{"id":12328,"date":"2024-01-09T14:56:36","date_gmt":"2024-01-09T13:56:36","guid":{"rendered":"https:\/\/kaks.hb-dev.de\/about-retinoblastoma\/aftercare\/"},"modified":"2026-09-07T11:24:00","modified_gmt":"2026-09-07T09:24:00","slug":"aftercare","status":"publish","type":"page","link":"https:\/\/kinderaugenkrebsstiftung.de\/en\/about-retinoblastoma\/aftercare\/","title":{"rendered":"Aftercare"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"12328\" class=\"elementor elementor-12328 elementor-298\" data-elementor-settings=\"{&quot;ha_cmc_init_switcher&quot;:&quot;no&quot;}\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6642988 e-flex e-con-boxed e-con e-parent\" data-id=\"6642988\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a80ef17 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"a80ef17\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Aftercare<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-979aada e-flex e-con-boxed e-con e-parent\" data-id=\"979aada\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bf20ea elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"2bf20ea\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tWhy? Follow-up care is essential to ensure that long-term effects and relapses are detected and treated as early as possible.   \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3721bd9 e-flex e-con-boxed elementor-invisible e-con e-parent\" data-id=\"3721bd9\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;animation&quot;:&quot;fadeIn&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-837d27b elementor-widget elementor-widget-ha-breadcrumbs happy-addon ha-breadcrumbs happy-addon-pro\" data-id=\"837d27b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"ha-breadcrumbs.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<ul class=\"ha-breadcrumbs\"><li class=\"ha-breadcrumbs-item ha-breadcrumbs-start\"><a href=\"https:\/\/kinderaugenkrebsstiftung.de\/en\/\" rel=\"home\"><span class=\"ha-breadcrumbs-text\"><span class=\"ha-breadcrumbs-home-icon\"><span class=\"fas fa-home\" aria-hidden=\"true\"><\/span><\/span><\/span><\/a><\/li><\/ul>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-912e5c5 e-flex e-con-boxed e-con e-parent\" data-id=\"912e5c5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-df56a3f e-con-full e-flex e-con e-child\" data-id=\"df56a3f\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-ce5fca4 elementor-widget elementor-widget-spacer\" data-id=\"ce5fca4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-10282c0 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"10282c0\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>One of the KinderAugenKrebsStiftung&#8217;s main concerns is to ensure that our children remain healthy and well cared for in the long term.<\/strong>  To this end, we regularly attend conferences and training sessions to stay informed\u2014we pass this information on to you and keep you up to date. The following information is particularly valuable for families whose children have been diagnosed with a genetic mutation. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-71162d5 elementor-widget elementor-widget-spacer\" data-id=\"71162d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3422aaa e-con-full e-flex e-con e-child\" data-id=\"3422aaa\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8657178 elementor-invisible elementor-widget elementor-widget-n-accordion\" data-id=\"8657178\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1400\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1400\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> General <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1400\" class=\"elementor-element elementor-element-eaa5a2b e-con-full e-flex e-con e-child\" data-id=\"eaa5a2b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1400\" class=\"elementor-element elementor-element-5de75e6 e-con-full e-flex e-con e-child\" data-id=\"5de75e6\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9fd40e5 elementor-widget elementor-widget-text-editor\" data-id=\"9fd40e5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Guidelines for Follow-up Care and Screening for Retinoblastoma, <\/strong><strong>based on the KAKS LIV(F)E meeting with <\/strong><strong>Prof. Dr. Ketteler<\/strong><\/p><p>This guide summarizes the most important recommendations for follow-up care after retinoblastoma. It is intended to help patients and their families better understand the next steps and keep track of important issues. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-637d684 elementor-widget elementor-widget-text-editor\" data-id=\"637d684\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>1. What Is Especially Important in Follow-Up Care<\/strong><\/p><p>After retinoblastoma, it\u2019s not just about detecting a recurrence. It\u2019s equally important to monitor potential long-term effects of treatment, address questions about<br\/>development, and respond promptly to new symptoms if necessary. <\/p><p><strong>Eye exams<\/strong> are the most important pillar of follow-up care. They are a top priority during childhood and remain crucial later on as well. <\/p><p>In addition, <strong>pediatric oncology follow-up care<\/strong> is also beneficial. It complements ophthalmological care because it takes into account not only the eyes but the child as a whole.<br\/>This includes, for example, general development, possible side effects of previous treatments, and the question of whether further examinations are necessary. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6524363 elementor-widget elementor-widget-text-editor\" data-id=\"6524363\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>2. What Follow-Up Care Might Look Like During Childhood<\/strong><\/p><p>After treatment, <strong>more frequent follow-up care<\/strong> is usually recommended during the first year following chemotherapy. After that, <strong>annual checkups<\/strong> are sufficient in many cases.<br\/>The following guidelines were provided: <\/p><ul><li>During the first year after chemotherapy: about every 3 months<\/li><li>after that: <strong>once a year<\/strong><\/li><li>For <strong>non-hereditary retinoblastoma<\/strong>: usually until the child starts school or approximately 5 years after diagnosis<\/li><\/ul><p>It is important to note that this follow-up care can also be provided <strong>close to home at a specialized pediatric oncology center<\/strong>. It does not necessarily always have to take place at the original treatment center. However, a general pediatrician generally cannot fully replace specialized oncological follow-up care.  <\/p><p>Even if everything seems normal as time goes on, it may be helpful to schedule follow-up appointments at longer intervals later on. This is especially helpful as children get older and begin to have questions of their own about their condition, their future, or their family planning. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f88706c elementor-widget elementor-widget-text-editor\" data-id=\"f88706c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>3. What Long-Term Effects Are Possible?<\/strong><\/p><p>The consequences of retinoblastoma and its treatment vary greatly from person to person. They depend, among other factors, on the location of the tumors and the type of<br\/>therapy used. <\/p><p>Possible long-term effects include:<\/p><ul><li><strong>Visual impairments<\/strong><\/li><li><strong>Hearing problems<\/strong> are rare after chemotherapy<\/li><li>After radiation therapy, <strong>changes in <\/strong><strong>bone growth<\/strong> may occur, particularly in the facial area<\/li><li>Occasional cosmetic abnormalities when irradiated bones grow less<\/li><\/ul><p>Problems with <strong>growth, puberty, or hormonal balance<\/strong> do not seem to be typical with standard therapy. However, in specific cases, a targeted hormonal evaluation (<br\/>) may be advisable.   <\/p><p>After chemotherapy, hearing tests are also often recommended until a reliable test can be performed at an appropriate age.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b1ad7c4 elementor-widget elementor-widget-text-editor\" data-id=\"b1ad7c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>4. Secondary Tumors: What You Should Know<\/strong><\/p><p>For many families, the fear of secondary tumors developing later on is particularly distressing. It is important, however, to assess the risks realistically: While certain secondary tumors can occur<br\/>, they are <strong>rare<\/strong> overall. <\/p><p>A distinction is made between:<br\/><strong><br\/> Risks unrelated to treatment<\/strong><\/p><p>Above all, this includes a slightly increased risk of <strong>osteosarcomas<\/strong>, which are malignant bone tumors. They typically occur during adolescence or early adulthood<br\/>. <\/p><p><strong>Treatment-Related Risks<\/strong><\/p><ul><li>In very rare cases, <strong>blood cancer<\/strong> can develop after <strong>chemotherapy<\/strong>.<\/li><li>After <strong>radiation therapy<\/strong>, the risk of <strong>sarcomas in the <\/strong><strong>treatment field<\/strong> may be increased.<\/li><\/ul><p><br>Based on the data discussed, no clearly increased risk of a second tumor was observed for <strong>radiation plates<\/strong>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-56f4147 elementor-widget elementor-widget-text-editor\" data-id=\"56f4147\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>5. Why Mindfulness Is Often More Important Than Rigid<\/strong><br\/><strong>routine checkups<\/strong><\/p><p>A key idea was that not every sensible preventive measure automatically involves as many tests as possible.