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2001/2002 Annual Report - the Pediatric Oncology Group of Ontario
2001/2002 Annual Report - the Pediatric Oncology Group of Ontario
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<strong>“</strong><br />
LIFE MEANS SO MUCH but we don’t realize<br />
how precious it is until it is taken away.<br />
I took life for granted and then<br />
each breath of life was a struggle.<br />
<strong>”</strong><br />
— Julia Brown, age 15
A MESSAGE FROM THE<br />
PRESIDENT<br />
As POGO fast approaches its 20th<br />
anniversary, it is time to reflect on the goals<br />
and accomplishments of this unique organization<br />
and to anticipate its successes in the<br />
years to come. From humble beginnings as a<br />
well-meaning but seriously underfunded, and<br />
otherwise under-resourced, entity devoted to<br />
improving the care of children with cancer in<br />
Ontario, POGO has grown in stature and professionalism<br />
to enjoy an official role as advisor<br />
on pediatric oncology to the provincial ministry<br />
of health, supported by a dedicated secretariat<br />
and a multi-million dollar annual<br />
budget.<br />
POGO's effectiveness lies, in part, in its<br />
functioning as a supra-institutional body, collaborating<br />
with and supporting the important<br />
work of institutions across this province which<br />
deliver pediatric cancer care (including The Hospital for Sick<br />
Children; McMaster Children's Hospital; Children's Hospital of<br />
Western Ontario; Kingston General Hospital; and Children's<br />
Hospital of Eastern Ontario). Thanks to POGO, each of these<br />
institutions, and the patients and families they care for, have benefited<br />
from increased funding and a province-wide system of<br />
comprehensive care based on the highest standards and practice<br />
guidelines.<br />
Opportunities for further accomplishments abound and will<br />
be enabled by the establishment of partnerships with other<br />
organizations, as envisaged in a formal business plan, and by the<br />
imminent birth of the POGO Childhood<br />
Cancer Foundation (the application for<br />
which is under review at Canada Customs<br />
and Revenue Agency as of press time). By<br />
word of mouth and through the dissemination<br />
of POGO's standards, guidelines and<br />
policy documents, POGO's experience and<br />
expertise has found its way to children with<br />
cancer throughout Canada, and in the USA<br />
and developing countries. With your help,<br />
there is much more we can do to ensure the<br />
best possible care for children everywhere.<br />
I thank the Ministry of Health and Long-<br />
Term Care and the many generous corporate<br />
and private sector donors for the commitment<br />
with which they have supported<br />
POGO's growth so far. We look forward to<br />
their continued partnership as we embark<br />
on the many challenges and opportunities ahead to improve the<br />
circumstances of the children and their families who struggle<br />
with pediatric cancer—in Ontario and beyond.<br />
Dr. Ronald D. Barr,<br />
President<br />
Sudbury Regional<br />
Hospital Corporation<br />
The Credit Valley<br />
Hospital, Mississauga<br />
Children's Hospital<br />
of Western Ontario<br />
University of<br />
Western Ontario<br />
The Hospital<br />
for Sick Children<br />
University of Toronto<br />
The Pediatric Oncology<br />
Group of Ontario<br />
Kingston<br />
General Hospital<br />
Queen's University<br />
Orillia Soldiers'<br />
Memorial Hospital<br />
Children's Hospital<br />
Hamilton<br />
McMaster University<br />
Children's Hospital<br />
of Eastern Ontario<br />
University of Ottawa<br />
Grand River Hospital,<br />
Kitchener Waterloo<br />
Health Centre<br />
POGO: An update 3
INTRODUCTION TO POGO<br />
Each year, over 2,500 of Ontario’s children undergo treatment<br />
or require follow-up care for cancer. Despite decades of<br />
remarkable progress, 25% of children newly diagnosed with<br />
cancer will not survive. In fact, cancer kills more of our children<br />
than any other disease: on average, 2 children die of malignant<br />
disease each week in Ontario.<br />
Investments of human and financial resources, and a high<br />
level of professional collaboration, have resulted in a 75% overall<br />
survival rate for children with cancer. However, when survival<br />
is reached, it can come at a high cost. Quality of life may be<br />
compromised, and children and their families may struggle with<br />
the physical, psychological and socio-economic impacts of the<br />
disease and its treatment<br />
Founded in 1983, the Pediatric Oncology Group of Ontario<br />
(POGO) champions childhood cancer care and control. The<br />
organization seeks to ensure access for all of Ontario’s children to<br />
well coordinated, state-of-the-art cancer care and to ensure that<br />
POGO’S VISION<br />
POGO’s vision, conceived in the mid-1990’s, was translated<br />
into seven strategic initiatives, all substantially on their way<br />
to completion. These are:<br />
1. The creation of a childhood cancer system that allows<br />
the child and family to take advantage of medical,<br />
nursing and behavioural expertise in five specialized<br />
childhood cancer programs when necessary, and<br />
closer to home when safe and appropriate.<br />
2. A standard for acceptable staffing levels and professional-to-child<br />
ratios.<br />
3. The implementation of a provincial network of specialized<br />
After Care clinics, to address the predictable<br />
and often remediable issues of survivors.<br />
4. Mechanisms for easing the enormous financial burden<br />
experienced by families when confronted by the catastrophic<br />
diagnosis of pediatric cancer.<br />
5. The recognition of a pediatric cancer coordinating<br />
body (POGO) linked to the Ministry of Health and<br />
Long-Term Care and other stakeholders, and commitment<br />
to support it.<br />
6. A provincial childhood cancer database electronically<br />
linking the programs that care for children and providing<br />
accurate provincial information on cancer in<br />
the population.<br />
7. Creation of a childhood cancer-focused research unit.<br />
the services needed are available. POGO works on behalf of,<br />
and along with the children and their families to ensure optimal<br />
care, advocating for appropriate clinical, research and educational<br />
resources for caregivers of all disciplines, and generating<br />
standards and guidelines for practice. The organization is a collaboration<br />
of the five specialty pediatric oncology programs in<br />
Ontario—The Hospital for Sick Children (Toronto); McMaster<br />
Children’s Hospital (Hamilton); Children’s Hospital of Western<br />
Ontario (London); Kingston General Hospital; and Children’s<br />
Hospital of Eastern Ontario (Ottawa)—along with a growing<br />
number of partners. The collaboration’s mission is threefold,<br />
focusing on Care, Education and Research:<br />
■<br />
■<br />
■<br />
CARE: POGO seeks to ensure that each child in this<br />
province has equal access to the most current care and that<br />
the full range of needs of these children, their families and<br />
caregivers are met.<br />
EDUCATION: POGO creates regular opportunities for professional<br />
update in this rapidly advancing field.<br />
RESEARCH: POGO promotes and conducts research probing<br />
incidence, trends, program delivery effectiveness and<br />
costs, and quality of survival—an often neglected research<br />
agenda.<br />
A strong partnership with Ontario’s Ministry of Health and<br />
Long-Term Care (MOHLTC) and with the childhood cancer community,<br />
and an unfaltering collaboration among the POGO programs<br />
and professionals, have led to many successes, as a result<br />
of which, POGO is now designated the official source of<br />
