Sylvie Roberge is the Pediatric Oncology Satellite Nurse Coordinator in the POGO Pediatric Oncology Satellite Clinic at the Northeast Cancer Centre, Health Sciences North, Sudbury. She shares her insights on the importance to her practice of the POGO Satellite Manual. POGO Satellite Clinics are located in eight Ontario communities and provide some aspects of a child’s cancer care closer to home.

 Q. How does the Satellite Manual impact patient care?

Sylvie: The POGO Satellite Manual directs Satellites in the day-to-day care of our patients/families by providing clear, best-practice documents in such areas as chemotherapy delivery, management of supportive care issues and palliative care. It guides healthcare professionals (HCPs), ensuring that families who are eligible for some of their care in the Satellite setting can safely receive high-quality care in their community comparable to that received in tertiary hospitals. The POGO Satellite Manual is a great tool for both for in-patient units and outpatient clinics.

Q. What difference does the Satellite Manual make in your job?

Sylvie: The Northeast Cancer Centre uses the POGO Satellite Manual as a reference in the development of our hospital guidelines, standards of care, and policies and procedures. The Manual also provides standard communication tools that can be downloaded for use between Satellites and tertiary centres so that all required information is shared between institutions in a timely, organized manner. Again, this facilitates the seamless, comprehensive delivery of services to our patients.  The Manual also includes tools for Satellites to use in their annual report to POGO. This ensures that POGO receives the required data from the Satellites for its reporting to the Ministry of Health for data collection and research.

Q. What should families know about the necessity of the POGO Satellite Manual in the delivery of pediatric cancer care in the community?

Sylvie: The POGO Satellite Manual is an important tool that enables HCPs to keep pace with the rapidly advancing field of pediatric oncology. The content is regularly reviewed and updated in collaboration with HCPs in tertiary and Satellite centres to ensure that care in both settings is guided by the same principles. Families can be reassured that best-practice guidelines are being followed in their Satellite, much like in their tertiary centre, and that the standard of care is equivalent.

Q. How has the change from a binder and downloadable PDF to a web-based format improved the Satellite Manual?

Sylvie: This new format, including the removal of password protection, has made the information more accessible to HCPs in all settings, outpatient as well as in-patient. Physicians can now refer to the Manual from home, on any device, whenever they need to find information on a particular topic. The online Manual is easy to locate on the POGO website, user-friendly and the information is clear and well organized. This format also allows for easy updating of individual sections of the Manual.

The POGO Satellite Manual is a resource for healthcare teams working in the POGO Provincial Pediatric Oncology Satellite Program. 

Susan Grace April 5, 1953 – May 4, 2017

From POGO employee to POGO volunteer, Susan Grace was a true champion of kids with cancer and their families. On May 4, 2017, Susan lost her own personal battle with breast cancer.

In 1992, Susan started her journey with POGO as an administrative assistant. Over the years, she was the mainstay for POGO, performing such other roles as receptionist, office manager, controller, assistant to the executive director, publicist, event planner, project manager, and even dish washer! She saw POGO grow from just two employees to its present staff of about 60. Susan worked tirelessly weekdays and many weekends and met every deadline with a smile.

Susan was diagnosed with breast cancer in 2003, and after treatment and surgery, went into remission in 2004.  In spite of her diagnosis, Susan considered herself very fortunate and made the most of every day thereafter.

In 2004, Susan received the POGO Companion Award which recognizes those who have made a prolonged and enduring, exceptional and sustained commitment to advancing state-of-the-art childhood cancer control. 

Susan returned to POGO in June 2005 until March 2006 as the temporary controller until the organization filled the position permanently.

In June 2006, after 15 years with POGO, Susan resigned and began her second career with POGO as a volunteer. Susan’s overall contributions to POGO are invaluable and include work on POGO’s annual staffing study, infrastructure improvements, and POGO’s legacy database tracking milestones in the organization’s history.

A volunteer par excellence, some of Susan’s happiest days were at St. Bartholomew’s Church in Regent Park (Toronto) where she volunteered in the early-morning Breakfast Program from 1987 until recently. When Susan and her husband relocated to Alcona, on the shores of Lake Simcoe, she refused to even contemplate giving up the Breakfast Program and would rise early every Thursday morning, leaving the house at 3:10 a.m. for the drive into Toronto, arriving at the church by 4:30 a.m. to open the doors and welcome all who were waiting. From there, she would make her way to volunteer at POGO.

A lover of life, Susan was a cheerful, positive and optimistic person, always with a ready smile for everybody.

When Susan relapsed in December 2015, she faced this new challenge with the same positive attitude, truly believing that she was going to once again beat the disease. She was determined to meet her life goals, which included more travel, selling her dream home on Lake Simcoe and settling into a new condo in Toronto.      