<\/p><p>Regular <strong>MRI follow-ups<\/strong> are often requested, primarily due to fears of secondary tumors. However, based on current evidence, there is no clear proof that routine MRIs in the absence of symptoms actually provide a definite benefit in terms of early detection. <\/p><p>That is why special emphasis was placed on:<\/p><ul><li>Taking Change Seriously<\/li><li>Don&#8217;t wait too long to address symptoms; get them checked out<\/li><li>If you notice any unusual symptoms, see a specialist right away<\/li><li>Perform an MRI when clinically indicated<\/li><\/ul><p>This form of attention, or \u201cawareness,\u201d has been described as one of the most important tools.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-18de112 elementor-widget elementor-widget-text-editor\" data-id=\"18de112\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>6. Follow-up Care in Adulthood<\/strong><\/p><p>For adults with <strong>hereditary retinoblastoma<\/strong>, it has been recommended that they continue to participate in <strong>regular oncological screening<\/strong>, approximately once a year.<br\/>This does not necessarily mean undergoing extensive diagnostic testing at every appointment<br\/>. Rather, what is important is: <\/p><ul><li>having a dedicated point of contact<\/li><li>not having to spend a long time looking for a suitable place when new symptoms arise<\/li><li>to be able to realistically assess one&#8217;s own risk<\/li><\/ul><p><br><strong>Tumor predisposition clinics<\/strong>\u2014that is, specialized services for people with a hereditary increased risk of cancer\u2014are particularly suitable.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-afb8520 elementor-widget elementor-widget-text-editor\" data-id=\"afb8520\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>7. Which preventive care is particularly recommended for adults <\/strong><strong>?<\/strong><\/p><p>In the case of <strong>hereditary retinoblastoma<\/strong>, the following points in particular were mentioned:<\/p><ul><li><strong>Annual oncological follow-up<\/strong><\/li><li><strong>Dermatological checkups starting at puberty<\/strong>, due to a slightly increased risk of skin cancer<\/li><li>For women, <strong>gynecological screenings<\/strong> are also recommended, as tumors can rarely occur in the uterus or abdominal cavity<\/li><li>Participation in <strong>general cancer screening<\/strong> programs, which are recommended for everyone<\/li><\/ul><p><br>It was emphasized, particularly with regard to women, that gynecological screenings can be important because otherwise some changes in the abdominal cavity might not be noticed until it is too late.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d2ea856 elementor-widget elementor-widget-text-editor\" data-id=\"d2ea856\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>8. Avoid radiation as much as possible<\/strong><\/p><p>If diagnostic tests are necessary, unnecessary radiation exposure should be avoided as much as possible.<\/p><p>This means:<\/p><ul><li>If possible, <strong>an MRI instead of a CT scan<\/strong><\/li><li>X-rays and CT scans should be performed only when they are truly medically necessary<\/li><li>At the same time, do not skip any important tests out of fear of radiation<\/li><\/ul><p><br>For certain conditions, however, a CT scan remains necessary\u2014for example, for <strong>the lungs<\/strong> or <strong>bones<\/strong>. Occasional X-rays, such as those taken at the dentist or following an accident, were not identified as a major concern.<br\/>As a general rule, however, the principle is: <strong>as little radiation as possible, as much as necessary<\/strong>. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bcb73fb elementor-widget elementor-widget-text-editor\" data-id=\"bcb73fb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>9. Siblings: When an Evaluation Is Advisable<\/strong><\/p><p>Whether siblings should be screened depends on whether the retinoblastoma is <strong>hereditary<\/strong> or <strong>non-hereditary<\/strong>.<\/p><ul><li>In cases of <strong>non-hereditary retinoblastoma<\/strong>, no special measures are generally necessary for siblings.<\/li><li>In cases of <strong>hereditary retinoblastoma<\/strong>, genetic testing of the family is important.<\/li><\/ul><p><br>Siblings are often tested shortly after birth, for example using <strong>umbilical cord blood<\/strong>. If the familial mutation is detected, the child will need close-monitored ophthalmological care starting very early on. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-536e732 elementor-widget elementor-widget-text-editor\" data-id=\"536e732\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p class=\"p1\"><strong>10. Why Genetic Counseling Is So Important<\/strong><\/p><p class=\"p1\">For adolescents with hereditary retinoblastoma, it is recommended that they seek genetic counseling again around <strong>the age<\/strong> of <strong>17<\/strong>.<\/p><p class=\"p1\">This is important because several major life transitions often occur at the same time at this age:<\/p><ul><li class=\"p1\">Transition from Pediatrics to Adult Medicine<\/li><li class=\"p1\">more personal responsibility<\/li><li class=\"p1\">Future Questions About Relationships and Family Planning<\/li><\/ul><p class=\"p1\"><br>The young people should be able to understand for themselves:<\/p><ul><li class=\"p1\">whether her retinoblastoma was hereditary or non-hereditary<\/li><li class=\"p1\">what risks result from this<\/li><li class=\"p1\">what this might mean for future children<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7481819 elementor-widget elementor-widget-text-editor\" data-id=\"7481819\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>11. Family Planning for Hereditary Retinoblastoma<\/strong><br\/>If one parent carries a hereditary RB1 mutation, the risk for a child to inherit this mutation is 50 percent.<\/p><p>Before planning a family, genetic counseling can help you discuss your options at your own pace.<br\/>The following were mentioned:<\/p><ul><li><strong>Prenatal<\/strong> Diagnostics During Pregnancy<\/li><li><strong>Postpartum Testing<\/strong><\/li><li><strong>Preimplantation Genetic Testing (PGT)<\/strong> as Part of In Vitro Fertilization<\/li><\/ul><p>Preimplantation genetic testing (PGT) is permitted in Germany under certain conditions, but is generally <strong>not covered by health insurance<\/strong>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1dde52d elementor-widget elementor-widget-text-editor\" data-id=\"1dde52d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>12. What to Consider in Cases of Non-Hereditary Retinoblastoma<\/strong><\/p><p>Even in cases of <strong>non-hereditary retinoblastoma<\/strong>, follow-up care during childhood is advisable. However, this care is generally less complex overall. <\/p><p>This group is generally much less likely to experience genetic or oncological concerns later in life. Nevertheless, it can be helpful to explain to adolescents again at a later time exactly what their condition was, so that incomplete information does not lead to unnecessary anxiety. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5215c66 elementor-widget elementor-widget-text-editor\" data-id=\"5215c66\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>13. How to Improve Research<\/strong><\/p><p>An important issue for the future is how treatment can be tailored even better to each individual tumor. The goal is<strong>personalized therapy<\/strong>: some children<br\/>may need less intensive treatment, while others may need a more targeted approach. <\/p><p>Other areas of research include:<\/p><ul><li>new treatments with fewer long-term effects<\/li><li>better assessment of an individual&#8217;s risk of a second tumor<\/li><li>Development of <strong>liquid biopsy methods<\/strong>, i.e., detection of tumors through blood, urine, or saliva<\/li><li>Improved early detection and treatment of rare secondary tumors<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2404008 elementor-widget elementor-widget-text-editor\" data-id=\"2404008\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>14. Practical Guidance for Families and Those Affected<\/strong><\/p><p>It&#8217;s helpful to keep a few basic principles in mind:<\/p><ul><li><strong>Be sure to get regular eye exams<\/strong><\/li><li><strong>Receive pediatric oncology care or, later on, general oncology care<\/strong><\/li><li><strong>Take Complaints Seriously<\/strong><\/li><li><strong>Avoid unnecessary radiation exposure<\/strong><\/li><li><strong>Store genetic test results properly<\/strong><\/li><li><strong>Seek genetic counseling before planning a family<\/strong><\/li><li><strong>It&#8217;s better to ask a specific question than to do nothing out of uncertainty.<\/strong><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2bc6d27 elementor-widget elementor-widget-text-editor\" data-id=\"2bc6d27\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>15. Key Takeaway<\/strong><\/p><p>The goal of follow-up care is not to constantly instill fear or to make your whole life revolve around risks. Rather, it\u2019s about being informed, taking changes seriously, and having the right people to turn to at the right time. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1401\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1401\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Aftercare bilateral RB <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1401\" class=\"elementor-element elementor-element-0093236 e-con-full e-flex e-con e-child\" data-id=\"0093236\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1401\" class=\"elementor-element elementor-element-ed0d1b2 e-con-full e-flex e-con e-child\" data-id=\"ed0d1b2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5063a74 elementor-widget elementor-widget-text-editor\" data-id=\"5063a74\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>PRINCIPAL QUESTION<\/strong><br><strong>The question facing everyone who is confronted with a diagnosis of bilateral retinoblastoma is: What and how much do I want to know &#8211; for myself &#8211; for my child?