advice to the MOHLTC on pediatric cancer care and control.<br />
POGO has built a reputation for recommendations<br />
based on solid provincial data, scientific evidence and significant<br />
clinical experiences.<br />
Thanks to POGO, care for Ontario’s children with cancer has<br />
been enhanced and integrated, and pediatric cancer is, today,<br />
designated a Priority Program by Ontario’s MOHLTC. POGO<br />
and its partner hospitals have created an environment in which<br />
the gaps in care and control are identified, and funds for childhood<br />
cancer care continue to flow from government to the institutions<br />
in which diagnosis and care take place.<br />
POGO is dedicated to building a seamless system for the<br />
care of pediatric cancer patients, supported by practice guidelines,<br />
professional education, accurate information and<br />
research. POGO works hard for the survival of these young<br />
cancer patients and strives to improve quality of life during all<br />
phases of the journey.<br />
4 POGO: An update
REPORT FROM THE<br />
EXECUTIVE DIRECTOR<br />
Looking back to POGO’s<br />
beginnings in the 1980’s, it is<br />
truly astonishing to observe<br />
how far along the road this<br />
collaboration of concerned<br />
professionals and programs<br />
has come toward realizing its<br />
vision of a state-of-the-art<br />
childhood cancer system for<br />
Ontario.<br />
On behalf of children<br />
fighting cancer in our<br />
province, their families, and<br />
the dedicated professionals<br />
who care for them, we thank<br />
you for the many and different<br />
Dr. Corin Greenberg at<br />
the ‘80s-themed Party for<br />
POGO, 2002<br />
ways in which you offer your support—through partnerships,<br />
expert consultations, and much needed financial support. With<br />
your help, POGO is in a position to continue and expand its<br />
scope of work. This work is focused on the improvement of cancer<br />
care and quality of survival for the children of Ontario, professional<br />
education and research.<br />
We are grateful for the steadfast support of Ontario’s Ministry<br />
of Health and Long-Term Care (MOHLTC), of pediatric oncology<br />
professionals, the wider childhood cancer care community, and<br />
the many supporters who share our challenges and victories.<br />
On behalf of POGO’s Board, I would like to thank Dr.<br />
Anthony Melman, Fundraising Chair, our donors, sponsors and<br />
volunteers who have generously contributed to POGO’s<br />
Fundraising Campaigns. Their efforts enabled us to establish the<br />
POGO Chair in Childhood Cancer Control at the University of<br />
Toronto, and with it the position of Medical Director of POGO,<br />
both critical to the advancement of POGO care, education and<br />
research initiatives which, in turn, enhance the care of the children<br />
we serve.<br />
I am pleased to report that POGO is operating on a surplus<br />
basis. For the fiscal year ended March 31, 2001 (the most recent<br />
year for which we currently have audited financial statements),<br />
our financial statements, audited by Schwartz Levitsky Feldman<br />
llp, report total income of $2,600,005 and total expenses of<br />
$1,159,393. POGO’s policy is to allocate a portion of any yearend<br />
surpluses against high-priority needs and programs as<br />
approved by the POGO Board, while retaining a positive fund<br />
balance into the subsequent fiscal year. For detailed financial<br />
statements and to receive audited financial statements for the fiscal<br />
year ended March 2002, please contact Susan Grace at our<br />
office at 416-592-1232.<br />
POGO’s work will continue to focus on Care, Education<br />
and Research. In the year ahead, these directions will lead to:<br />
■ Expansion of the Provincial Pediatric Oncology Satellite<br />
Program (PPOSP), a network of community care centres<br />
which provide components of care closer to the family<br />
home, thereby minimizing the disruption on the lives of<br />
patients and their families;<br />
■ Implementation of a partnership with the Interlink<br />
Community Cancer Nurses, a pediatric community cancer<br />
nursing program which will support children/families when<br />
they return home;<br />
■ Operation of a Financial Assistance Program, created to help<br />
with the enormous financial burden experienced by families<br />
as they struggle with childhood cancer. In addition, the<br />
■ Expansion of the Provincial Pediatric Oncology AfterCare<br />
Program which greatly increases the health system’s capacity<br />
for health monitoring and health promotion for all survivors.<br />
As with all POGO initiatives, the AfterCare program is<br />
designed to help children and families deal with the physical,<br />
psychosocial, cognitive and behavioral challenges associated<br />
with their disease and treatment.<br />
In addition, POGO will convene the 2002 Multidisciplinary<br />
Symposium. This year’s symposium is on <strong>“</strong>Care at the End of Life<strong>”</strong><br />
and deals with palliative care for those children who will not survive.<br />
Our annual conferences bring together cancer care professionals,<br />
researchers and other experts to discuss key dimensions<br />
of advancing frontiers. More than 200 pediatric oncology professionals<br />
are expected to attend.<br />
It is my privilege to report, in the pages that follow, some of<br />
the recent and substantial accomplishments of the enduring and<br />
committed collaboration that has become known as POGO.<br />
Dr. Corin Greenberg<br />
Executive Director<br />
POGO: An update 5
A MEASURE OF OUR SUCCESS<br />
OBJECTIVES & INITIATIVES<br />
Ensure government has expert pediatric oncology advice<br />
Create, sustain and expand a provincial database<br />
Establish a Provincial Pediatric Oncology Satellite system<br />
CURRENT STATUS<br />
• POGO linked to MOH<br />
• Data to support decision making developed<br />
• Rapid policy development enabled<br />
• Blueprint for expansion completed, several steps implemented<br />
• Computerized networking of hospitals implemented<br />
• Key information and analysis achieved<br />
• Four provincial pediatric oncology sites prepared and activated<br />
Major expansion of expert staff in all disciplines<br />
Provincial system of After Care Clinics for survivors of all ages<br />
• Phase l funding secured for all POGO hospitals, Phase ll expansion<br />
approved partially by MOHLTC, Phase III under consideration<br />
• New staff and funding secured for:<br />
- After care clinics<br />
- Satellite system<br />
- Expanded database<br />
- Provincial umbrella POGO office<br />
• Approved and funded, guidelines developed<br />
• In preparation:<br />
- Development of health promotion brochure<br />
Initiate an integrated, comprehensive and provincial system of care<br />
• Funding approved<br />
• Several standards and guidelines completed<br />
Increased opportunities for parent/survivor participation in care &<br />
policy development<br />
• Parent and survivor representation on POGO committees<br />
• Childhood Cancer Resources, guide completed<br />
- 2,000 copies distributed to professionals and families<br />
• Parent education handbook approved and distributed<br />
• POGO originated & co-hosted first FORUM on childhood cancer<br />
Initiated supportive strategies for parents/families<br />
Increased opportunities for professional development and specialization<br />
in pediatric oncology<br />
• Increased compensation for babysitting hours achieved<br />
• Trillium Drug program: qualifying threshold changed<br />
• Proposal developed for the management of effective, expensive<br />
supportive care drugs and chemotherapeutic agents<br />
• Increased access achieved to allied health staff & care coordinators<br />