Susan Grace is a POGO Champion who made lasting, behind-the-scenes contributions that will forever endure across the childhood cancer community and system.

In November 2016, POGO welcomed Dr. David Hodgson as its new Medical Director and Chair in Childhood Cancer Control. Here are Dr. Hodgson’s remarks on the occasion of his welcome reception at the University of Toronto’s Massey College. 

In the summer of 1989 I came to the Associate Dean’s office, about 800m from here, for my medical school admissions interview. At that time, admissions interviews were done after the med school applicants had already accepted, so the stakes were low.

We discussed undergraduate experience, my hopes for medical school, and after about 20 minutes, the Dean asks me, “Are you excited about going to medical school?” I said, “Sure, why do you ask?” He replied, “Well you don’t look very excited.” I told a friend in grad school about this and he said I should have answered, “Are you excited about being Dean?” But I didn’t say that, which in part is why I’m here today.

I learned a lot in medical school, but of course many of the most important lessons were learned afterward, and two in particular I’ll mention today.

Only after some time in practice did I learn the first lesson, which was to appreciate how scared our patients and their families are. The writer James Hollingsworth wrote, “Courage is not the absence of fear, but rather the judgement that there is something more important than fear.”

And what greater fear could there be than to have what one values most – one’s life, or even more so the life of one’s child – taken away? Imagine how it feels to give a group of strangers permission to surgically remove parts of your child’s body, irradiate them, and give them so much chemotherapy that their bone marrow is wiped out, saved only by a plastic bag of stem cells kept in a freezer. But every day we have the privilege of helping families who give us permission to do exactly that, with incredible courage, because they work towards something more important than their fear: a normal healthy life for their child.

The second lesson is that it’s harder than I expected it would be to be a good doctor; to consistently provide high quality care. Now, fortunately, we work in a system that for the most part facilitates good care, and one only needs to talk to our counterparts around the world to see how lucky we are to work where we do.

But our knowledge is incomplete, our treatments imperfect, our resources limited, and we battle inefficiencies and bureaucratic absurdities that can wear us down. Too often we are not able to deliver the healthy life that our patients and their parents hope for.

That is why the work of POGO, in collaboration with the tertiary care centres and satellite clinics that make up the pediatric oncology system, is so important. Work to roll out new treatments in a timely and equitable way, to provide financial support for families being crushed by out-of-pocket costs, to offer academic and vocational support for survivors to succeed long after treatment is over, and to conduct research to further improve system performance. This is critical work that POGO does that benefits patients for sure, but make no mistake, also benefits everyone in this room trying to reduce the burden of childhood cancer care in Ontario.

So I’d like to say that I am very excited to do my part to help with this important work – work that strives to be worthy of the courage of our patients and their families, and that allows us to provide the kind of care we aspired to give when we started school.

And Dean Young, just so you know:  this is what it looks like when I’m excited, in case you didn’t recognize it.

— Dr. David Hodgson, POGO Medical Director and Chair in Childhood Cancer Control, November 28, 2016

Read more about Dr. David Hodgson

The 2016 POGO Symposium on Childhood Cancer examined clinical and scientific advances in the diagnosis and treatment of leukemia in children and adolescents. This professional education event attracted an exceptional roster of internationally renowned childhood cancer healthcare practitioners to present on this topic, and scores of delegates—practising and emerging professionals alike. Among the latter were seven undergraduate and post-graduate students who attended on bursaries and subsequently shared their learnings and inspirations from this year’s event.

Here are excerpts from their recaps.

Networking at the POGO Symposium

“As I begin my graduate career, the opportunity to speak with scientists, nurses and allied health professionals in the field was incredibly helpful. I was informed of the variety of specializations I could follow, was given advice for career development, and started a network of connections to work with. Learning more about current research, and speaking to experts who share similar passions for their work, was incredibly inspiring! I left the Symposium feeling motivated in my work and connected to an amazing community of equally passionate healthcare professionals!”

-Jacqueline van Warmerdam, MSc Candidate, The Hospital for Sick Children & The University of Toronto

“Throughout my experience at the POGO Symposium, I was able to meet other nursing students, nurses, nurse educators and nurse managers. I was fortunate enough to sit at a table with a few oncology/haematology nurses that currently work at SickKids and was able to ask a lot of questions about their experience. I am excited to learn more as I pursue a career as a pediatric oncology nurse and look forward to future POGO Symposiums.”