<\/strong><br>We are convinced that there is a minimum level of knowledge that both parents and those affected (depending on their age) should possess. This involves understanding the risks so that they can develop mindfulness and awareness and facilitate early diagnosis. This includes open communication between parents and children, as well as thoughtful self-observation.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-255f7f7 elementor-widget elementor-widget-text-editor\" data-id=\"255f7f7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>THE BIOLOGY OF RB<\/strong><br\/>It is important to understand the biology of RB in order to be able to deal with the diagnosis of bilateral RB properly and responsibly:<br><strong>In people with bilateral retinoblastoma, one copy of the RB gene is usually defective in all cells of the body. This means that each cell contains one healthy copy of the RB gene and one defective copy. <\/strong>  The RB protein is responsible for preventing the cell from dividing indefinitely (\u201cstop signal\u201d). In people with the bilateral form of retinoblastoma, only one gene produces this protein\u2014in healthy people, two genes produce it. So even if one gene fails, the protein continues to be produced.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1586af8 elementor-widget elementor-widget-text-editor\" data-id=\"1586af8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>However, because one copy is defective, the likelihood that no more RB protein will be produced is greater, since only one gene needs to lose its function, rather than two. As mentioned, without the stop signal, this single cell can then divide unchecked, which can lead to cancer.   <strong>HOWEVER, if this cell is intercepted and destroyed by the immune system before it can harm the body, the body can recognize these cancer cells and destroy them. So a strong immune system is important! <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0c4461d elementor-widget elementor-widget-text-editor\" data-id=\"0c4461d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>RESEARCH FINDINGS<\/strong><br\/>Studies have shown that various secondary primary tumors occur more frequently during certain phases or time windows. These studies are difficult for the layperson to interpret correctly and are difficult to apply to individual cases because some of the data is outdated, the cohorts are very small, and the research questions are nonspecific.   <strong>We are happy to share these studies and also regularly host Zoom meetings on this important topic. For more information\u2014and if you are interested in the available studies\u2014please contact us by email at <a href=\"mailto:info@kaks.de\" target=\"_blank\" rel=\"noopener\">info@kaks.de<\/a>. <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-17ad97b elementor-widget elementor-widget-text-editor\" data-id=\"17ad97b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>One thing is certain:<\/strong><\/p><ul><li>People with bilateral retinoblastoma have an increased risk of skin cancer (see also <a href=\"#rbhautkrebs\">&#8220;Skin cancer prevention&#8221;)<\/a>.<\/li><li>Preventive care in the form of regular skin screening once a year is simple and extremely sensible!<\/li><li>Osteosarcomas\u2014that is, bone cancer\u2014occur more frequently during puberty because bone growth is particularly rapid at that time. The most important thing during this phase is to be attentive and encourage self-monitoring in collaboration with the child. The child should observe their body and be able to report any changes to parents and doctors. Important: Bone pain is normal during puberty and, as \u201cgrowing pains,\u201d is not uncommon even among \u201chealthy\u201d adolescents.   <\/li><li>Whole-body MRIs for screening: Some doctors recommend whole-body MRIs for early detection and screening. This is a highly personal decision, as the stress on children can be significant and may lead to unnecessary anxiety. The existing research on MRIs for early detection shows a demonstrable benefit only in people who have undergone radiation therapy. ONE to TWO whole-body MRIs may be useful for having comparison images later on.   <\/li><li>X-rays should be avoided in cases of acute injuries and accidents, as well as during visits to the dentist and orthodontist. Alternatives include MRI or ultrasound. <\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b33e041 elementor-widget elementor-widget-text-editor\" data-id=\"b33e041\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>FUTURE OF CANCER TREATMENT<\/strong><br\/>One thing is certain, and this should be a source of great encouragement to all those affected: We are in the age of precision medicine, which opens up completely new treatment options for cancer. <strong>Effective therapies and early detection will lead to far fewer people dying from cancer.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element 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xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" height=\"140\" viewBox=\"0 0 151.192 140\" width=\"151.192\"><clipPath id=\"a\"><path d=\"m0 0h151.192v140h-151.192z\"><\/path><\/clipPath><clipPath id=\"b\"><path d=\"m0 0h74.797v68.922h-74.797z\"><\/path><\/clipPath><g clip-path=\"url(#a)\"><path d=\"m128.457 110.044c-15.867 20.913-34.295 29.956-58.457 29.956a70 70 0 1 1 19.972-137.108s13.771 3.784 22.984 15.292c0 0 7.659 8.213 13.346 10.219a26.335 26.335 0 0 0 8.53 1.418 26.267 26.267 0 0 0 16.348-5.674s1.27 54.276-22.723 85.9\" fill=\"#f80000\"><\/path><\/g><g clip-path=\"url(#b)\" transform=\"translate(33.441 36.34)\"><path d=\"m35.116 66.029.382.116c1.4.425 2.731.826 3.606 2.583a.345.345 0 0 0 .091.115.337.337 0 0 0 .221.079.345.345 0 0 0 .191-.057c.645-.424 1.252-.808 1.829-1.173 1.208-.764 2.251-1.424 3.249-2.193a59.577 59.577 0 0 0 9.735-9.229c3.8-4.594 7.727-9.344 11.426-14.316a85.76 85.76 0 0 0 5.955-9.6 24.222 24.222 0 0 0 2.911-9.9 22.825 22.825 0 0 0 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-9.7-15.554 18.835 18.835 0 0 1 1.3-15.4\" fill=\"#fff\"><\/path><\/g><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4ce9765 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"4ce9765\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Prof. Dr. Michael Hallek from the University Hospital of Cologne, one of the most renowned oncologists in Germany<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9eac198 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"9eac198\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>&#8220;The treatment of cancer is currently undergoing a radical change that is unprecedented in history. We will be able to control many cancers in the future with the drugs and procedures we are developing and researching today. This is brilliant and fascinating.&#8221;<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b6fa8aa e-flex e-con-boxed e-con e-parent\" data-id=\"b6fa8aa\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-c96d3d5 e-con-full e-flex e-con e-child\" data-id=\"c96d3d5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-81ef980 elementor-invisible elementor-widget elementor-widget-n-accordion\" data-id=\"81ef980\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1360\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1360\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Aftercare unilateral RB <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1360\" class=\"elementor-element elementor-element-d081073 e-con-full e-flex e-con e-child\" data-id=\"d081073\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1360\" class=\"elementor-element elementor-element-bdd9bfd e-con-full e-flex e-con e-child\" data-id=\"bdd9bfd\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-dde7ad6 elementor-widget elementor-widget-text-editor\" data-id=\"dde7ad6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIn about one-third of children, the disease affects both eyes (bilateral retinoblastoma). If the latter is the case, it is almost always indicative of hereditary retinoblastoma. The tumors can form either in a single location within the eye (unifocal) or in multiple locations (multifocal).  \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-40f8d84 elementor-widget elementor-widget-text-editor\" data-id=\"40f8d84\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIf your child has bilateral retinoblastoma, doctors will strive to bring the tumor completely under control using a personalized combination of available treatment methods, while at the same time preserving vision in at least one eye.\n\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c1cd16b elementor-widget elementor-widget-text-editor\" data-id=\"c1cd16b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The treatment of choice is initially local therapy. Individual small retinoblastomas can be safely destroyed using local treatment methods (<a href=\"http:\/\/www.kinderkrebsinfo.de\/services\/glossar\/index_ger.html?selected=L#_laserkoagulation\" target=\"_blank\" rel=\"noopener\">laser coagulation<\/a>, <a href=\"http:\/\/www.kinderkrebsinfo.de\/services\/glossar\/index_ger.html?selected=K#_kryotherapie\" target=\"_blank\" rel=\"noopener\">cryotherapy<\/a>, or <a href=\"http:\/\/www.kinderkrebsinfo.de\/services\/glossar\/index_ger.html?selected=B#_brachytherapie\" target=\"_blank\" rel=\"noopener\">brachytherapy<\/a>). However, repeated treatment is often necessary.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7bd9eff elementor-widget elementor-widget-text-editor\" data-id=\"7bd9eff\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIf the tumors are already too large for such treatment, in some cases chemotherapy can be carried out with the aim of reducing the size of the tumor (chemoreduction) in order to subsequently enable local treatment (i.e. laser, cryotherapy or brachytherapy).