• Initiated professional development opportunities<br />
• Pediatric oncology nursing curriculum developed & implemented<br />
• Annual POGO Symposia<br />
• Mentoring and abstract review system developed<br />
• Staff education for Satellite practice and AfterCare program<br />
Establish the POGO Research Unit (PRU)<br />
• Ministry commitment for 5 years, ends March, 2003<br />
• First studies underway<br />
6 POGO: An update
CARE<br />
In 1988 and again in 1994, POGO delivered comprehensive<br />
reports to the Ontario Ministry of Health and Long-Term Care<br />
(MOHLTC) on available and missing childhood cancer services. In<br />
these reports and through the strenuous schedule of work that<br />
followed, POGO systematically identified gaps in service; new<br />
approaches to treatment; efficiencies to be realized; serious<br />
understaffing; areas in critical need of strategic investment; and<br />
new ways of delivering service.<br />
The result is a strong partnership with Ontario’s MOHLTC,<br />
POGO and the childhood cancer community, and major steps<br />
towards a coordinated, well-integrated, province-wide system of<br />
care, directed and delivered by affiliated, hospital-based programs<br />
which are in regular contact with each other.<br />
Today, Ontario has a childhood cancer system founded on<br />
state-of-the-art practice guidelines and significant new MOHLTC<br />
funding. The province-wide network is the result of a sustained<br />
and determined collaboration of professionals working with parents<br />
and survivors, and the help and support of three successive<br />
governments led by each of the major political parties.<br />
POGO has sought to enhance the care of the children<br />
through:<br />
■ increasing the numbers of staff available in all pediatric cancer<br />
programs, thanks to increased funding from the<br />
MOHLTC;<br />
■ the creation and ongoing support of the Provincial Pediatric<br />
Oncology Satellite Program (PPOSP), a network of community<br />
care centres established in partnership with POGO hospitals;<br />
■ the implementation of a province-wide network of AfterCare<br />
Clinics to monitor the care and promote the health and<br />
well-being of the nearly 75% of children who survive their<br />
cancer;<br />
■ the publication of <strong>“</strong>Childhood Cancer Resources: POGO's<br />
Guide to Services in Ontario<strong>”</strong>, and development of a searchable<br />
online database of resources available across Ontario—<br />
an initiative funded through a private foundation grant;<br />
■ a search for mechanisms for easing the enormous financial<br />
burden experienced by families when confronted by this<br />
catastrophic diagnosis, in collaboration with the Canadian<br />
Cancer Society, Ontario Division and Ontario’s MOHLTC.<br />
■<br />
■<br />
Plans for the future include:<br />
the provision of reliable funding to POGO’s new partner,<br />
Interlink, a community-based pediatric cancer nursing program,<br />
and integration of this program into the childhood<br />
cancer network in Ontario;<br />
maintaining and updating guidelines that direct care in the<br />
■<br />
■<br />
Provincial Pediatric Oncology Satellite centres;<br />
maintaining and updating guidelines that direct care in<br />
POGO AfterCare Clinics;<br />
the management of a financial assistance fund to help families<br />
with treatment-related out-of-pocket costs.<br />
EDUCATION<br />
Over the years, POGO has worked to identify the challenges and<br />
issues arising from childhood cancer control and from the practice<br />
of pediatric oncology professionals. POGO’s educational<br />
programs are dynamic, interesting learning opportunities<br />
where the experts assemble to identify and examine the<br />
issues and where the exchange of ideas, problem solving,<br />
and research collaborations on the entire childhood cancer<br />
population result. These programs help keep caregivers<br />
abreast of new developments, provide regular opportunities for<br />
contact, consultation and collaboration among colleagues<br />
across the province and country, and stimulate discussion that<br />
advances policy, program, and practice innovation.<br />
■<br />
POGO’s ongoing educational activities include:<br />
MULTIDISCIPLINARY SYMPOSIA: Each year, professionals<br />
who care for children with malignant disease<br />
attend the POGO Symposia in large numbers. These<br />
conferences provide cutting-edge information on caring<br />
for the whole child, and networking opportunities<br />
from which research collaborations and clinical consultation<br />
flow in abundance. POGO Symposia are rated<br />
POGO: An update 7
y participants as an effective way of providing new<br />
information for practice and new ideas for research,<br />
and of colleague-to-colleague discovery and discussion.<br />
POGO Symposia are typically attended by approximately<br />
200 multidisciplinary professionals, representing<br />
more than 25 organizations across Ontario,<br />
Canada and the United States.<br />
■<br />
SPECIALIZED PRACTICE UPDATES: POGO updates<br />
enhance professional knowledge in a rapidly advancing<br />
specialty. A program in 2002, for example, focused on Bone<br />
Marrow Transplantation (BMT) and included Management<br />
of BMT Complications; Psycho-social Impacts of<br />
Transplantation; and Nutritional Needs in the Post-<br />
Transplant Patient.<br />
■<br />
■<br />
ROUND TABLE DISCUSSION FORUMS: Round Tables<br />
are designed to foster the development of clinical policies<br />
and programs supported by consensus.<br />
RESEARCH REVIEW AND CONSULTATION: Members of<br />
the POGO Research Committee assist interested researchers<br />
with the development of posters presenting new research<br />
and innovative programs, and with the development of<br />
research proposals.<br />
■<br />
NURSING CONFERENCES: These conferences, which<br />
occur in alternate years, offer nurses rich and valued opportunities<br />
for professional education, career development, literature<br />
updates and clinical consultation. Recent conference<br />
topics included: State-of-the-Art Nursing; Ethical and<br />
Moral Issues in the Care of Children with Cancer; Integration<br />
of New Information into Bedside Nursing; Education for a<br />
Career in Pediatric Cancer Nursing: the Pediatric Oncology<br />
Nursing Curriculum; and Provincial and National Nursing<br />
Partnerships.<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
RECENT MULTIDISCIPLINARY<br />
SYMPOSIA TOPICS<br />
New approaches to Diagnosis, Treatment and<br />
Rehabilitation of Children With Malignant Disease<br />
Experience and Evaluation: a demonstration of how the<br />
latest research findings may be translated into practice<br />
Beyond Cure: Consequences and Care (focusing on the<br />
major late effects of childhood cancer)<br />
The Challenges and Rewards of Caring for Children with<br />
Cancer<br />
Coping with Stress: Applications to Pediatric Oncology<br />
Practice (addressing professional caregiver concerns<br />
about high levels of burnout, stress and emotional<br />
exhaustion)<br />
Causes of Cancer: Environment vs. Heredity<br />
Bill 109 and the Right to Refuse Treatment<br />
Complementary and Adjunctive Therapies<br />
A Vision of Pediatric Oncology for Ontario<br />
A CHILDHOOD CANCER NURSING<br />
CURRICULUM<br />
POGO's first Nursing Committee identified a pressing need<br />
for a childhood cancer nursing curriculum that would help<br />
nurses develop the skills to address the unique medical and<br />
social aspects of caring for children and families throughout<br />
the childhood cancer treatment journey. POGO secured<br />
funding to develop a Pediatric Oncology Nursing<br />
Curriculum from The Max Bell Foundation and The Richard<br />
and Jean Ivey Fund, and spearheaded its development. In<br />
