Next Steps News

Resources for childhood cancer and bone marrow transplant survivors

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In this issue:

• Transitions.
• Life after high school: Considerations for the pediatric cancer survivor.
• Keep active in the cold!
• Nutrition survival: Healthful eating during the holidays.
• Meet our staff!
• • Mary Jo Kupst, PhD, pediatric hematology/oncology psychologist, Children's Hospital of Wisconsin.
  • Kristin Bingen, PhD, pediatric psychologist, Children's Hospital of Wisconsin.
  • Heather Christiansen, PsyD, psychology fellow, Children's Hospital of Wisconsin.
  • Rose Lucey, doctoral candidate, Psychology.

Scholarships

Check sites for new applications and updated deadlines.

• American Cancer Society.
• Care. Commit. Change.
• Cancer For College.
• Children's Oncology Services, Inc.
• Pediatric Brain Tumor Foundation.
• The SAMFund.
• The Ulman Cancer Fund for Young Adults.

Previous issues

• July - History of the Next Steps Clinic; Provider spotlight: Lynnette Anderson and Deb Schmidt; Produce power; Exercise tips for the long-term survivor.

Upcoming events

• 1 p.m. to 4 p.m. Saturday, Nov. 14
  Teen/Young Adult Mixer, Bowler Lanes, Wauwatosa, Wis., Young Adult Oncology Group at Childrens Hospital of Wisconsin. Contact Kristen Bingen, PhD, for details.
• Thursday, Nov. 19
  Parenting a Child with Cancer: Have you Hugged Yourself Today? Free teleconference from CureSearch. Register.
• Saturday, Dec. 12
  Annual tree lighting event, the nation's largest annual childhood cancer awareness event from Candlelighters, Old Post Office Pavilion, Washington, D.C. 

Transitions

For many cancer survivors, life after cancer treatment can be both an exciting and anxious time. You may be looking forward to completing chemotherapy or radiation and have to come to the hospital or clinic less often. At the same time, you may be concerned about the future and may be asking yourself what to do next, since cancer treatment may have interrupted school, work or other life events.

The transition from high school to new life adventures, such as college or employment, can be both thrilling with newfound independence and scary for young adult survivors because you may feel out of the loop due to cancer treatment.

You are not alone. Survivors of childhood cancer share these feelings and concerns as they transition to life after treatment and into college or the workforce. There are professionals and resources to help you adjust to these transitions in a healthy, positive way.

For emotional care, there are support and educational Web sites for teens and young adults with cancer, such as Group Loop or Planet Cancer. For professional support related to cancer survivorship, you may contact the Next Steps Clinic coordinator for assistance and referrals. Children's Hospital sponsors a Young Adult Oncology Group that provides monthly social support and networking to survivors who are 18 years and older.

If you are a cancer survivor with a physical, cognitive/learning or emotional disability, your county's Department of Vocational Rehabilitation or your college or university's disability program may be able to help with school- or work-related struggles.  

Next Steps Clinic Coordinator: (414) 266-2774.

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Life after high school: Considerations for the pediatric cancer survivor

The year after high school graduation often is full of transitions. For some, it may be the first time entering the workforce. Others may be moving away from home and pursuing new academic endeavors. Regardless of your postgraduation plans, there are things you will need to consider as a survivor of childhood cancer.

It is vital that you continue to receive routine primary care. Your primary care physician can help you monitor potential late effects from your cancer treatment, provide encouragement, help you develop healthy lifestyle behaviors and refer you to specialists when necessary. If you've recently moved and need to establish care with a new primary physician, call the nearest cancer survivorship clinic and ask for referrals. Speak with your insurance provider and ask for a list of physicians who have experience providing care to cancer survivors.

In order for your physician to provide the best care, he or she will need accurate and comprehensive information about your medical history, particularly about your cancer treatment. For example, your physician will want to know about the kinds of chemotherapy agents you were given and the doses and locations of radiation you received.