\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-22e4033 elementor-widget elementor-widget-text-editor\" data-id=\"22e4033\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>However, in one of the two eyes, the disease is often so advanced that preserving the eyeball does not seem advisable, and enucleation is therefore performed. In cases where <a href=\"http:\/\/www.kinderkrebsinfo.de\/services\/glossar\/index_ger.html?selected=C#_chemotherapie\" target=\"_blank\" rel=\"noopener\">chemotherapy<\/a> is being considered for the treatment of the better-seeing eye, it is sometimes possible to delay enucleation of the more severely affected eye initially. This is because the therapy can lead to significant tumor regression, making eye-preserving treatment possible after all. However, if the worse eye has already lost vision or if there is infiltration of the anterior segment or the optic nerve, there is no alternative to enucleation.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6839526 elementor-widget elementor-widget-text-editor\" data-id=\"6839526\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIf the disease progresses in the second eye\u2014which was initially in better condition\u2014(tumor involvement of the optic nerve or choroid; vitreous seeding), percutaneous radiation therapy is often the only treatment option that preserves the eyeball. Again, this is performed only on the condition that sufficient vision is preserved. If this is not the case, the second eye must also be removed to avoid endangering the child\u2019s life.  \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-182d099 elementor-widget elementor-widget-text-editor\" data-id=\"182d099\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Since the risk associated with modern chemotherapy appears to be lower than that of radiation therapy alone, the current practice is to avoid <a href=\"http:\/\/www.kinderkrebsinfo.de\/services\/glossar\/index_ger.html?selected=P#_perkutane_strahlentherapie\" target=\"_blank\" rel=\"noopener\">percutaneous radiation therapy<\/a>whenever possible, especially during the first year of life. However, the effectiveness of percutaneous radiation therapy for retinoblastoma\u2014which is highly sensitive to radiation\u2014remains undisputed. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aa128b8 elementor-widget elementor-widget-text-editor\" data-id=\"aa128b8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t(Source: <a href=\"http:\/\/www.kinderkrebsinfo.de\/Retinoblastom_Kurzinfo\" target=\"_blank\" rel=\"noopener\">www.kinderkrebsinfo.de\/Retinoblastom_Kurzinfo)<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1361\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1361\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> RB-World App <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1361\" class=\"elementor-element elementor-element-d79eb71 e-con-full e-flex e-con e-child\" data-id=\"d79eb71\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1361\" class=\"elementor-element elementor-element-e47ebf5 e-con-full e-flex e-con e-child\" data-id=\"e47ebf5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-aee9e53 elementor-widget elementor-widget-text-editor\" data-id=\"aee9e53\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Learning and benefiting from each other &#8211; for good provision throughout life.<\/strong>  KAKS has formed a working group for you to improve preventive care for RB survivors affected on both sides. We want to develop a platform to gather experiences, medical information, and important points of contact and make them available to everyone. Our adult RB survivors, who have already gained a great deal of life experience, have taken the first steps in this effort. They\u2014and we\u2014would like to share these experiences with you and incorporate your important experiences as well.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-be4330d elementor-widget elementor-widget-image\" data-id=\"be4330d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"1900\" height=\"1086\" src=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01.jpg\" class=\"attachment-full size-full wp-image-3271\" alt=\"\" srcset=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01.jpg 1900w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01-300x171.jpg 300w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01-1024x585.jpg 1024w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01-768x439.jpg 768w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/02\/RB-World-App-01-1536x878.jpg 1536w\" sizes=\"(max-width: 1900px) 100vw, 1900px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-318960f elementor-widget elementor-widget-text-editor\" data-id=\"318960f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>We use the RB-World app for this and are constantly developing our documents there as &#8220;living documents&#8221; with your support and participation in the project.<\/strong><br\/><strong>If you would like to take part, please contact Katja K\u00f6nig in the app (kkh@kinderaugenkrebsstiftung.de).<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82b4804 elementor-align-left elementor-widget elementor-widget-button\" data-id=\"82b4804\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/apps.apple.com\/de\/app\/rb-world-2-0\/id1460108948\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">RB-World App<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1362\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1362\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> RB register <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1362\" class=\"elementor-element elementor-element-5cb5461 e-con-full e-flex e-con e-child\" data-id=\"5cb5461\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1362\" class=\"elementor-element elementor-element-cc66220 e-con-full e-flex e-con e-child\" data-id=\"cc66220\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-35981b4 elementor-widget elementor-widget-text-editor\" data-id=\"35981b4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>The Retinoblastoma Registry, headed by PD Dr. Petra Ketteler from the Department of Pediatrics III Pediatric Hematology and Oncology at Essen University Hospital, has been in existence since November 1, 2013.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0d36886 elementor-widget elementor-widget-text-editor\" data-id=\"0d36886\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tUnlike with all other types of cancer, this has not been done for retinoblastoma to date, and it represents an important step toward systematically collecting information about retinoblastoma in the form of a database in order to record data and optimize treatment methods. Since retinoblastoma is a very rare disease, there is currently little data available to support a risk-adapted, evidence-based selection of the various treatment options, such as eye removal and various eye-sparing treatments like cryotherapy, laser treatment, radiation therapy, or chemotherapy. These treatment options vary in their success rates and in the range of long-term consequences.  \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-223b8c4 elementor-widget elementor-widget-text-editor\" data-id=\"223b8c4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tFor children with a genetic predisposition, the increased risk of a secondary tumor is of particular concern. For this reason, the RB-Registry\u2014a clinical registry covering Germany and Austria\u2014is designed to prospectively collect data on the epidemiology and disease course of retinoblastoma. A neuroradiological and histopathological reference review is intended to improve the comparability of the examination results across the various centers.  \n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f79e20f elementor-widget elementor-widget-text-editor\" data-id=\"f79e20f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tThe data recorded in the registry are used to better educate affected patients and their parents and form the foundation for conducting interventional clinical trials aimed at improving early detection, treatment, and follow-up care for affected patients. As another key focus, the database and the existing biobank support accompanying research projects in the field of retinoblastoma. \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-effb7d4 elementor-widget elementor-widget-text-editor\" data-id=\"effb7d4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tThe long-term goal of the clinical registry and the accompanying research is to improve survival rates among patients with advanced-stage tumors, as well as to reduce long-term complications and improve the quality of life for all long-term survivors.\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a49431 elementor-widget elementor-widget-text-editor\" data-id=\"3a49431\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Important Hotline:<\/strong> If pediatricians or pediatric oncologists have questions regarding appropriate follow-up care, a hotline is available at the University Hospital of Essen: <a href=\"tel:0201-723-2003\">0201-723-2003<\/a>. Parents and doctors who have questions about the follow-up care of their patients or children can contact this hotline. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-420b6de elementor-widget elementor-widget-text-editor\" data-id=\"420b6de\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tYou can find all important information about the RB register under this link.