1994 the program was successfully adopted by the<br />
McMaster School of Nursing in Hamilton, where it grew rapidly<br />
into a training opportunity for childhood cancer nurses<br />
across Canada, and was cloned as the model for the development<br />
of a national, adult cancer nursing curriculum.<br />
POGO NEWS<br />
Periodically POGO publishes a newsletter that summarizes new<br />
advances; analyzes the implications of new policies, legislation<br />
and programs; and reviews upcoming conferences and relevant,<br />
recent publications. The newsletter is read by 2000 pediatric cancer<br />
professionals across North America.<br />
8 POGO: An update
RESEARCH<br />
The POGO Research Unit (PRU) was activated in 1998. In barely<br />
4 years of operation the PRU has developed a strong and unique<br />
research mandate that has attracted 30 research proposals,<br />
involving 82 researchers, from 26 institutions and 19 different<br />
professional disciplines.<br />
The mission of the PRU is:<br />
■ to emphasize the importance of translating new knowledge<br />
into better care for children and better health policy;<br />
■ to stimulate investigations focused on population, program<br />
and system questions, on health economics and on quality<br />
of life and other issues relating to patient outcomes;<br />
■ and to spread the culture of multi-hospital and multi-disciplinary<br />
research collaboration.<br />
The existence of the PRU creates new opportunities for the<br />
exploration of innovative research methods and tools and for mentorship<br />
during the formative phases of research development.<br />
The PRU will promote research that is not typically<br />
undertaken by its partner hospitals, nor funded by major<br />
research foundations, yet critically important to advancing<br />
childhood cancer control. This could include:<br />
■ examination of the incidence and trends in childhood cancer<br />
for the purposes of tracking and forecasting cancer in<br />
children<br />
■ evaluation of programs and models of care delivery<br />
■<br />
■<br />
health-economic investigations<br />
health-related quality of life research<br />
POGO is uniquely able to carry out its selected areas of<br />
research because of the breadth of disciplines it encompasses, its<br />
access to an entire population, and its unique database, POGO-<br />
NIS (Pediatric Oncology Group of Ontario Networked Information<br />
System). It is imperative that the PRU capitalize on the momentum<br />
achieved during the first, low-budget years of existence, and that<br />
its significant potential to contribute to the advancement of pediatric<br />
cancer care and control is fully realized.<br />
Some of the studies to date and their implications are<br />
described below:<br />
A Projection of the Future Demand for Pediatric Cancer<br />
Services and a Determination of the Staffing Funding<br />
Required—POGO researchers analyzed patterns and trends in<br />
cancer incidence among children, and determined the number<br />
of adolescents with cancer cared for outside the pediatric<br />
oncology network, in order to anticipate and ready the system<br />
for the future demand for services. Staffing, funding and health<br />
policy implications were presented to the Ontario Ministry of<br />
Health & Long-Term Care. As a result, funding for teams of multidisciplinary<br />
staff has flowed from government to all the POGO<br />
hospitals across Ontario, in accordance with staff-to-patient<br />
ratios determined by POGO.<br />
An Exploration of the Risk Factors for Childhood<br />
Cancer—A number of studies were undertaken to investigate<br />
the relationship between environmental exposure and the child’s<br />
genetic ability to permit or obstruct the development of childhood<br />
malignancies. These studies addressed the development of<br />
Brain Tumours, Osteosarcoma (one of the most common<br />
tumours of adolescence), malignant Germ Cell Tumours (a poorly<br />
understood category of malignancy), and Neuroblastoma. The<br />
latter study investigates the relationship of Neuroblastoma to<br />
dietary supplementation.<br />
DR. GREENBERG APPOINTED<br />
OFFICER OF ORDER OF CANADA<br />
POGO is proud to announce that Dr. Mark Greenberg was<br />
appointed an Officer of the Order of Canada in recognition of<br />
his work to reduce the trauma of childhood cancer on patients<br />
and their families. As former Chief of Oncology at Toronto's<br />
Hospital for Sick Children and with POGO, he initiated a system<br />
of care that addresses both the medical and psychosocial needs<br />
of patients. Equally involved with international cancer organizations<br />
as with grassroots projects, he is beloved by patients and<br />
respected by students and colleagues as a man of immense<br />
compassion and humanity.<br />
An Investigation of the Pediatric Oncology Nursing<br />
Workforce—POGO nurse researchers surveyed their ranks to<br />
determine the current education levels, experience and age distribution<br />
of childhood cancer nurses, as well as the proportions<br />
of their time spent in care, research, teaching and administration.<br />
This investigation enabled POGO to anticipate shortages and<br />
educational needs, and to develop strategies designed to prevent<br />
nursing shortages experienced in other jurisdictions.<br />
A Series of Studies Probing Quality of Life of Survivors —<br />
Six quality of life studies are underway, investigating the relation-<br />
POGO: An update 9
ship of disease and treatment to the health and psychosocial outcomes<br />
of survivors. These studies will lead to an increased understanding<br />
of the late effects of childhood cancer and its treatment.<br />
They will permit researchers and clinicians to re-evaluate current<br />
treatment approaches and to identify interventions with the<br />
potential to moderate the impact of factors found to impair later<br />
quality of survival.<br />
Future plans for childhood cancer research to be undertaken<br />
by the PRU include:<br />
■ further study of risk factors for childhood cancer;<br />
■ continued pursuit of the most effective ways to deliver care<br />
and to ensure access to care;<br />
■ further development of the culture of collaboration and<br />
research partnerships.<br />
■<br />
■<br />
■<br />
In order to fulfill its mission, the PRU will also focus on:<br />
securing requisite financial and human resources and essential<br />
infrastructure;<br />
further development of the capacity of the POGO<br />
Networked Information System (POGONIS) to support<br />
research;<br />
the full integration of the POGO Chair in Childhood Cancer<br />
Control and the Chair’s research agenda.<br />
POGO FAMILY FUN DAY<br />
Over 150 families attended the 2002 POGO Family Fun Day at<br />
Camp Green Acres this spring. The various POGO fundraising<br />
events have successfully raised money and awareness of childhood<br />
cancer and POGO's work.<br />
DATA DEVELOPMENT<br />
POGO has built and maintains a database and registry of childhood<br />
cancer called POGONIS (Pediatric Oncology Group of<br />
Ontario Networked Information System). The purpose of POGO-<br />
NIS is to monitor the incidence and prevalence of cancer in childhood,<br />
the demand for care, and the long-term effects of malignancy<br />
in childhood and its treatment. This database is a dynamic,<br />
unique, and state-of-the-art repository of information on all<br />
children with malignant disease treated in POGO centres. It is<br />
essential for planning new programs and ensuring that decisions<br />
about where to locate these are informed. The comprehensive<br />
nature of the POGO database has led to:<br />
■<br />
■<br />
■<br />
■<br />
reliable information on the incidence of childhood cancer in<br />
the province;<br />