It's not uncommon for survivors to know little about their treatment, which is why the Next Steps Clinic has implemented a passport system. The passport is a small card - about the size of a driver's license - that includes a comprehensive summary of your treatment and relevant screening guidelines. A vital tool for your physician!

Finally, in order to finance your primary care, it is important that you maintain your health insurance coverage. Many young adults allow their health insurance to lapse and adopt a "hope for the best" attitude. For people with chronic medical conditions or a history of illness, this is a risk not worth taking.

There are many options available for health insurance coverage. If you plan to attend college full time, you may be eligible to remain on your parents' insurance plan. If this is not possible, check with your college or university. Most four-year colleges offer student health insurance plans at a reduced rate. If you are entering the workforce, speak with potential employers to find out if you qualify for their group health coverage. Other options available in Wisconsin include Medicaid (if you earn less than poverty level or have a disability and are unable to work) and BadgerCare Plus Core Plan.

For more information on these programs or to see if you qualify, call (800) 362-3002. If you'd like general information about health insurance, such as information about what questions to ask when you are deciding on a plan, check out www.ahrq.gov/consumer/insuranceqa for an easy-to-read summary.

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Keep active in the cold!

As the year draws to an end, so does the warm weather. As the colder months approach, it can be difficult to be active.

Have no fear, there are ways to get your body moving and stay healthy. With snow and ice come exciting activities such as sledding, ice skating, snowshoeing, cross-country and downhill skiing and general winter fun including making a snowman or having a snowball fight with friends. Don't forget that even helping out family and friends with shoveling helps to build muscle and works up a sweat. Just remember to take breaks and use proper body mechanics, turning your feet and not your body when you are shoveling the snow away.

But there are those days where it can be too cold to venture outside. There are great family games that can get everyone active and having fun at the same time such as Wii FitÔ , HullabalooÔ , Dance Dance RevolutionÔ , Twister MovesÔ, Twister Hop ScotchÔ and Hyper DashÔ.

Exercise doesn't have to be a chore. Exercise is what you make of it, so make it fun!

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Nutrition survival: Healthful eating during the holidays

Food is an important part of the holiday season and the many activities and traditions we've come to enjoy. Whether it's gatherings at home, work, school or neighborhood caroling parties, by following these tips, you and your family can enjoy special foods while keeping a balanced and healthy diet.

• Vegetables, fruits, low-fat dairy, whole grains and lean meats all have a place in a healthy diet. Choose fewer foods that are high in fat and sugar and select more fruits and vegetables, which are packed with important vitamins and minerals.
• A balanced diet with regular meals and snacks provides a steady stream of energy, repairs and restores the body and helps manage stress, which has a positive impact on our immune system. Choose colorful foods rich in antioxidants such as crunchy red and green peppers, fresh or frozen strawberries and blueberries, sweet potatoes, juicy grape tomatoes, and oranges or clementines, which are packed with vitamin C.
• Although soda generally is not recommended for children, it will likely be offered at holiday gatherings. Limit the number of sodas your children drink. Better yet, substitute soda with low-calorie or diet fruit drinks, such as Diet V-8 SplashÒ or hot cocoa made with skim milk.
• If you're hosting a holiday gathering, include healthier items such as vegetable trays, fresh salads and fruit with low-fat dip. Putting these items out before the souffles and chocolate sweets will give everyone a better chance of not overdoing it with high-fat, high-calorie choices.
• Look for healthy substitutes for ingredients when you whip up your favorite holiday fare. Try low fat or skim milk in place of whole milk products. In some baked goods, you can swap applesauce for oil. Switching ingredients can create tasty results without the high calories that often come with rich foods.
• Remember, all foods fit! There are no good and bad foods, only good and bad eating habits. Eat smaller portions of food, especially at a buffet. Choose the items you want to try and eat a small portion of each.