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7686f96 elementor-align-left elementor-widget elementor-widget-button\" data-id=\"7686f96\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/www.gpoh.de\/studienportal\/onkologische_studien_und_register\/retinoblastom_register\/index_ger.html\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Learn more<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1363\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1363\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> OPILATER <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1363\" class=\"elementor-element elementor-element-fd5b1be e-con-full e-flex e-con e-child\" data-id=\"fd5b1be\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1363\" class=\"elementor-element elementor-element-3560b67 e-con-full e-flex e-con e-child\" data-id=\"3560b67\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4efb8f0 elementor-widget elementor-widget-text-editor\" data-id=\"4efb8f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>What happens after someone has survived cancer? Survivors must cope with the various consequences of the disease, yet they are often inadequately informed about them. The \u201cOptilater\u201d consortium, initiated by Prof. Uta Dirksen and Prof. Viktor Gr\u00fcnwald and coordinated by WTZ Essen, aims to change this and improve long-term care nationwide for people who have or have had cancer.  <\/p><p>You can find all important information about the RB register under this link.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7cd0915 elementor-align-left elementor-widget elementor-widget-button\" data-id=\"7cd0915\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/wtz.nrw\/optilater\/\" target=\"_blank\" rel=\"noopener\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Learn more<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b4a83b2 e-flex e-con-boxed e-con e-parent\" data-id=\"b4a83b2\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f8e8f0f elementor-widget elementor-widget-spacer\" data-id=\"f8e8f0f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-c522aa3 e-con-full e-flex e-con e-child\" data-id=\"c522aa3\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f8bfef0 elementor-invisible elementor-widget elementor-widget-image\" data-id=\"f8bfef0\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"450\" height=\"300\" src=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-Dirksen.jpg\" class=\"attachment-full size-full wp-image-7015\" alt=\"\" srcset=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-Dirksen.jpg 450w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-Dirksen-300x200.jpg 300w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-e20023b e-con-full e-flex e-con e-child\" data-id=\"e20023b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-90c0111 elementor-absolute elementor-view-default elementor-invisible elementor-widget elementor-widget-icon\" data-id=\"90c0111\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_position&quot;:&quot;absolute&quot;,&quot;_animation&quot;:&quot;fadeInRight&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"icon.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-wrapper\">\n\t\t\t<div class=\"elementor-icon\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" height=\"140\" viewBox=\"0 0 151.192 140\" width=\"151.192\"><clipPath id=\"a\"><path d=\"m0 0h151.192v140h-151.192z\"><\/path><\/clipPath><clipPath id=\"b\"><path d=\"m0 0h74.797v68.922h-74.797z\"><\/path><\/clipPath><g clip-path=\"url(#a)\"><path d=\"m128.457 110.044c-15.867 20.913-34.295 29.956-58.457 29.956a70 70 0 1 1 19.972-137.108s13.771 3.784 22.984 15.292c0 0 7.659 8.213 13.346 10.219a26.335 26.335 0 0 0 8.53 1.418 26.267 26.267 0 0 0 16.348-5.674s1.27 54.276-22.723 85.9\" fill=\"#f80000\"><\/path><\/g><g clip-path=\"url(#b)\" transform=\"translate(33.441 36.34)\"><path d=\"m35.116 66.029.382.116c1.4.425 2.731.826 3.606 2.583a.345.345 0 0 0 .091.115.337.337 0 0 0 .221.079.345.345 0 0 0 .191-.057c.645-.424 1.252-.808 1.829-1.173 1.208-.764 2.251-1.424 3.249-2.193a59.577 59.577 0 0 0 9.735-9.229c3.8-4.594 7.727-9.344 11.426-14.316a85.76 85.76 0 0 0 5.955-9.6 24.222 24.222 0 0 0 2.911-9.9 22.825 22.825 0 0 0 -4-15.288c-3.45-4.936-8.043-7.341-13.639-7.156a23.986 23.986 0 0 0 -16.5 7.242 6.894 6.894 0 0 0 -.624.748 2.844 2.844 0 0 1 -1.217 1.1c-5.41-5.318-9.545-7.4-15.732-7.933-6.349-.547-11.489 1.514-15.277 6.125a44.2 44.2 0 0 0 -4.923 7.357 23.183 23.183 0 0 0 -1.83 17.719 44.3 44.3 0 0 0 7.659 15.118 52.978 52.978 0 0 0 26.487 18.543m-26.189-50.319a43.188 43.188 0 0 1 2.71-4.475 11.346 11.346 0 0 1 9.903-5.235q.784 0 1.609.081a18.327 18.327 0 0 1 13.431 7.45c.394.527.823 1.015 1.2 1.445.154.175.3.34.427.492a.349.349 0 0 0 .207.118 2.241 2.241 0 0 0 2.592-1.3c2.633-4.41 6.732-7.043 12.9-8.284a15.066 15.066 0 0 1 4.421-.111 8.44 8.44 0 0 1 5.958 3.444 15.028 15.028 0 0 1 3.132 8.242 19.059 19.059 0 0 1 -1.824 10.1 60.941 60.941 0 0 1 -3.9 7.027c-2.7 4.012-5.577 8-8.361 11.857l-.968 1.342c-2.073 2.875-4.218 5.773-6.291 8.576q-1.122 1.521-2.243 3.037c-.323.437-.658.865-1.013 1.318l-.357.457-2.913-1.211c-2.242-.931-4.379-1.819-6.511-2.72a47.043 47.043 0 0 1 -15.712-10.7 41.424 41.424 0 0 1 -9.7-15.554 18.835 18.835 0 0 1 1.3-15.4\" fill=\"#fff\"><\/path><\/g><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-333c1a8 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"333c1a8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Interview with Prof. Dr. med. Uta Dirksen.<br\/>Everything for good aftercare after cancer.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-559101e elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"559101e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>What happens after someone has beaten cancer? What care needs arise after a cancer diagnosis, depending on age?  Survivors have to deal with various consequences of the disease, but are often inadequately informed about them.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f7464e6 elementor-position-inline-start elementor-mobile-position-inline-end elementor-view-default elementor-widget elementor-widget-icon-box\" data-id=\"f7464e6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"icon-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-icon-box-wrapper\">\n\n\t\t\t\t\t\t<div class=\"elementor-icon-box-icon\">\n\t\t\t\t<a href=\"https:\/\/kinderaugenkrebsstiftung.de\/en\/prof-dr-med-uta-dirksen-everything-for-good-aftercare-after-cancer\/\" class=\"elementor-icon\" tabindex=\"-1\">\n\t\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" height=\"25.02\" viewBox=\"0 0 60 25.02\" width=\"60\"><path d=\"m-11.653 0 4.393 5.8 4.324 5.659h-56.764v2.1h56.764l-4.324 5.662-4.393 5.8h2.46l9.493-12.511-9.493-12.51z\" fill=\"#283444\" transform=\"translate(59.703)\"><\/path><\/svg>\t\t\t\t<\/a>\n\t\t\t<\/div>\n\t\t\t\n\t\t\t\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-6f91c37 e-flex e-con-boxed e-con e-parent\" data-id=\"6f91c37\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-1746c66 e-con-full e-flex e-con e-child\" data-id=\"1746c66\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-719d141 elementor-invisible elementor-widget elementor-widget-n-accordion\" data-id=\"719d141\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"rbhautkrebs\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1190\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1190\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> RB &amp; skin cancer <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1190\" class=\"elementor-element elementor-element-75cf502 e-con-full e-flex e-con e-child\" data-id=\"75cf502\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1190\" class=\"elementor-element elementor-element-3d7e307 e-con-full e-flex e-con e-child\" data-id=\"3d7e307\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-972105b elementor-widget elementor-widget-text-editor\" data-id=\"972105b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Dr. Benedikt Hofmann, specialist in dermatology, explains skin cancer prevention for RB patients.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0f601de elementor-widget elementor-widget-image\" data-id=\"0f601de\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"960\" height=\"543\" src=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-rb-hautkrebs.jpg\" class=\"attachment-full size-full wp-image-7017\" alt=\"\" srcset=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-rb-hautkrebs.jpg 960w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-rb-hautkrebs-300x170.jpg 300w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/KAKS-Nachsorge-rb-hautkrebs-768x434.jpg 768w\" sizes=\"(max-width: 960px) 100vw, 960px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9528067 elementor-widget elementor-widget-text-editor\" data-id=\"9528067\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Patients with the hereditary form of RB have an increased risk of developing melanoma compared to the normal population and should therefore take UV protection more seriously.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-97e39d2 elementor-widget elementor-widget-text-editor\" data-id=\"97e39d2\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tHere is a current one from 2021, a relatively large study with data from around 1800 RB patients in the follow-up: <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/34153328\/\" target=\"_blank\" rel=\"noopener\">https:\/\/pubmed.ncbi.nlm.nih.gov\/34153328\/<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c22d558 elementor-widget elementor-widget-text-editor\" data-id=\"c22d558\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tEven though the mechanisms underlying the increased risk of tumor development are not yet fully understood, it is strongly recommended to minimize the carcinogenic effects of UV light on the skin of young patients. This applies in particular to patients with hereditary RB, especially following chemotherapy and radiation therapy and in the presence of additional risk factors (fair skin type, family history of atypical nevi or melanomas). Thanks to the exemplary education provided by KAKS, the patients\u2019 parents are generally aware of this.    \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a0f3c7e elementor-widget elementor-widget-text-editor\" data-id=\"a0f3c7e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>But how do we best protect the skin of young patients?