accurate projections of the number of children to be treated<br />
in future decades;<br />
forecasting the number of staff needed in relation to the<br />
number of patients/ families who will need care;<br />
a clear understanding of where the children live, in relation<br />
to where they are treated.<br />
POGONIS has generated a great deal of interest. Requests<br />
for data are typically received from speakers, researchers, policy<br />
makers and service planners across Ontario and Canada. The<br />
discussions between these applicants and knowledgeable<br />
POGO database staff, often lead to more sophisticated research<br />
questions, exploration of additional implications for pediatric<br />
oncology, and thus greater potential for both knowledge and<br />
the application of that knowledge.<br />
The database was the brainchild of Dr. Mark Greenberg,<br />
now the Medical Director and POGO Chair in Childhood Cancer<br />
Control. The idea was embraced by pediatric oncology programs<br />
which grasped immediately the contribution they could<br />
make to the field by contributing anonymous data on every child<br />
treated. Their commitment to this endeavor has never faltered.<br />
Funding from Ontario’s Ministry of Health and Long-Term Care,<br />
which began in FY 1992-93, permitted the POGO network to<br />
acquire paid data management staff, and enabled the conversion<br />
of the POGO database from a manual to a networked, electronic<br />
information system, greatly increasing its accessibility and<br />
utility for POGO programs and researchers.<br />
POGONIS, coupled with the knowledge capital represented<br />
within POGO's Board and standing committees, is the cornerstone<br />
of POGO’s ability to provide expert advice and planning for<br />
the province.<br />
10 POGO: An update
A MESSAGE FROM<br />
DR. MARK GREENBERG<br />
POGO CHAIR IN CHILDHOOD CANCER CONTROL & MEDICAL DIRECTOR<br />
The POGO Chair in Childhood Cancer Control and the position<br />
of Medical Director of POGO were created as complementary<br />
roles to achieve integration between education and<br />
research into childhood cancer control and the practical<br />
delivery of childhood cancer care across the province of<br />
Ontario in order to enhance care and survival of children<br />
with cancer. The combined mandate of these roles is to develop<br />
evidence-based policies, guidelines and programs for delivering<br />
care to children with cancer—work that encompasses treatment<br />
and cure as well as quality of life and family well-being.<br />
Important responsibilities of the Chair include:<br />
■ developing practice guidelines with the institutions and professionals<br />
who care for children with cancer;<br />
■ working with government to develop new programs;<br />
■ advising on the allocation of scarce health care resources<br />
across the province;<br />
■ facilitating new research programs;<br />
■ consulting on programs to assist families to emerge from the<br />
rigors of treatment as intact as is possible; and<br />
■ enabling survivors to live as normal and productive lives as<br />
is possible.<br />
Much of this is achieved by the creation of programs that<br />
help children with cancer all over the province through diagnosis,<br />
treatment, survival, and even the end of life. My work is a collaboration<br />
with experts in areas such as biological sciences, epidemiology,<br />
health economics and health policy, and includes regular<br />
consultation with patients, survivors, and their families.<br />
Increasingly, I am called upon to share POGO prototypes and programs<br />
with other jurisdictions across Canada and internationally.<br />
The establishment of the POGO Chair in Childhood Cancer<br />
Control has enabled POGO to focus on several important initiatives<br />
to date. These include:<br />
■ The design, development and updating of guidelines for<br />
care in a network of community satellite care centres (the<br />
Provincial Pediatric Oncology Satellite Program, or PPOSP),<br />
designed by POGO, which enable children to receive certain<br />
aspects of their care closer to home. These programs<br />
minimize the disruption lengthy cancer treatment can cause<br />
on the lives of the children and their families. An evaluation<br />
of the effectiveness of this system will be undertaken.<br />
■<br />
■<br />
■<br />
■<br />
The realization of the POGO Research Unit (PRU). This unit<br />
will enhance clinical care, research, and policy development,<br />
which will translate into better care and better outcomes<br />
for the children. Some research is already underway<br />
and the PRU is expected to be fully functioning as soon as<br />
funding is secure.<br />
The development of guidelines and a province-wide system<br />
for the care of survivors of childhood cancer, a significant<br />
proportion of whom have serious long-term complications<br />
after cure. This network of clinics is referred to as AfterCare<br />
Clinics. A research base is built into this care network.<br />
The development of guidelines for the preservation of fertility<br />
of children undergoing potentially sterilizing therapy is<br />
underway.<br />
Advancement of POGONIS, the Pediatric Oncology Group<br />
of Ontario Networked Information System. POGONIS is a<br />
POGO: An update 11
unique population-focused database created to track care and outcomes<br />
of survivors of childhood cancer, evaluate service delivery, and<br />
enable research on the population of patients and survivors. Using<br />
POGONIS, several studies are underway, in which I participate.<br />
These include:<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
■<br />
an evaluation of the impact of incremental funding for childhood<br />
cancer care delivery, secured by POGO, to assess adequacy and timeliness<br />
of care delivered to childhood cancer patients;<br />
a study evaluating the out-of-pocket costs to families of children with<br />
cancer, to fully assess their needs, and aid in the administration and<br />
development of a Family Assistance Program;<br />
studies predicting trends in incidences of childhood cancer, which<br />
will influence planning and resource allocation for Ontario;<br />
an investigation into the impact of changes in diet on the incidence<br />
of childhood cancer;<br />
a study of quality of life of children and families in acute care hospitals;<br />
a study of the determinants of outcomes in childhood medulloblastoma,<br />
a childhood brain tumor. This can uniquely be done in Ontario<br />
because of the population-based data that are available;<br />
a population-based study of the quality of life of survivors of<br />
Childhood and Adolescent Hodgkin’s Disease.<br />
The cancer care community is committed to education which<br />
remains a top priority for POGO and the POGO Chair in Childhood Cancer<br />
Control. I was pleased to convene and co-ordinate continuing education<br />
endeavours, including the POGO Multidisciplinary Symposium in 2001,<br />
"Beyond Cure: Care and Consequences", which focused on survivorship in<br />
childhood cancer, and the 2002 Symposium on <strong>“</strong>Care at the End of Life<strong>”</strong>.<br />
In addition, continuing education programs have been created and delivered<br />
for satellite and community caregivers to better allow devolved care in<br />
the community.<br />
As inaugural Chair holder, I am proud to collaborate with Ontario’s<br />
leaders in childhood cancer control to enhance the care of those afflicted<br />
with childhood cancer. Together, our vision is to provide cutting<br />
edge care, enhance systems that provide that care and ensure precious<br />
resources are used effectively. We are committed to working<br />
with other institutions to advance care, research, education and<br />
