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Pediatric Oncology Late Effects of Cancer

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Survive and Thrive Teams provide dedicated care for adolescent and young adult cancer patients.

Treating Late Effects of Cancer

Late effects may occur between two to five years after completion of treatment, but other late effects may not show up until more than 10 years after treatment. The Children's Mercy Section of Oncology has created the Survive & Thrive Program to provide specialized services for childhood cancer survivors.

The Survive and Thrive Clinic is offered four times per month at the Children’s Mercy Kansas City Adele Hall Campus. A Survive and Thrive Clinic is also offered in Joplin, Missouri twice a year.  

Common Late Effects

  • Learning or memory issues
  • Emotional concerns such as depression, post traumatic stress disorder, anxiety
  • Heart or lung problems
  • Growth failure, hypothyroidism, infertility
  • Secondary cancers

Survive and Thrive Services

The program offers comprehensive medical and emotional care, education on late effects of cancer treatment, and recommendations for maintaining a healthy lifestyle. The team follows the Children’s Oncology Group’s Long-term Follow-up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers to make recommendations for long-term monitoring for potential late effects of treatment. The program also works with survivors to prepare for transition of medical care to adult providers.

Late effects are health issues that can occur any time after treatment for childhood cancer. Many late effects occur between two to five years after completion of therapy but other late effects may not show up for many years after the treatment.

Many childhood cancer survivors and their families are not aware of the potential late effects that may occur many years after treatment. The earlier the problem is identified the sooner treatment can be started. The Survive and Thrive clinic can help provide information about your child's healthcare needs to their primary care doctor, ensuring that the necessary screening will continue. 

Clinical Care

  • Complete physical exam, including any labs, x-rays or other tests that may be indicated
  • Medical evaluation and consultation with specialists as needed

Psychosocial Support

  • Clinical social work assessment
  • Therapeutic interventions with patients and families


  • Summary including diagnosis, treatment details, complications and late effects 
  • Individualized recommendations for follow up based on patient’s cancer history
  • Recommendations for maintaining a healthy lifestyle

Transition of Care

The Survive & Thrive team assists survivors by assessing readiness to transition and barriers to transition. Preparation for transition begins when survivors are 15-16 years old. The team works with each survivor to develop a plan for transition of care once they are 21 years old. The treatment summary and recommendations for follow up are shared with the primary care provider.

Collaborative Care

The Survive and Thrive team, in collaboration with the University of Kansas Medical Center and the Midwest Cancer Alliance, has developed the Survivorship Transition Clinic. This clinic is designed to meet the ongoing health care needs of young adult survivors who have transitioned from Children’s Mercy. A nurse navigator works jointly with the Survive and Thrive Program and the Survivorship Transition Clinic. 

Survivors meet the nurse navigator before leaving the Survive and Thrive Program. The nurse navigator helps survivors navigate the new health care system and continues to meet their educational needs during visits in the Survivorship Transition Clinic. The Survivorship Transition Clinic is only one option for survivors leaving Children’s Mercy. Survivors have a choice of where to continue their follow-up care and the Survive and Thrive team will work to develop a plan that best meets each survivor’s needs.  

Who is eligible to attend the Survive & Thrive Clinic?

Patients who may take part in the clinic:

  • Diagnosed with cancer at least five years ago
  • Have been off therapy for at least two years
  • Are currently in remission
  • Those over 18 years of age, even if above criteria are not met so we can assist with transition of medical care

Hem-Onc Teen Board
The Hem-Onc Teen Board was started in 2013 as part of the Hem/Onc Adolescent and Young Adult (AYA) Program with the goal of improving care and support for our AYA patients receiving treatment for cancer or blood disorders.

Each year, the Division of Pediatric Hematology, Oncology and Bone Marrow Transplantation at Children’s Mercy Kansas City provides comprehensive care to nearly 2,000 children with childhood cancers, sickle cell disease, hemophilia and other blood disorders, with survival rates frequently above national averages. 

Our commitment to clinical research and innovation has helped us earn recognition as one of the top cancer programs for kids in the nation by U.S. News and World Report. Children’s Mercy also has received accreditation from the American College of Surgeons Commission on Cancer and the Foundation for Accreditation of Cellular Therapy. 

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