<\/strong> <br>It is absolutely correct that the first line of defense against the sun\u2019s rays is physical sun protection, including good (tested!) UV-protective clothing and following standard sun safety guidelines. If spending time outdoors with somewhat more intense UV exposure is unavoidable, or if UV-protective clothing is no longer being worn, then exposed skin should be protected with a sufficient amount (!) of SPF 30\u201350 sunscreen. In most cases, sunscreen is applied too sparingly and therefore never achieves the maximum sun protection factor indicated. In addition, the sunscreen should provide protection against both UVB and UVA rays. For an adult without an increased risk of skin cancer, an SPF of 30 is usually sufficient. Patients with an increased risk\u2014and unfortunately, RB patients fall into this category\u2014should use SPF 50. Of course, this should be adjusted according to the current UV index. With an index of 3, SPF 20\u201320 would normally be sufficient; with a UVI of 8\u201310, SPF 50 would naturally be recommended.       <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-10efbae elementor-widget elementor-widget-text-editor\" data-id=\"10efbae\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>On the question of the health risks of the higher SPF products in relation to the ingredients.<\/strong>  All SPF products approved in the EU show no evidence of health risks when used properly. In fact, greater harm is likely to result from verifiable DNA damage to the skin caused by inadequate UV protection. The risk assessment by the Federal Office for Risk Assessment and the Federal Office for Radiation Protection is clearly grounded in the available scientific evidence.    <strong>What we do not recommend are sunscreens with a high concentration of nanoparticles, which, while they leave less of a white cast, have effects on human tissue that have not yet been fully clarified. Hormone-disrupting sunscreens are no longer approved by the EU. <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-35f02f0 elementor-widget elementor-widget-text-editor\" data-id=\"35f02f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tHere is information on the LSF from the BFR: <a href=\"https:\/\/www.bfr.bund.de\/cm\/343\/sonnencreme-und-co-gibt-es-gesundheitliche-risiken.pdf\" target=\"_blank\" rel=\"noopener\">https:\/\/www.bfr.bund.de\/cm\/343\/sonnencreme-und-co-gibt-es-gesundheitliche-risiken.pdf<\/a>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-203b4a0 elementor-widget elementor-widget-text-editor\" data-id=\"203b4a0\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Two other aspects are important: UV-induced DNA damage occurs even before the first signs of sunburn.<\/strong>  Therefore, please apply sunscreen regularly as a preventive measure based on the UV index. Please do not forget to provide vitamin D supplements to young patients when consistent UV protection is in place. No UV, no vitamin D\u2026  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b0e9dfb elementor-widget elementor-widget-text-editor\" data-id=\"b0e9dfb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Skin cancer &#8211; the dark side of sunlight<\/strong><br\/>The feeling of light and warmth on the skin and the brightness evokes a sense of well-being in most people that we find very difficult to escape.  <strong>However, sunlight does have a downside: the ultraviolet radiation it contains. When exposed to it in excess, this radiation causes damage to skin cells, which, in the worst-case scenario, can lead to skin cancer. <\/strong>  Of course, our bodies can repair some of this damage on their own. Unfortunately, however, this remarkable ability is significantly less effective in children and young people than in adults. This is why sunburns sustained during adolescence are a major factor in the rising rate of skin cancer in adulthood.    <strong>We should protect ourselves.<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a9ebbdb elementor-widget elementor-widget-text-editor\" data-id=\"a9ebbdb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>UV protection is important.<\/strong><br\/>Unfortunately, UV damage occurs even before a sunburn \u201cwarns\u201d us. Proper UV protection starts earlier\u2014and begins in the mind! We must be aware of the harmful effects of UV radiation and not underestimate them. <strong>Following the <a href=\"#sonnenschutzregeln\">rules for UV protection<\/a> is the best preventive measure and has been proven to help prevent skin cancer.<\/strong>  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-baf45a9 e-flex e-con-boxed e-con e-parent\" data-id=\"baf45a9\" data-element_type=\"container\" data-e-type=\"container\" id=\"sonnenschutzregeln\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-874f750 e-con-full e-flex e-con e-child\" data-id=\"874f750\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-61c79eb elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"61c79eb\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">The most important sun protection rules<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b3d877b elementor-widget-divider--view-line elementor-invisible elementor-widget elementor-widget-divider\" data-id=\"b3d877b\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ab97a29 e-con-full e-flex e-con e-child\" data-id=\"ab97a29\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a2fab0d elementor-widget elementor-widget-spacer\" data-id=\"a2fab0d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0183e61 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"0183e61\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Avoid strong sun, especially at midday.<\/li><li>Dress &#8211; the best and simplest protection is UV protective clothing and headgear.<\/li><li>Apply sunscreen generously, at least sun protection factor 30. Apply plenty of sunscreen half an hour before going out in the sun and repeat several times a day.<\/li><li>Protection when bathing, preferably UV swimwear.<\/li><li>No sunbeds, is prohibited by law for children and young people in Germany!<\/li><li>Infants should never be exposed to direct sunlight! Sunscreen should not be used during the first year of life. <\/li><li>Be a role model! And lead by example. <\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d992be4 e-flex e-con-boxed e-con e-parent\" data-id=\"d992be4\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-c7c39f4 e-con-full e-flex e-con e-child\" data-id=\"c7c39f4\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2bc92ac elementor-widget elementor-widget-spacer\" data-id=\"2bc92ac\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e35c8c elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"8e35c8c\" data-element_type=\"widget\" data-e-type=\"widget\" id=\"abcderegel\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>The Most Important Preventive Measure.<\/strong><br\/>For the simplest form of prevention, we don\u2019t even need a doctor: Our skin is right in front of us, and we can examine it at any time with family or a partner. If moles change significantly from the overall pattern of existing moles or show abnormalities after applying the simple <a href=\"#abcderegel\"><strong>ABCDE rule<\/strong><\/a> , you should have them examined by a dermatologist. <strong>This simple form of vigilance can save lives.<\/strong> <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-2ab6227 e-flex e-con-boxed e-con e-parent\" data-id=\"2ab6227\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;,&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-9b14138 e-con-full e-flex e-con e-child\" data-id=\"9b14138\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-58413dd elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"58413dd\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">ABCDE rule<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e50df64 elementor-widget-divider--view-line elementor-invisible elementor-widget elementor-widget-divider\" data-id=\"e50df64\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-ed8946a e-con-full e-flex e-con e-child\" data-id=\"ed8946a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-a808d34 elementor-widget elementor-widget-spacer\" data-id=\"a808d34\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-87999b8 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"87999b8\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The ABCDE rule helps with the self-examination of pigment spots for the early detection of skin cancer:<\/p><p><strong>A = Asymmetry:<\/strong> asymmetrical growth, not round or oval<br\/> B<strong>= Boundary:<\/strong> uneven, blurred, smooth change to normal tissue<br\/> C<strong>= Color:<\/strong> unevenly strong pigmentation or multicolor<br\/> D<strong>= Diameter or dynamic:<\/strong> rapid growth, often enlarged diameter (5 mm or larger)<br\/> E<strong>= Elevation:<\/strong> growth nodular in height or newly formed on otherwise flat ground<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8c9bee5 e-flex e-con-boxed e-con e-parent\" data-id=\"8c9bee5\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-da0dd6e e-con-full e-flex e-con e-child\" data-id=\"da0dd6e\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-6eaa507 elementor-widget elementor-widget-spacer\" data-id=\"6eaa507\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c529a2e elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"c529a2e\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;_animation_mobile&quot;:&quot;fadeIn&quot;,&quot;_animation_mobile_extra&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Of course, an examination by a dermatologist is safer.