Supporting Childhood Cancer Survivors: Meet Dr. Bjornard

As we honor Childhood Cancer Awareness Month, we would like to introduce you to Dr. Kari Bjornard. Dr. Bjornard leads the Survivorship Clinic at Riley Children’s Health, where a multidisciplinary team provides ongoing support to survivors of childhood cancer. They develop individualized care plans for patients, helping children and young adults thrive even as they face long-lasting side effects from chemotherapy and other treatments. “It is inspiring to see all that these young people have overcome and to see the ways they plan to influence the world,” Dr. Bjornard said.

Keep reading to learn more about Dr. Bjornard’s important work and her hopes for a better future for childhood cancer survivors.

What does a typical day look like for patients in the survivorship clinic?

Our multidisciplinary team does most of our survivorship care on Fridays at our IU Health North clinic. Patients typically meet first with a member of our oncology team. During this visit, we complete a detailed update of the medical history, assess any new questions or concerns, and complete a comprehensive physical exam. Our medical team then goes over the individualized survivorship care plan made for each patient, including information about their diagnosis, treatment, and surveillance guidelines based on the patient’s individual treatment exposures. Patients will also see our education specialist to discuss how things are going at school and plans for future education and/or vocational training. They will also meet with a social worker to evaluate several aspects of health, including financial and mental, and whether there are any other services that could be beneficial to help our patients and families thrive. Some patients will also see our cardiologist, particularly if they have a history of receiving cardiotoxic therapies, including certain chemotherapies and radiation to the chest. Lastly, our nurse coordinator meets with families to ensure we have up to date contact information for families and the rest of their medical teams to ensure optimal flow of health information to all who care for these children, adolescents and young adults. Typically, after the clinic visit, our patients will have lab work or other testing done as recommended in their survivorship care plan.

Why is it critical to provide long-term support to survivors of childhood cancer?

We are fortunate in pediatric oncology to see overall cure rates upwards of 80 percent. However, the cancer experience may affect patients for many years after treatment has completed. Many treatments, including chemotherapy medications and radiation therapy, carry with them serious side effects that may not become apparent until years after the therapy exposure, and may persist into adulthood and beyond. We know from prior research that compared to their peers that didn’t receive cancer therapy, adult survivors of childhood cancer are more likely to have a greater number of chronic conditions and experience earlier death. While our patients may be seeing their primary care practitioners regularly, those medical teams may not be as familiar with their specific treatment details or updated surveillance guidelines recommended to screen for early signs of disease. This is where survivorship programs, like ours, come in. We do not replace primary care – we are an adjunct program. Our major role is in education, specifically to ensure that survivors understand their treatment history and what services they need to stay as healthy as possible.

What is your “why” behind your work?

When I’m not seeing patients in survivorship clinic, I’m seeing patients with solid tumors. For many patients with solid tumor diagnoses, the chance of a cure isn’t as high. Those of us that work with children who have life-threatening illnesses often hear questions and comments from others regarding how they could never work with sick children or how we are able to do this work. For me, seeing patients in survivorship clinic continues to fuel my passion to take care of these patients. It is always inspiring to see all that these young people have overcome and to see the ways they plan to influence the world. Beyond that, it’s a constant reminder of how far we still must go. I imagine a future where all kids are able to survive a cancer diagnosis, and are cured with less toxic therapies.

If you could share a message with Riley Children's Foundation donors, what would you say?

The effects of a childhood cancer diagnosis reach far beyond the immediate period of treatment and many patients and families continue to need support long after the treatment is over. For some, the survivorship period can feel lonelier and challenging to navigate. Resources are continually needed to meet the needs of our patients and families in educational programming, psychosocial support and new research initiatives to better serve these families and patients and help them thrive.