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Adolescents and young adults (AYA) with cancer have an increased risk of developing secondary cancers, cardiovascular, metabolic and bone diseases as well as cognitive impairments, which can reduce their survival and quality of life. Furthermore, most AYA cancer survivors do not meet the recommended guidelines for physical activity. Dr. Nock is conducting a pilot study using 'cybercycling' (stationary cycling with interactive video gaming) to improve quality of life in AYA cancer survivors. She will also see if this exercise program improves their motivation to exercise, body composition (weight, body fat), fatigue, depression, and sleep habits.

By increasing physical activity, survivors may reduce their risk of obesity and chronic diseases, and improve their quality of life. Dr. Mendoza's research aims to examine the use of a wearable physical activity device, the Fitbit, paired with a Facebook group, to increase physical activity among teen childhood cancer survivors. This approach aims to harness new wearable technology and the widespread use of smart phones to use individual- and peer-influences to promote physical activity.

Adolescents and young adults with cancer do not receive adequate support and face a higher rate of relapse relative to younger patients. Dr. Schwartz's project is taking a current texting intervention which aims to improve health-related knowledge and engagement, and upgrading the technology and content in order to maximize the impact. This research aims to ultimately help improve the health and well-being of adolescents and young adults with cancer.

Survivors of pediatric brain tumors commonly struggle with progressive declines in attention and memory that emerge following neurosurgery, chemotherapy and radiation. Unfortunately, little is known about the neurobiological substrates of these cognitive dysfunctions. Dr. Posner's Grace for Good St. Baldrick’s Supportive Care Grant aims to identify the specific changes in functional and structural brain connectivity that correlate with neurocognitive decline by collecting advanced magnetic resonance imaging (MRI) and neuropsychological test data on survivors. This data is being compared with healthy controls across three academic medical centers: Columbia University Medical Center, Children’s Medical Center-Dallas and Seattle Children’s Hospital. This grant is named for the Grace for Good Fund created in honor of Grace Carey, a medulloblastoma survivor. It supports research of brain tumors and survivorship issues in the hopes of changing kids’ lives for good.

While great advances have been made in childhood cancer treatment, all children do not benefit equally from these innovations. Previous research suggests that disadvantaged children are more likely to die from cancer because their families have difficulty complying with treatment guidelines. Enhancing childhood cancer families’ abilities to adhere to treatment protocols is of critical importance to ensure that all children benefit from innovations in care. Dr. Gage-Bouchard is examining the factors that shape families’ abilities to comply with treatment protocols – a critical first step in developing interventions to increase treatment adherence among children diagnosed with cancer.

Although most kids with a brain tumor survive the tumor itself, many have trouble doing activities that require attention and memory, and they often have difficulty fitting in with peers. Both types of difficulty could be related to changes in their brain structure or function, but research on this hasn'’t been done yet. Dr. Hoskinson is looking at whether there's a connection between these changes in brain structure and function and how kids get along with their peers. If there is, this research aims to help predict which kids will have social problems after treatment and identify ways to help.

Most children treated for cancer can now expect to be cured. However, in a significant majority, future fertility may be compromised by their disease or its treatment. Girls are particularly at risk to ovarian injury. These children are cured; however the girls will live the rest of their life in menopause and they will also sadly be unable to have a child of their own. Dr. Lukish's work aims to open the field of ovarian cryopreservation in children by providing an evidence base for future practice, with significant potential benefit to young girls with cancer.

Brain tumors are the most common solid cancer in children, and are often cured with radiation therapy. While radiation attacks the tumor, it can also leave the child with significant learning problems that affect their quality of life over the many years following cancer. Dr. Castellino focuses on understanding how heart function and brain vessel function may have been affected during treatment of the brain tumor. The goal of this research is to create strategies to prevent or lessen the injury to the brain during treatment, not only to cure the cancer in children, but also to preserve normal function for productive and healthy lives as cancer survivors.

Nutrition experts recommend that pediatric cancer survivors eat more fruits, vegetables, and whole grain products, and to lead active lifestyles. However, studies suggest that childhood cancer survivors are at risk for excessive weight gain and poor fitness. Strategies to enhance the nutritional quality of diets and to promote physical activity among cancer survivors are greatly needed. This study assesses the feasibility of healthy lifestyle coaching by group televideo conferencing to encourage healthy lifestyle modifications.

The project involves creating a web application that will generate computerized tailored resilience profiles for adolescents and young adults with cancer (AYA) and their parents. The tailored resilience profiles will summarize meaningful of information regarding the AYAs' and parents' strengths and areas that could be improved. The overall goal is to give them information to help them achieve a sense of resilience during cancer treatment. Resilience means a person feels a sense of confidence and well-being in the midst of a life-threatening illness. Fostering resilience during the cancer experience leads to improve quality of life.