<\/strong><br\/>Currently, only people with public health insurance are eligible for skin cancer screenings by a dermatologist starting at age 35. Some health insurance plans offer this starting at age 20. The reason for this is that the rate of skin cancer rises significantly starting at this age. Note that this refers to the rate of skin cancer, not the rate of precancerous lesions. These can certainly develop even in adolescents. This is particularly true for people with high-risk skin types. In this regard, the preventive care provided by public health insurance plans falls short and, unfortunately, does not distinguish between risk groups. However, any dermatologist will perform skin cancer screenings for those who are not eligible for coverage as a self-pay service at a reasonable cost.       <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-31fa5af e-flex e-con-boxed e-con e-parent\" data-id=\"31fa5af\" data-element_type=\"container\" data-e-type=\"container\" id=\"kinderonkologie\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-f29bec9 e-con-full e-flex e-con e-child\" data-id=\"f29bec9\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8468a68 elementor-invisible elementor-widget elementor-widget-n-accordion\" data-id=\"8468a68\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;all_collapsed&quot;,&quot;_animation&quot;:&quot;fadeInUp&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1380\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1380\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> RB &amp; X-ray <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1380\" class=\"elementor-element elementor-element-6a4e983 e-con-full e-flex e-con e-child\" data-id=\"6a4e983\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1380\" class=\"elementor-element elementor-element-60e3ed1 e-con-full e-flex e-con e-child\" data-id=\"60e3ed1\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4e841a8 elementor-widget elementor-widget-text-editor\" data-id=\"4e841a8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Eight-year-old Julia is sitting in the orthodontist\u2019s office, about to get her first set of braces. Twelve-year-old Paul twisted his ankle playing soccer today and is in severe pain. Four-year-old Emma fell off her bike onto her shoulder and can\u2019t move it. These are everyday stories for parents that don\u2019t always make it possible to avoid a doctor\u2019s visit and the accompanying X-ray. But is that really the case?    <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e0588b elementor-widget elementor-widget-text-editor\" data-id=\"8e0588b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tFrom bone fractures and joint inflammation to suspected cancer: radiological methods have become indispensable for doctors.  <strong>However, there are differences we need to be aware of, and these are particularly important for children with a hereditary form of retinoblastoma. For them, the rule is: AVOID X-RAYS! <\/strong>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d8540c elementor-widget elementor-widget-image\" data-id=\"4d8540c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"960\" height=\"543\" src=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/RetinoblastomRoentgen.jpg\" class=\"attachment-full size-full wp-image-7023\" alt=\"\" srcset=\"https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/RetinoblastomRoentgen.jpg 960w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/RetinoblastomRoentgen-300x170.jpg 300w, https:\/\/kinderaugenkrebsstiftung.de\/wp-content\/uploads\/2024\/05\/RetinoblastomRoentgen-768x434.jpg 768w\" sizes=\"(max-width: 960px) 100vw, 960px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-22024e4 elementor-widget elementor-widget-text-editor\" data-id=\"22024e4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The most important imaging techniques are conventional X-rays, computed tomography (CT), and magnetic resonance imaging (MRI). X-rays and CT are based on the same principle: in both cases, the body is, so to speak, \u201cX-rayed.\u201d MRI, on the other hand, creates an image of the body\u2019s interior using a strong magnetic field and radio waves. X-rays are most commonly associated with examinations for broken bones and joint problems.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8007b15 elementor-widget elementor-widget-text-editor\" data-id=\"8007b15\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tBut be aware: \u201cX-rays have biological effects and can cause cancer. The emphasis here, however, is on \u2018can,\u2019 because the increase in the normal risk of cancer is less than one per mille,\u201d explains Michael Wucherer, a radiation physicist at Nuremberg Hospital: \u201cThe lower the radiation dose, the lower the risk. The dose depends on several factors. First and foremost, it depends on which parts of the body are to be imaged. The desired level of accuracy also plays a role; depending on the clinical question, a higher radiation dose may then need to be used.\u201d (Source: welt.de) Computed tomography (CT) scans also involve radiation exposure. Unlike standard X-ray examinations, CT scans can produce three-dimensional images that provide far more information than two-dimensional X-ray images. Here, too, the following applies: when using ionizing X-rays, the benefits must always be weighed against the risks! And this is especially true for children with an RB mutation. Parents should always discuss the matter privately with the treating physician to determine whether an X-ray examination is necessary or whether it can be replaced by another imaging modality, such as an MRI. Or whether, under certain circumstances, the exam can be avoided altogether. According to our research, this is particularly common at the dentist\u2019s or orthodontist\u2019s office.        \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-012b56d elementor-widget elementor-widget-text-editor\" data-id=\"012b56d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tMagnetic resonance imaging (MRI) does not use ionizing radiation. It is based on the fact that all water molecules in the body behave like tiny magnets that respond to an externally applied magnetic field. When these molecules are then excited by radio waves, they emit energy once the radio source is turned off. From the multitude of individual signals\u2014each of which depends on the composition of the respective tissue and its surroundings\u2014a computer ultimately calculates the image. MRI is considered a very safe and harmless method, since the body is not exposed to any radiation other than the comparatively low-energy radio waves. However, due to the strong magnetic field, the procedure is contraindicated for people who have certain metals or, for example, pacemakers implanted in their bodies. Because the patient must lie in a narrow tube for an extended period of time, the examination is uncomfortable for many people. The MRI scanner is a high-tech device that is extremely expensive to purchase and maintain. Hospitals and doctors therefore use MRI only selectively, as each examination costs many times more than other methods.          \t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-235decd elementor-widget elementor-widget-text-editor\" data-id=\"235decd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>CONCLUSION: Minimize the use of X-rays! Everyone who might find themselves in situations with children where X-rays could be necessary\u2014whether at home, at school, or during leisure activities\u2014should be aware of this information. <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f8f0a90 elementor-widget elementor-widget-text-editor\" data-id=\"f8f0a90\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The KAKS would like to see a personalized X-ray record with an additional note for RB patients. In addition to listing previous X-rays, this would highlight measures taken due to the RB condition. This way, in an emergency, the treating physicians can act proactively and, if necessary, refrain from taking another X-ray of the RB survivor.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1381\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1381\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Pediatric oncology in Germany and Austria <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1381\" class=\"elementor-element elementor-element-85bc57a e-con-full e-flex e-con e-child\" data-id=\"85bc57a\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1381\" class=\"elementor-element elementor-element-0bc7b60 e-con-full e-flex e-con e-child\" data-id=\"0bc7b60\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2a5f874 elementor-widget elementor-widget-text-editor\" data-id=\"2a5f874\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The following list includes the locations of treatment centers where you can find a pediatric oncologist for your children\u2019s RB follow-up care\u2014beyond the follow-up care provided by an ophthalmologist. Clicking on the link will take you to the respective websites of the treatment centers. If you\u2019d like to search more specifically in your area, you can find help here:  <br><a href=\"https:\/\/klinikradar.de\/kinderonkologie\/kliniken\/\" target=\"_blank\" rel=\"noopener\"><strong>CHILDREN&#8217;S ONCOLOGISTS NEAR ME<\/strong><\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-eb23999 elementor-widget elementor-widget-text-editor\" data-id=\"eb23999\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>If pediatricians or pediatric oncologists have questions regarding the proper follow-up care for RB patients, a hotline is available at Essen University Hospital: +49(0)201 7232003.<\/strong> Parents and doctors who have questions about the follow-up care of their children or patients can contact this hotline.