knowledge transfer in Ontario, Canada and across the globe.<br />
Thank you for supporting the POGO Chair in Childhood Cancer<br />
Control and recognizing the importance of research and education to the<br />
children we all hold so dear.<br />
Dr. Mark Greenberg<br />
POGO Chair in Childhood Cancer Control<br />
Medical Director<br />
<strong>“</strong><br />
The Chair should make a powerful<br />
difference to the cause of children with<br />
cancer. People will know we’re not here for a<br />
year or three years or five years; people will<br />
know that we’re here for the long, long haul<br />
and this Chair will be the centrepiece of the<br />
<strong>”</strong><br />
POGO effort.<br />
— J. Robert S. Prichard,<br />
Former President,<br />
University of Toronto<br />
12 POGO: An update
A MESSAGE FROM POGO’S<br />
FUNDRAISING COMMITTEE CHAIR<br />
As the Chair of the POGO<br />
Fundraising Committee, it is my pleasure<br />
to report on our fundraising activities.At<br />
the end of 1999, we established the<br />
POGO Chair in Childhood Cancer<br />
Control. As of September, 2002, nearly $3<br />
million has been raised (see report from<br />
the University of Toronto on page 14) in<br />
the Chair endowment fund. This has<br />
been made possible through the generosity<br />
of hundreds of individuals and corporations<br />
who have made donations and<br />
sponsored and attended our fundraising<br />
events. In addition, sponsorship dollars<br />
have subsidized the expenses of the<br />
annual POGO Symposia on Childhood<br />
Cancer which provide valuable continuing<br />
education to pediatric oncology professionals. On behalf<br />
of POGO and the children we serve, I extend my sincerest<br />
thanks to all our supporters. It is heartwarming to witness how<br />
many of you have opened your hearts to such an important<br />
cause.<br />
On behalf of POGO, I would like to congratulate my<br />
daughter and partner in POGO Fundraising, Vanessa Melman<br />
Yakobson, her colleague Judy Kopelow, her friend Carolyn<br />
Ansley, and the volunteers of the POGO Fundraising<br />
Committee for the tremendous success of POGO fundraising<br />
events. The 1st Annual Gala at Casa Loma, the "Spy Casino",<br />
hosted over 500 people for an evening of food, dancing and<br />
casino games, all in support of the POGO Chair. The Camp<br />
Green Acres Family Fun Day for POGO brought out over 150<br />
families for a day of fun and games. In addition to raising<br />
approximately $200,000 for the Chair to date, our various<br />
events have also resulted in important publicity and media coverage<br />
for POGO and our cause.<br />
POGO has benefited from tremendous community support<br />
in 2002, with Cedarvale School, Forest Hill Public School,<br />
the Rocket to Freedom Party, and Golf Town’s Golf Tournament<br />
all organizing events to benefit POGO. Funds raised from these<br />
events will be included in the 2002/2003 report.<br />
I am pleased to report that as of Fall, 2002, the Canada<br />
Customs and Revenue Agency is reviewing our application to<br />
endow charitable status upon the POGO Childhood Cancer<br />
Foundation. Upon receipt of a charitable registration number,<br />
the Foundation will facilitate fundraising<br />
efforts and provide an important source<br />
of additional revenue for POGO. This revenue<br />
will enable POGO to expand the<br />
scope of work it currently does, and help<br />
it to fulfill its mission. Vanessa Melman<br />
Yakobson and Judy Kopelow, currently<br />
acting as POGO’s Development Officers,<br />
will move over to the Foundation, ensuring<br />
a continued efficient and dynamic<br />
relationship with all POGO’s supporters. I<br />
will also play a key role in Foundation<br />
activities and, in that capacity, will call<br />
upon the continued generosity and<br />
determination of our supporters to<br />
ensure excellence in research, education<br />
and front line patient care.<br />
Please accept my heartfelt gratitude for your generous<br />
support of POGO. Thanks to you, children with cancer in<br />
Ontario will get the best chance possible to survive and thrive.<br />
Anthony Melman<br />
Fundraising Committee Chair<br />
POGO: An update 13
UNIVERSITY OF TORONTO<br />
POGO CHAIR IN CHILDHOOD<br />
CANCER CONTROL<br />
(Established at December 7, 1999)<br />
Statement of Endowment Fund<br />
For the Year Ended April 30, 2002 (with comparative figures for the year ended April 30, 2001)<br />
2001-02 2000-01<br />
Book value of endowment<br />
Balance, beginning of the year<br />
Donations (additions)<br />
University matching<br />
Gain on sale of donated shares<br />
Balance, end of the year<br />
$ $<br />
2,215,403.49 1,618,733.15<br />
526,031.36 569,721.59<br />
447.00 25,625.00<br />
— 1,323.75<br />
2,741,881.85 2,215,403.49<br />
Market value of endowment<br />
2,482,992.92 2,084,802.00<br />
FACTS ABOUT CHILDHOOD CANCER<br />
■<br />
Cancer is the leading disease-related<br />
cause of death in Ontario children.<br />
About 100 Ontario children succumb<br />
to cancer every year.<br />
■<br />
Survivorship in the pediatric population<br />
has improved across all diagnoses<br />
during the past 20 years. It is now 75<br />
percent.<br />
■<br />
By the year 2010, it is estimated that<br />
one in 250–400 young adults (aged<br />
15 to 45) will be a survivor of childhood<br />
cancer.<br />
■<br />
Between 1987 and 2000, pediatric<br />
cancer cases have risen 16 percent,<br />
due to the growth in Ontario’s population,<br />
and an absolute increase in the<br />
incidence of certain cancer types.<br />
■<br />
Treatment of childhood cancers are<br />
typically intense, causing severe illness<br />
and complications, and in some cases<br />
resulting in long-term medical consequences.<br />
■<br />
The psychological and social impact<br />
of childhood cancer can be significant.<br />
It may include problems of coping<br />
and adjustment of patient, siblings<br />
and parents, lapsed school<br />
achievement, learning deficits, and<br />
financial distress of the family.<br />
14 POGO: An update
THANK YOU TO ALL OUR SUPPORTERS SINCE 2000!<br />
1015284 Ontario Inc<br />
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677345 Ontario Limited<br />
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Corporation<br />
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Inc<br />
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Inc<br />
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Incorporated<br />
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Associates<br />
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Inc<br />
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Ltd<br />
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Mishchenko<br />
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THANK YOU TO ALL OUR SUPPORTERS SINCE 2000!<br />
Mr. Jeremy Freedman<br />
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Mr. Seth Weinstein<br />
Mr. Seymour Haber<br />
Mr. Seymour Rosenblatt<br />
Mr. Shawn D. Porter<br />
Mr. Shawn Richmor<br />
Mr. Sheldon Parks<br />
Mr. Sidney Zigah<br />
Mr. Simmy Mayer<br />
Mr. Stan Raphael<br />
Mr. Stan Segal<br />
Mr. Stan Zukerman<br />
Mr. Stanley H Feldman<br />
Mr. Stanley M Goldstein<br />
Mr. Stephen Codas<br />
Mr. Stephen Florence<br />
Mr. Stephen Karr<br />
Mr. Stephen Pincus<br />
Mr. Steve Katz<br />
Mr. Steve Posen<br />
Mr. Steve Till<br />
Mr. Steven Halperin<br />
Mr. Steven Israel<br />
Mr. Steven L Winokur<br />
Mr. Steven Marks<br />
Mr. Steven Spears<br />
Mr. Terrence G Hibbert<br />
Mr. Thomas O Harbison<br />
Mr. Thomas P Dea<br />
Mr. Thomas Rusnov<br />
Mr. Tim Webster<br />
Mr. Timothy A<br />
Duncanson<br />
Mr. Timothy P Stinson<br />
Mr. Tom Silverman<br />
Mr. Victor Paul<br />
Mr. Vincent Mercier<br />
Mr. W. Stajer<br />