Beginning Saturday, Nov. 7, Milwaukee County will sponsor a Winter Farmer's Market. The market will be held at the Tommy Thompson Youth Center at State Fair Park. For details, visit mcwfm.org. Enjoy a wonderful bounty of fresh produce during the winter months!

Here's a healthful holiday recipe to share with family and friends. Happy holidays to all!

Festive Holiday Salad
Ingredients

• Mixed baby greens with spinach
• ½ cup dried cranberries
• 1 cucumber, sliced then quartered
• ½ cup walnuts, coarsely chopped
• 2 tablespoons Gorgonzola, or to taste

• 2 tablespoons extra virgin olive oil
• 2 tablespoons balsamic vinegar

Toss salad with dressing and serve. Enjoy!

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Meet our staff!

Mary Jo Kupst, PhD, pediatric hematology/oncology psychologist, Children's Hospital of Wisconsin

Mary Jo Kupst, PhD, has been involved with Next Steps from its inception. She is a professor of Pediatrics at The Medical College of Wisconsin. Dr. Kupst received her doctorate in Psychology from Loyola University in Chicago, and completed her postdoctoral studies as a fellow at the University of Illinois Medical Center. She was a research psychologist at Children's Memorial Hospital and an associate professor in Pediatrics and Psychiatry at Northwestern University, both in Chicago, for 16 years until coming to Children's Hospital in 1990.

Most of Dr. Kupst's research has been in the area of coping with pediatric cancer, including long-term studies of children and families. "I have been continually struck with survivors' resilience despite significant and serious difficulties due to cancer, its treatment and late effects," said Dr. Kupst. "That is why I enjoy working with survivors, as we continue to learn from them and, as a result, try to improve our care."

Dr. Kupst enjoys working with the Next Steps team and believes it is an important resource for survivors and families. She also is involved in several national advocacy efforts related to pediatric cancer. Dr. Kupst is married and lives in Illinois on a small farm. She enjoys gardening and traveling.

Kristin Bingen, PhD, pediatric psychologist, Children's Hospital of Wisconsin

Kristin Bingen, PhD, has been with the Next Steps team since 2001, after completing her fellowship at The Medical College of Wisconsin in Pediatric Hematology/Oncology/BMT. She completed her internship at Children's Hospital of Minnesota, after she received her doctorate from the Illinois Institute of Technology in Chicago and a bachelor's in Psychology/Social Welfare from the University of Wisconsin-Madison. Since 2003, she has been an assistant professor of Pediatrics at the Medical College.

Dr. Bingen is married and has two children, Kamren, 4 years, and Kyra, 3 months. They enjoy going up north and love the outdoors. She also is a huge sports fanatic, especially for the Packers and Marquette basketball!

The best things about working with survivors for Dr. Bingen is seeing the patients mature and do well. She appreciates that survivors can make it through all they do and blossom. She admires their resilience.

Heather Christiansen, PsyD, psychology fellow, Children's Hospital of Wisconsin

Welcome to Heather Christiansen, PsyD, our new fellow in psychology who started here this past July. Heather came from the UCLA Semel Institute, where she was an intern. She has a doctorate in Clinical Psychology from Nova Southeastern University and a bachelor of science in Psychology from the University of Iowa. Her research interests are the psychosocial impact and interventions for cancer/cancer treatments.

In her free time, Dr. Christiansen enjoys staying active by running, spinning, Pilates and playing golf. She also loves listening to music and spending time with family and friends. Heather enjoys working with survivors because she says they are tough. She feels survivors were dealt a difficult hand early in life yet find ways to manage and overcome it. Their perseverance makes them great role models.

Rose is a student at Marquette University in Counseling Psychology. She worked as a practicum student in the MACC Fund Center for Cancer and Blood Disorders from 2007 to 2008. She has been with Next Steps as a clinical research coordinator since November 2008.

Rose likes hearing cancer survivors' stories and celebrating in their living. Outside of work she enjoys running, ballet and reading fantasy and nonfiction.

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