While most childhood cancer patients no longer die from cancer, young adult survivors of childhood cancer face enormously distressing side effects from their life-saving treatments. These include severe sexual and reproductive problems. Currently, no support is available to help educate young adult survivors about how to manage treatment-related sexual problems and fertility-related distress. This project aims to develop and deliver the first sexual health educational intervention for young adult survivors. This research can make a significantly positive impact on the quality of life for thousands of young adult cancer survivors who are struggling and in need of support.

Dr. Phipps is studying what happens to children who were treated with bone marrow transplant for cancer many years ago. This is a very challenging treatment that can cause problems for survivors in a number of areas, including their thinking and learning ability, their physical health, and their ability to have children. He is learning how these children and young adults are faring relative to their healthy peers, to identify factors that lead to better or poorer outcomes so that researchers can develop treatments to prevent any negative effects.

Despite major improvement in outcomes for children and older adults with cancer over the past three decades, there has been little or no improvement in survival among adolescent and young adult (AYA) cancer patients (ages 15-39 years). The reasons for this disparity are not completely understood and likely include many factors, including differences in tumor biology, insurance coverage, clinical trial participation and adherence to treatment. This research aims to produce detailed information about the factors affecting AYA cancer incidence and survival that will help doctors target care and close this gap. The project will also produce detailed information for local cancer care service providers on where to target their efforts, and information that will help clinicians recruit AYA patients most in need of help to clinical trials to address their needs.

Having friends is vitally important for all children. Children surviving brain tumors often have physical problems (jerky movements, slurred speech, etc.) and cognitive delays caused by their disease or treatment. These cancer survivors are frequently described by peers as "not well liked," "having few friends" and "isolated". This puts them at risk for being bullied, dropping out of school, becoming anxious or depressed, and being less likely to marry or have good jobs as adults. Dr. Noll is conducting a research-backed, school-based project to support brain tumor survivors' social involvement by training classmates to be more inclusive of others viewed as "different."

Childhood cancer survivors are at risk for developing long term health problems including heart disease. Dr. Ruble's research finds ways to make survivors healthy by participating in physical activity. Currently less than 50 percent of survivors participate in adequate amounts of exercise, which increases the risk of developing health problems. This project aims to find out the best way to support survivors in changing behaviors and being healthy.

Even though more and more children are being cured of cancer, the treatment can cause major life-long health problems for survivors. Unfortunately, most adult survivors don't seek appropriate medical care to monitor and care for these problems. This project is to study whether or not adult survivors referred to adult-focused follow-up care actually engage in such care and what might get in the way of doing so. The results of the study will help medical providers better prepare young adult survivors to engage in adult-focused follow-up care to assure that they stay as healthy as possible.

Cancer therapy for childhood leukemia is often successful, but not without side effects. Pancreatitis, characterized by severe abdominal pain and inability to digest food, is a severe side effect seen in some children but not others who are similarly treated for leukemia. This side effect is sometimes fatal, and very often causes significant delays in continuing with treatment. This research is to learn the reasons why some children are more likely to develop this side effect than others, with the goal of helping all patients avoid it.

About 80% of children and adolescents diagnosed with cancer become long-term survivors. About half of them develop therapy-induced hearing loss that is cumulative and irreversible. Most at risk are patients with brain tumors, neuroblastomas, osteosarcomas, soft tissue sarcomas, retinoblastomas, hepatoblastomas, or germ cell tumors who need to be treated with cisplatin, combinations of cisplatin and carboplatin, radiation to the head and neck, or combinations of platins and radiation. Therapy-induced hearing loss adversely affects speech and language development, reading ability, communication, academic performance and psychosocial development. It frequently causes stress, social isolation, low self-esteem, and low overall quality of life. This project explores the use of moderate to high doses of dietary selenium as means to reduce or prevent cisplatin-induced hearing loss.

Although most children with leukemia can be cured, chemotherapy frequently causes permanent brain dysfunction in survivors. With previous support from St. Baldricks, Dr. Cole's lab identified promising protective interventions, and he will now test them among those children at greatest risk for brain damage. To identify this population researchers are studying whether variation in neurocognitive function among leukemia survivors is related to specific inherited differences in genes related to repair mechanisms or to metabolism of drugs thought to cause cognitive deficits.

Research in the last 30 years has had a wonderful impact on the survival rate of kids with many types of cancers. However, aggressive treatment regimens on children's young bodies have many negative side effects. One class of chemotherapy drugs, anthracyclines, have been used to effectively treat more than 135,000 childhood cancer survivors, but cause significant risk for cardiovascular disease by the time these children reach their 30s. This research will use Cardiac Magnetic Resonance Imaging and chemical markers in the blood to identify heart damage caused by anthracyclines before symptoms begin, thereby reducing long-term life-threatening heart conditions for pediatric cancer survivors.