Mr. William H Strong<br />
Mr. William Michael<br />
Ainley<br />
Mr. William P Molson<br />
Mr. Y J Mirza<br />
Mrs. Al Yuffa<br />
Mrs. Ali Taradash<br />
Mrs. Barbara Axel<br />
Mrs. Batia Gortler<br />
Mrs. Bella Rabinowicz<br />
Mrs. Bruna Di Monte<br />
Mrs. Carol Kaplan<br />
Mrs. Carolyn Abugov<br />
Mrs. Carrie Gelkopf<br />
Mrs. Cheryl D Harris<br />
Mrs. Deborah A Rocket<br />
Mrs. Diane Hollander<br />
Mrs. Donna Goldman<br />
Mrs. Doreen B Rakusin<br />
Mrs. Doreen Zucker<br />
Mrs. Eleanor Barlin-<br />
Daniels<br />
Mrs. Ellise G Gasner<br />
Mrs. Evette Seroda<br />
Mrs. Evie Shulman<br />
Mrs. Freda Yermus<br />
Mrs. Frieda Torkin<br />
Mrs. Gail Fenwick<br />
Mrs. Helen A. Craig<br />
Mrs. Helen Litman<br />
Mrs. Irma Robinson<br />
Mrs. Jennifer Rowsell<br />
Mrs. Joan M Schatz<br />
Mrs. Justine E Fernie<br />
Mrs. Karen Bookman<br />
Mrs. Kathryn Grossman<br />
Mrs. Larisa Yakobson<br />
Mrs. Laura Steinhauer<br />
Mrs. Leah Duckman<br />
Mrs. Lee Kraemer<br />
Mrs. Lili A Davis-Burchat<br />
Mrs. Lilia Kharlip<br />
Mrs. Lillian Winton<br />
Mrs. Linda Judelman<br />
Mrs. Lori Goldenberg<br />
Mrs. Louise Glicksman<br />
Mrs. Lynne Morrison<br />
Mrs. Margot Zukerman<br />
Mrs. Marjorie MacKinnon<br />
Mrs. Merill L Kichler<br />
Mrs. Mindy Tayar<br />
Mrs. O Margaret Colman<br />
Mrs. Phyllis Clarfield<br />
Mrs. Phyllis R Brodkin<br />
Mrs. Robyn Greenspan<br />
Mrs. Roslyn Roth<br />
Mrs. Ruth Levine<br />
Mrs. Ruth Trinier<br />
Mrs. S Sugar<br />
Mrs. Sandi Cracower<br />
Mrs. Sandra Ossip<br />
Taradash<br />
Mrs. Sherry Zweig<br />
Mrs. Shirley Rosenberg<br />
Mrs. Stacy Rosenberg<br />
Mrs. Susan Gortler<br />
Mrs. Susan Wineberg<br />
Mrs. Sylvia Bermack<br />
Mrs. Tamara Dawn Finch<br />
Mrs. Tobie Bekhor<br />
Mrs. Valerie Melman<br />
Mrs. Vivien Cohen<br />
Mrs. Vivien T Sharon<br />
Mrs. Yona Barzilay<br />
Ms. Adele Freeman<br />
Ms. Airinda Neto<br />
Ms. Alexandra Halpert<br />
Ms. Alison Green<br />
Ms. Allison Whiteman<br />
Ms. Alka Dhir<br />
Ms. Amie Rocket<br />
Ms. Amy Au<br />
Ms. Amy Greenberg<br />
Ms. Andrea Hirshberg<br />
Ms. Andreana Rust<br />
Ms. Angela Trope<br />
Ms. Anna Di Manno<br />
Ms. Anne Marie DiManno<br />
Ms. Annette Blum<br />
Ms. Asta K. M. Dvorak<br />
Ms. Audrey Ronoff<br />
Ms. Aviva Grinberg<br />
Ms. Barbara Gomperts<br />
Ms. Becky Eisen<br />
Rosenberg<br />
Ms. Bella Slimukoff<br />
Ms. Bernice Litman<br />
Ms. Bernice Penciner<br />
Ms. Bernice Stern<br />
Ms. Betty Lowenstein<br />
Ms. Bianca Israeli<br />
Ms. Bonnie Chandler<br />
Ms. Carla J Nicolson<br />
Ms. Carol J Watt<br />
Ms. Carole J Munro<br />
Ms. Carolyn F Watson<br />
Ms. Carolyn Feldman<br />
Ms. Carolyne L Gosling<br />
Ms. Caryl Baker<br />
Ms. Catherina Mackowski<br />
Ms. Catharine Fennell<br />
Ms. Cathy Kaufman<br />
Ms. Cindy Turk<br />
Ms. Connie Kussner<br />
Ms. Cynthia R<br />
Cooperstone<br />
Ms. Dale Plyley<br />
Ms. Debby Turk<br />
Ms. Deborah M<br />
Bloomberg<br />
Ms. Deborah Smith-<br />
Webber<br />
Ms. Debra Reiskind<br />
Ms.Deganit Levy<br />
Ms. Denise Brudner-<br />
Weingarten<br />
Ms. Diana Dante<br />
Ms. Diana Jordan<br />
Ms. Diane Fennell<br />
Ms. Dorothy Wuls<br />
Ms. Elaine Kunda<br />
Ms. Elania Kirsh<br />
Ms. Eleanor McGrath<br />
Ms. Eleonor Hendershot<br />
Ms. Elizabeth L Delbianco<br />
Ms. Elizabeth Vespasiami<br />
Ms. Elizabeth Wolfstadt<br />
Ms. Ellen P Cosman<br />
Ms. Erin Baker<br />
Ms. Erin J Lemon<br />
Ms. Estelle Feld<br />
Ms. Esther Cheskes<br />
Ms. Esther Green<br />
Ms. Eva Nightingale<br />
Ms. Ewa Yousufzai<br />
Ms. Faith Halman<br />
Ms. Felicia Jacobs<br />
Ms. Fiona Buchan<br />
Ms. Francy Kussner<br />
Ms. Frieda Iscove<br />
Ms. Gail Zalev<br />
Ms. Geri Winemaker<br />
Ms. Gila Ossip<br />
Ms. Gina Arezza<br />
Ms. Gina M Caldarelli<br />
Ms. Glynis A. Henry<br />
Ms. Goldie Litwin<br />
Ms. Grace Lok<br />
Ms. Haley D Field<br />
Ms. Hanna Shlesinger<br />
Ms. Heidi Miller<br />
Ms. Helen Lepek<br />
Ms. Helen Schwartz<br />
Ms. Helen Tannenbaum<br />
Ms. Helena Blum<br />
Ms. Ida Dick<br />
Ms. Indiana Pirau<br />
Ms. Inga Birfer<br />
16 POGO: An update
THANK YOU TO ALL OUR SUPPORTERS SINCE 2000!<br />
Ms. Irene Clarfield<br />
Ms. Isabel Herling<br />
Ms. Isabelle Edgecumbe<br />
Ms. Jaimie Grossman<br />
Ms. Jane Clifford<br />
Ms. Jane Herman<br />
Ms. Janice Brooks<br />
Ms. Janice Feldberg<br />
Ms. Janice Nathanson<br />
Ms. Jennifer Ansley<br />
Ms. Jennifer Badame<br />
Ms. Jennifer E Sipos<br />
Ms. Jennifer Gales<br />
Ms. Jennifer Koffman<br />
Ms. Jennifer Kominek<br />
Ms. Jennifer Lynn Steckel<br />
Ms. Jill Farber<br />
Ms. Jill Flicht<br />
Ms. Joan Pace<br />
Ms. Joan Rosenthal<br />
Ms. Joanne Richmond<br />
Ms. Jodi C Tanenbaum<br />
Ms. Joni Goldlust<br />
Ms. Judy Greenwald<br />
Ms. Judy Wolfe<br />
Ms. Julie A Feldman<br />
Ms. Julie Purkis<br />
Ms. Julie Sindalovsky<br />
Ms. Justine Melman<br />
Ms. Karen A Foley<br />
Ms. Karen Gough<br />
Ms. Katherine Richards<br />
Ms. Kathryn From<br />
Ms. Katy Waugh<br />
Ms. Kelly L. Toms<br />
Ms. Kelly Smith<br />
Ms. Kerry Jameson<br />
Ms. Kerry Smith Sacks<br />
Ms. Kim Alexander<br />
Ms. Kim Carmichael<br />
Ms. Laura Sousa<br />
Ms. Lee B Vernich<br />
Ms. Leslie M Haber<br />
Ms. Lila Satok<br />
Ms. Lily Stoll<br />
Ms. Lina Correi<br />
Ms. Linda Katz<br />
Ms. Linda M Westlund<br />
Ms. Lindsay Jones<br />
Ms. Lisa A Berkovitz<br />
Ms. Lisa Hock<br />
Ms. Lissie Sanders<br />
Ms. Liza Mauer<br />
Ms. Lora Spektor<br />
Ms. Lorelei R Wilkinson<br />
Ms. Loretta Brown<br />
Ms. Lori Anne Alter<br />
Ms. Lori Rosenthal<br />
Ms. Lorie S Ayukawa<br />
Ms. Louisa Hostick<br />
Ms. Louise Dimonte<br />
Ms. Lucy Steinfeld<br />
Ms. Margaret Porter<br />
Ms. Maria Maglietta<br />
Ms. Marilyn Firestone<br />
Ms. Marilyn Gilbert<br />
Ms. Marilyn Taitz<br />
Ms. Marissa Sari Rubinoff<br />
Ms. Marni Lokash<br />
Ms. Marnie Toben<br />
Ms. Marsha Goldstein<br />
Ms. Martha Sud<br />
Ms. Mary Anne Loftus<br />
Ms. Mehre Zuckerman<br />
Ms. Melissa Grossman<br />
Ms. Melissa Muskat<br />
Ms. Micheline Kleiner<br />
Ms. Michelle Abbot<br />
Ms. Missy Maister<br />
Ms. Molly Epstein<br />
Ms. Nadine Tytel<br />
Ms. Nancy Hamilton<br />
Ms. Nancy Kalifer<br />
Ms. Nicole Galimsky<br />
Ms. Norma Baram<br />
Ms. Paula B. Klein<br />
Ms. Paula Birnbaum<br />
Ms. Paula S. Feig<br />
Ms. Paula T Trussman<br />
Ms. Pearl Kronis<br />
Ms. Rachel Egan<br />
Ms. Rachel Fisher<br />
Ms. Rachel Michelle<br />
Braun<br />
Ms. Raissa Shestatsky<br />
Ms. Rebecca Greenberg<br />
Ms. Rena Goldstein<br />
Ms. Rhonda Silverstone<br />
Ms. Riwaz Sepiashvili<br />
Ms. Rochelle Ironstone<br />
Ms. Ronda Green<br />
Ms. Rosalie Naster<br />
Ms. Rosalyn Leese<br />
Ms. Rosanna Beth<br />
Breitman<br />
Ms. Rose Simone<br />
Ms. Rose Straitman<br />
Ms. Rosie Tizzoli<br />
AMGEN<br />
ANDERSEN<br />
Ashford Cleaners<br />
Asta Medica<br />
Auto Control Medical<br />
Baxter<br />
Benjamin's Funeral Home<br />
Borden Ladner Gervais<br />
Boston Scientific<br />
Canadian Cancer Society<br />
CGI<br />
Chestnut Park Realty<br />
Childcan<br />
Cimram<br />
City of Toronto, The Mayor's<br />
Ms. Roslyn Goldmintz<br />
Ms. Rowena Zamora<br />
Ms. Ruth Carbell<br />
Ms. Ruth Greiver<br />
Ms. Sacha S Hayward<br />
Ms. Sally Abrams<br />
Ms. Sandra Brown<br />
Ms. Sankey A. Johnson<br />
Ms. Sara Ehrlich<br />
Ms. Sarah Ryerson<br />
Ms. Sarah A Scott<br />
Ms. Seanna Millar<br />
Ms. Shannon Moore<br />
Ms. Shannon Weir<br />
Ms. Sharon Krikst<br />
Ms. Shawna Page<br />
Ms. Sheldon Barris<br />
Ms. Sheldon Freeman<br />
Ms. Shelly Zimmer<br />
Ms. Sherri Cygelfarb<br />
Ms. Sheryl Berg<br />
Ms. Shirley Korenblum<br />
Ms. Simone Bronfman<br />
Ms. Sophie Zukerman<br />
Ms. Stacey Low<br />
Ms. Stacey Mendelson<br />
Ms. Sue Ferri<br />
Ms. Susan Austin<br />
Ms. Susan E Grace<br />
Ms. Susan Eidelman<br />
Ms. Susan Freedman<br />
