
Casillas’ personal mission is to “make an impact in the access to and quality of medical care received by childhood cancer survivors so they can live long, healthy lives.” Her dedication to clinical care also extends outside of UCLA. She serves as a medical liaison for Padres Contra Cáncer (Parents Against Cancer), an organization that brings together children, families, healthcare professionals and community leaders to promote a comprehensive understanding of childhood cancer. The program provides culturally relevant educational and emotional support services for the Latino childhood cancer population.
Casillas is equally dedicated to her research. She is involved in many projects related to childhood cancer survivorship, including the study of access to follow-up care for adolescent and young adult survivors with a focus on minority populations and quality of life. Casillas is especially interested in the emerging patterns occurring as childhood cancer survivors transition to adolescence and young adulthood. This group is particularly vulnerable, Casillas says, because these young people have to deal not only with the normal challenges of this developmental stage, but with having had cancer as well. This double whammy can affect peer and family relationships, adjustment to the school environment and their own emerging independence.
One thing about her work that Casillas finds especially gratifying is that many childhood cancer survivors report that having dealt with the disease has enabled them to deal more effectively with obstacles in their lives and strengthened their family relationships. Overall, they say they have come away stronger, better and more altruistic people, something that Casillas finds very inspirational.
The first member of her family to go to college, Casillas completed medical school at UCLA. She credits several people for serving as role models: Dr. Lonnie Zeltzer for her work with childhood cancer survivors; Dr. Patricia Ganz for her breast cancer research accomplishments; and Dr. Roshan Bastani for her cancer prevention and control research in minority populations.
Casillas says she admires that their research “impacts the lives of not just UCLA cancer patients, but patients all across the United States and in other countries.”
The mother of a 3-year-old daughter, Casillas also says these female scientists showed her how to successfully combine the roles of clinician, researcher, educator and parent. She is especially grateful to Dr. Stephen Feig for emphasizing to her the importance of research early on in her clinical training in pediatric hematology/oncology.
-By Melanie Rome