-Mackenzie Heath, Bachelor of Science in Nursing, Year 4, Western University

“This conference provided me with the opportunity to network with nurses who work on the unit which I aspire to work on, as well as be introduced to the unit manager of the unit which I hope to work on upon graduation. This conference provided incredible networking opportunities as a student nurse, and I was able to learn from my future RN colleagues and gain their insight into the coming months leading into my career.”

-Kealey Clarke, Collaborative Bachelor of Science in Nursing Program, Year 4, Western University/Fanshawe College

The Multifaceted Field of Pediatric Oncology

“Although leukemia brings many challenges, the conference emphasized the successes and acknowledged how far the field has come in terms of cure rate which was amazing to learn about. Dr. Nina Kadan-Lottick gave a wonderful talk on managing behavioural treatments that are observed during treatment. She emphasized the importance of quality of life and how this includes mental health. She talked a lot about providing psychosocial support and how there are upcoming interventions that are used to help provide that support to youth who may be experiencing anxiety. Dr. Sharon Guger discussed how leukemia is having impacts on attention, memory and learning and how this can impact quality of life post treatment. Another major area of focus was on future research and future targets for leukemia treatment. One talk that stood out the most was Dr. Stephan Grupp who discussed CAR-T Cell Therapy. This talk was full of innovation and demonstrated the future direction of leukemia treatment. Overall, the Symposium provided an educational, interesting and innovative series of talks that really impacted my knowledge and education surrounding the topic. I always love how the Symposium has a variety of speakers that cover many different perspectives. It shows the multidisciplinary approach to pediatric oncology and makes the field so unique.”
-Nini Nguyen, Bachelor of Health Sciences (BHSc), Child Health Specialization, McMaster University

“I specifically enjoyed the sessions on the psychosocial aspects of cancer treatment, with an emphasis on the family. The discussion on sleep habits during treatment of both parents and the patient was of particular interest to me. I also enjoyed the session on managing behaviour changes during treatment. I felt empowered by the specific nursing interventions that were suggested with respect to post-treatment distress in families undergoing childhood cancer treatment. This helped solidify one of the main messages I took away from the conference which was the quality of the cure…I feel very fortunate for this opportunity and look forward to attending the Symposium as a registered nurse next year.”

-Lisa Delanghe, Bachelor of Science in Nursing, Year 4, University of Windsor

“The presentations taught me a lot about where we stand in the fight against childhood cancer. In particular, I found the opening talk by Dr. Sallan to be an engaging and informative start to the conference; this talk was the best way for someone without a lot of leukemia expertise to be quickly updated and set up for the other talks. I learned a lot about precision medicine which inspires me in my future goals to combine clinical practice with molecular research. Dr. Nathan’s talk on the late effects of childhood leukemia really helped me to understand the unique nature of childhood cancers and to comprehend the importance of reduction therapy and survivor care. The poster sessions were very helpful as I had the chance to share my summer research with healthcare professionals, receive their input and hone my presentation skills…I even got to see the results of studies I myself had participated in.”

-Hayley Insull, Bachelor of Science in Biochemistry, Year 2, McGill University

“Without a doubt, the highlight of the weekend was being able to learn, first-hand, from world experts in the field of oncology. As someone who aspires to be a pediatric oncologist, it was so motivating to hear the journeys of these physicians and experts. It was especially inspiring to know that some of them have been witness to and participants in the immense strides that have been made in pediatric oncology (such as the increased survival rate in ALL), and humbling to hear that they still felt that they needed to do so much more.”

-Meghna Dua, Pediatrics Resident, Year 2, Western University

Knowledge Translation through Poster Presentations

“The posters were also an enjoyable part of the Symposium. It was fantastic being able to engage with students and supervisors through visual representations of their work. I was able to ask critical questions that deepened my understanding of their work but also helped to inform my own research questions and methodology. I hope to present a poster at next year’s Symposium and so I also took note of differences in layout and design of the posters.”

-Ashna Khanna, MSc Candidate, Clinical Research, Institute for Medical Science, University of Toronto

Carley won an Outstanding Poster Award at POGO’s 2016 Multi-Disciplinary Symposium on Childhood Cancer

“Presenting at POGO was a great learning experience. As an undergraduate student, it was a phenomenal opportunity to practice my presenting skills and present on a project that I am passionate about. I was able to practice speaking in a professional manner with my target audience being informed healthcare professionals. I was able to disseminate knowledge regarding the iPeer2Peer Oncology project that I have been actively involved in and was able to connect some nurses with the principal investigator to potentially enrol current oncology patients at SickKids with a mentor in the iPeer2Peer program. I felt that this opportunity was a great knowledge translation experience and overall a great learning opportunity as an up and coming health professional and researcher.
-Carley Ouellette, Bachelor of Science in Nursing, Year 4, Western University.