Ms. Susan Kendall<br />
Ms. Susan Speigel<br />
Ms. Susan Strong<br />
Ms. Tammy Herzog<br />
Ms. Tanya Giorgio<br />
Ms. Tara Burns<br />
Ms. Terry Grachnik<br />
Ms. Theresa W Mersky<br />
Ms. Tina Brooks<br />
Ms. Tracy Posner<br />
Ms. Vanessa Yakobson<br />
Ms. Victoria Hand<br />
Ms. Wendy Himmel<br />
Ms. Yolanda Fernandez<br />
Ms. Zehavit Markovzki<br />
Ms. Zira Shmorgun<br />
Murphy's Food Sales &<br />
Marketing<br />
Naresh Tejpal<br />
Office<br />
Cover-All<br />
Dominion<br />
EMI Music Canada<br />
Famous Players<br />
Fasken Martineau<br />
Karen Foley<br />
Glaxo Smith Kline<br />
Goodmans<br />
Heathbrige Graham Inc.<br />
Kalles Real Estate<br />
Kiddie Proofers<br />
Knight Bain Seath &<br />
Holbrook<br />
Lego<br />
National Bank Financial<br />
Inc<br />
Nestle Canada<br />
Incorporated<br />
Nestle Nutrition<br />
New Paradigm Learning<br />
Corporation<br />
Newcrest Capital Inc<br />
Old Dutch Food Ltd<br />
Onex Corporation<br />
P & O Global Investment<br />
Inc<br />
Pat Roy<br />
Pediatric Oncology<br />
Group of Ontario<br />
staff<br />
Pilot Insurance Co Inc<br />
PKW Communications<br />
Ltd<br />
Quadrant Marketing Ltd<br />
R E Lax<br />
RBC Capital Markets<br />
Reliance Aerotech<br />
Canada Inc<br />
Rio Can Financial<br />
Services<br />
Rite-Chrome Furniture<br />
Manufacturing<br />
Company Limited<br />
Rocket to Freedom<br />
Charitable Fund<br />
Roots Canada<br />
Royop Properties<br />
Corporation<br />
Rozon Insurance Brokers<br />
Sari Goldberg<br />
Shainey Silver<br />
Shoppers Drug Mart<br />
Shore, Newman & Rose<br />
LLP<br />
Livewire Digital Imaging Inc.<br />
McCarthy Tetrault<br />
Minute Maid<br />
Nestle Canada<br />
Nestle Nutrition<br />
New Balance<br />
Nuline Realty<br />
Old Dutch<br />
Pharmacia<br />
Pilot Insurance Company<br />
Pricewaterhouse Coopers<br />
RBC Royal Bank<br />
Rexall<br />
RH Carter Architects Inc.<br />
Sandylion Stickers<br />
Succession Capital<br />
Corporation<br />
Summit View Homes Ltd<br />
Sun Life Assurance Co of<br />
Canada<br />
TD Bank Financial Group<br />
TD Securities<br />
The Backroom - Designer<br />
Imports Inc<br />
The D H Gales Family<br />
Charitable<br />
Foundation of<br />
Toronto<br />
The Fred A Litwin Family<br />
Foundation<br />
The Howard and Carole<br />
Tanenbaum Family<br />
Charitable<br />
Foundation<br />
The Ira Gluskin & Maxine<br />
Granovsky Charitable<br />
Foundation<br />
The Minute Maid<br />
Company Canada Inc<br />
The Ripplewood<br />
Foundation Inc<br />
Thompson Lightstone &<br />
Co Ltd<br />
Tiffany & Co<br />
Toronto Blue Jays<br />
Baseball Club<br />
Toronto Professional Fire<br />
Fighter's Association<br />
Toronto Stock Exchange<br />
Inc.<br />
Torstar Corporation<br />
Torys LLP<br />
Universal Music<br />
V Squared Sales Inc<br />
Voula Tascone<br />
Wierzbniker Friendly<br />
Mutual Benefit<br />
Wierzbniter Ladie's<br />
Auxiliary<br />
WTF Group<br />
Wycliffe Management<br />
Services<br />
Yo Inc<br />
POGO EVENT SPONSORS & IN-KIND DONATIONS<br />
Scotia Capital<br />
Scotia Mcleod<br />
Secured Courier<br />
Shoppers Drugmart<br />
Tammy Letner Centre<br />
TD Commercial Banking<br />
TD Securities<br />
Tetra Pak<br />
The Bay<br />
Thompson Lightstone<br />
Trillium Childhood Cancer<br />
Support Centre<br />
Unite Communications<br />
Christa Wessel<br />
POGO: An update 17
BOARD OF DIRECTORS<br />
DR. RONALD D. BARR (President)<br />
Chief of Service, Pediatric<br />
Hematology/Oncology<br />
Department of Pediatrics<br />
Children's Hospital, Hamilton Health<br />
Sciences Corporation<br />
DR. MARIANA SILVA (Treasurer)<br />
Head, Division of Pediatric<br />
Hematology/Oncology<br />
Kingston General Hospital<br />
DR. VICTOR S. BLANCHETTE (Secretary)<br />
Chief, Division of<br />
Haematology/Oncology<br />
The Hospital for Sick Children<br />
DR. MARU BARRERA<br />
Child/Health Psychologist<br />
Department of Psychology<br />
The Hospital for Sick Children<br />
DR. BETH CAIRNEY<br />
Pediatric Hematologist/Oncologist<br />
Children's Hospital of Eastern Ontario<br />
MS. MARILYN CASSIDY<br />
Pediatric Interlink Nurse Consultant<br />
Interlink Community Cancer Nurses/<br />
Children's Hospital of Eastern Ontario<br />
MR. WILLIAM FRID<br />
Senior Consultant<br />
Trillium Childhood Cancer Support<br />
Centre<br />
MRS. JANET GAMMON<br />
Nurse Coordinator/Clinical Research<br />
Associate<br />
New Agent & Innovative Therapy<br />
Program, Oncology<br />
The Hospital for Sick Children<br />
DR. MARK L. GREENBERG<br />
Medical Director, Pediatric Oncology<br />
Group of Ontario (POGO)<br />
Senior Pediatric Oncologist, The<br />
Hospital for Sick Children<br />
DR. CORIN GREENBERG<br />
Executive Director<br />
Pediatric Oncology Group of Ontario<br />
(POGO)<br />
DR. JACQUELINE HALTON<br />
Acting Chief, Division of<br />
Hematology/Oncology<br />
Medical Director, Oncology/MDU PSU<br />
Children's Hospital of Eastern Ontario<br />
DR. LAWRENCE JARDINE<br />
Head, Section of Pediatric<br />
Hematology/Oncology<br />
Children's Hospital of Western Ontario<br />
DR. K.H. LUKE<br />
Chief, Hematology/Blood Bank<br />
Division of Lab Medicine<br />
Children's Hospital of Eastern Ontario<br />
STAFF<br />
EXECUTIVE DIRECTOR<br />
Dr. Corin Greenberg<br />
MEDICAL DIRECTOR<br />
Dr. Mark Greenberg<br />
EPIDEMIOLOGIST<br />
Dr. Mohammed Agha<br />
POGO CONFERENCES<br />
Ms. Helen Craig<br />
POGONIS & DATA REQUESTS<br />
Ms. Bruna DiMonte<br />
ADMINISTRATIVE ASSISTANT<br />
Ms. Susan Grace<br />
DEVELOPMENT OFFICER<br />
Ms. Judy Kopelow<br />
DEVELOPMENT OFFICER<br />
Ms. Vanessa Yakobson<br />
CLINICAL PROGRAMS COORDINATOR<br />
Ms. Lesley Collins<br />
POFAP & INTERLINK PROGRAMS<br />
Ms. Vanessa Foran<br />
ADVISORY COUNCIL<br />
MS. JOCELYN LAMONT<br />
Executive Director<br />
Candlelighters Childhood Cancer Trust<br />
of Eastern Ontario and Western<br />
Quebec<br />
Parent of a child with cancer<br />
MRS. SUSAN KUCZYNSKI<br />
Co-Chair<br />
Ontario Parents Advocating for<br />
Childhood Cancer (OPACC)<br />
Parent of a child with cancer<br />
DR. SANDRA NUTTALL<br />
Hospital/Special Projects Consultant<br />
Institutions Branch<br />
Ontario Ministry of Health<br />
MS. NIKKI PARKINSON<br />
Survivor<br />
MRS. SUSAN SMITH<br />
Vice President, Specialty Services<br />
Hamilton Health Sciences Corporation<br />
MS. JILL SPRAWSON<br />
Rebounders Canada<br />
Survivor<br />
DR. IAN WILSON<br />
Pediatrician<br />
POGO Satellite, Grand River Hospital<br />
Kitchener-Waterloo Health Centre<br />
MS. VANESSA YAKOBSON<br />
Survivor<br />
Thank you all for your ongoing commitment and caring.<br />
18 POGO: An update
<strong>“</strong><br />
Congratulations on the next step of your success in<br />
convincing governments to do more in the development of<br />
strategies for pediatric cancer control.<br />
<strong>”</strong>— Bob Rae<br />
Former Premier of Ontario<br />
<strong>“</strong><br />
Through this unique relationship and partnership and our shared<br />
commitment to ensuring that an effective program of childhood cancer<br />
care is developed and maintained in Ontario, the establishment of<br />
the POGO Chair in Childhood Cancer Control is immensely<br />
gratifying. It represents for all of us in this province an unparalleled<br />
opportunity to synchronize the treatment, research and educational<br />
activities across the five tertiary centres and the Universities.<br />
Emphatically, this will result in a strengthened, integrated, more<br />
powerful entity for the care of children with cancer.<br />
<strong>”</strong><br />
— The Honourable Elizabeth Witmer<br />
Former Minister of Health (June 2000)<br />
POGO would like to thank the following<br />
for their contributions to this report:<br />
Printing:<br />
Craig Oldman<br />
Xerox Canada<br />
Graphic Design:<br />
Dave Bourne<br />
Toronto Community News