Evidence-based Guidelines
The BSC contributes to the development and endorsement of clinical
practice guidelines to support behavioral health (e.g., mental,
neurocognitive, psychosocial) across the cancer continuum from active
treatment to long-term survivorship. To guide patient care during
therapy, the COG Supportive Care Guidelines are a resource for
up-to-date guidelines aligned with Institute of Medicine
criteria7 that are reviewed, evaluated, and endorsed
by the COG Supportive Care Guidelines sub-Committee
(https://www.childrensoncologygroup.org/cog-supportive-care-endorsed-guidelines).
Currently, there are COG-endorsed guidelines to assist in the
psychosocial management of fatigue8 and chronic
pain.9 However, there remains a critical gap in
supportive care clinical practice guidelines that meet current
methodological standards.10
BSC members help to evaluate recent evidence on potential behavioral
health late effects of treatment and generate recommended surveillance
in the COG Long-Term Follow-Up Guidelines
(http://www.survivorshipguidelines.org).
These guidelines recommend annual assessment for educational and
vocational progress, social functioning, mental health disorders, risky
health behaviors, sleep, fatigue, and healthcare or insurance access for
all long-term survivors. For patients with a history of exposure to
neurotoxic therapy, guidelines recommend formal neuropsychological
evaluation upon entry to survivorship care with repeated evaluations as
needed for survivors with impairments in educational or vocational
progress. Despite the wealth of observational data documenting
neurocognitive and behavioral health late effects and associated risk
factors, interventions to address these late effects of treatment are
lacking and desperately needed to promote QOL among long-term
survivors.11–16