After Completion of Therapy (ACT) Clinic


Cancer survival

The mission of the After Completion of Therapy (ACT) clinic is to help patients stay healthy as they continue their journey as a survivor after active treatment ends.

This ACT Clinic, established in the mid-1980s, is the largest long-term follow-up clinic for pediatric cancer patients in the U.S. Regarded as one of the best and most extensive of its type in the world, the ACT Clinic has been a prototype for other long-term follow-up programs.

St. Jude patients can transfer to the ACT Clinic when their disease has been in remission five years. They then visit the clinic every year until they are 18 years of age or until 10 years after diagnosis. At that time, ACT patients graduate and become St. Jude alumni.

Today, we are following more than 4,000 adults who received treatment for cancer during childhood at St. Jude. Our first—and most important—goal is to confirm that patients’ cancer does not come back. ACT Clinic visits are also focused on the following:

  • Monitoring for late side effects of cancer and its therapy—Physicians or nurse practitioners check for potential adverse late effects of cancer on specific organs (for example, the brain, heart, lungs, and thyroid gland) that may affect patients’ quality of life or predispose them to future health risks.
  • Psychological assessments—ACT staff also study ways in which the “cancer experience” has psychologically affected patients. They look at cancer-related effects on patients’ performance in school or the workplace, how patients are adjusting emotionally to any physical disability caused by the cancer, and patients’ relationships with family and peers.
  • Ongoing health and risk education—–Patients are advised regarding potential health risks, including second cancer and cardiovascular disease and counseled regarding good health practices to minimize risks.
  • Social worker visit—ACT patients also talk to a social worker who can help with insurance, school, work, or social problems and make referrals as needed.
  • Transition to adult care—The ACT Clinic staff assists survivors’ transition from pediatric care to adult health care. ACT physicians work closely with community physicians to ensure that they are aware of each survivor’s previous cancer treatment and health risks associated with it. They also recommend the timing of medical evaluations as adults enter their middle years and beyond.

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