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1382\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1382\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Coordination office for psychosocial aftercare <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><i aria-hidden=\"true\" class=\"hm hm-minus-large\"><\/i><\/span>\n\t\t\t<span class='e-closed'><i aria-hidden=\"true\" class=\"hm hm-plus-open\"><\/i><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1382\" class=\"elementor-element elementor-element-c51ec8b e-con-full e-flex e-con e-child\" data-id=\"c51ec8b\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1382\" class=\"elementor-element elementor-element-35b80f9 e-con-full e-flex e-con e-child\" data-id=\"35b80f9\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0f4ac1f elementor-widget elementor-widget-text-editor\" data-id=\"0f4ac1f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The Coordination Center for Psychosocial Aftercare for Families with Children with Cancer is an invaluable resource, as KONA provides support for all questions and issues that arise following a cancer diagnosis. The goal is to ensure a good quality of life for patients and all family members. The services offered are diverse:  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2535183 elementor-widget elementor-widget-text-editor\" data-id=\"2535183\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Counseling:<\/strong> KONA has experience and knowledge in the field of childhood cancer and can therefore provide specific counseling and support in psychosocial aftercare and offer appropriate assistance.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0aee973 elementor-widget elementor-widget-text-editor\" data-id=\"0aee973\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Events:<\/strong> KONA offers experiential educational events for children and adolescents (patients and siblings), and group meetings and weekends for parents and families to exchange ideas and information.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-cc1911b elementor-widget elementor-widget-text-editor\" data-id=\"cc1911b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Training and information:<\/strong> On topics relating to cancer in children, e.g. dealing with the disease for specialist agencies or other interested institutions (e.g. kindergarten, school).<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-adcc999 elementor-widget elementor-widget-text-editor\" data-id=\"adcc999\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Youth &#038; Future project:<\/strong> advice and support on the subject of training and careers.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2976ec6 elementor-widget elementor-widget-text-editor\" data-id=\"2976ec6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Coping with Illness:<\/strong> How can I better manage my fear of a relapse? Is it normal that I\u2019m still so worried? Who can I talk to about this? How can I lead a self-determined life despite the effects of my illness?   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7b9dd92 elementor-widget elementor-widget-text-editor\" data-id=\"7b9dd92\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Preschool, School:<\/strong> Which school is right for my child? Is my child entitled to accommodations at school, and how can I arrange them? What is causing my child\u2019s concentration problems, and what can I do about them?  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4941d6c elementor-widget elementor-widget-text-editor\" data-id=\"4941d6c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Exhaustion:<\/strong> What options do I have for finding relief in my daily life? How can I reconnect with my own needs? <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7c97137 elementor-widget elementor-widget-text-editor\" data-id=\"7c97137\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Behavioral Issues:<\/strong> Why is my child wetting the bed again? Why is my child acting so aggressively? <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dbc75cd elementor-widget elementor-widget-text-editor\" data-id=\"dbc75cd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Relationships, family, social circle:<\/strong> Where can I find support if I&#8217;m having relationship problems? How do I deal with the lack of understanding from those around me regarding my child&#8217;s illness? Do other parents feel the same way I do?  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-761942b elementor-widget elementor-widget-text-editor\" data-id=\"761942b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Treatment Options:<\/strong> Does my child need psychotherapy? What is the appropriate therapy for my child, especially after a brain tumor? How can I pay for equine therapy?  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b4e368f elementor-widget elementor-widget-text-editor\" data-id=\"b4e368f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Social Security Law:<\/strong> Should I renew my disability ID card? Am I eligible to apply for a second inpatient rehabilitation program? <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c81fb28 elementor-widget elementor-widget-text-editor\" data-id=\"c81fb28\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Financial problems:<\/strong> Where can I get help with my financial difficulties?<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c2d03fd elementor-widget elementor-widget-text-editor\" data-id=\"c2d03fd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Grief:<\/strong> Where can I find help and understanding in my grief?<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-dd28dfb elementor-widget elementor-widget-text-editor\" data-id=\"dd28dfb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Information:<\/strong> Could my child experience long-term effects? What can I do as a precaution? <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e451e5d elementor-widget elementor-widget-text-editor\" data-id=\"e451e5d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Education and Careers:<\/strong> How can I find a suitable apprenticeship even though I have health limitations? 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fill=\"#f80000\"><\/path><\/g><g clip-path=\"url(#b)\" transform=\"translate(33.441 36.34)\"><path d=\"m35.116 66.029.382.116c1.4.425 2.731.826 3.606 2.583a.345.345 0 0 0 .091.115.337.337 0 0 0 .221.079.345.345 0 0 0 .191-.057c.645-.424 1.252-.808 1.829-1.173 1.208-.764 2.251-1.424 3.249-2.193a59.577 59.577 0 0 0 9.735-9.229c3.8-4.594 7.727-9.344 11.426-14.316a85.76 85.76 0 0 0 5.955-9.6 24.222 24.222 0 0 0 2.911-9.9 22.825 22.825 0 0 0 -4-15.288c-3.45-4.936-8.043-7.341-13.639-7.156a23.986 23.986 0 0 0 -16.5 7.242 6.894 6.894 0 0 0 -.624.748 2.844 2.844 0 0 1 -1.217 1.1c-5.41-5.318-9.545-7.4-15.732-7.933-6.349-.547-11.489 1.514-15.277 6.125a44.2 44.2 0 0 0 -4.923 7.357 23.183 23.183 0 0 0 -1.83 17.719 44.3 44.3 0 0 0 7.659 15.118 52.978 52.978 0 0 0 26.487 18.543m-26.189-50.319a43.188 43.188 0 0 1 2.71-4.475 11.346 11.346 0 0 1 9.903-5.235q.784 0 1.609.081a18.327 18.327 0 0 1 13.431 7.45c.394.527.823 1.015 1.2 1.445.154.175.3.34.427.492a.349.349 0 0 0 .207.118 2.241 2.241 0 0 0 2.592-1.3c2.633-4.41 6.732-7.043 12.9-8.284a15.066 15.066 0 0 1 4.421-.111 8.44 8.44 0 0 1 5.958 3.444 15.028 15.028 0 0 1 3.132 8.242 19.059 19.059 0 0 1 -1.824 10.1 60.941 60.941 0 0 1 -3.9 7.027c-2.7 4.012-5.577 8-8.361 11.857l-.968 1.342c-2.073 2.875-4.218 5.773-6.291 8.576q-1.122 1.521-2.243 3.037c-.323.437-.658.865-1.013 1.318l-.357.457-2.913-1.211c-2.242-.931-4.379-1.819-6.511-2.72a47.043 47.043 0 0 1 -15.712-10.7 41.424 41.424 0 0 1 -9.7-15.554 18.835 18.835 0 0 1 1.3-15.4\" fill=\"#fff\"><\/path><\/g><\/svg>\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ecb8272 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"ecb8272\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tElli&#8217;s Eyeland by KAKS\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-041a8c5 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"041a8c5\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Our team is deeply committed to supporting you and goes above and beyond to help. We&#8217;re happy to answer your questions and are here for you. <\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-33c8c04 elementor-align-left elementor-widget__width-initial elementor-widget elementor-widget-button\" data-id=\"33c8c04\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"mailto:info@kaks.de\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">info@kaks.de<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e12ca69 elementor-align-left elementor-widget__width-initial elementor-widget elementor-widget-button\" data-id=\"e12ca69\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"tel:+4921131191500\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">+49 211 311 91500<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-8e346fa e-flex e-con-boxed e-con e-parent\" data-id=\"8e346fa\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:&quot;yes&quot;,&quot;_ha_eqh_widget&quot;:[&quot;ha-infobox&quot;],&quot;_ha_eqh_disable_on_tablet&quot;:&quot;yes&quot;,&quot;_ha_eqh_to&quot;:&quot;widget&quot;,&quot;_ha_eqh_disable_on_mobile&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-49537a9 elementor-widget elementor-widget-heading\" data-id=\"49537a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\">Further information<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d315a02 e-con-full e-flex e-con e-child\" data-id=\"d315a02\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t<div class=\"elementor-element elementor-element-20d9d97 e-con-full e-flex e-con e-child\" data-id=\"20d9d97\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-71808f0 ha-infobox-media-dir-top ha-has-bg-overlay elementor-invisible elementor-widget elementor-widget-ha-infobox happy-addon ha-infobox\" data-id=\"71808f0\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"ha-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div class=\"ha-infobox-body\">\n\t\t\t<h3 class=\"ha-infobox-title\">  Artificial eyes<\/h3>\n\t\t\t\n\t\t\t<a class=\"ha-btn ha-btn--link\" href=\"https:\/\/kinderaugenkrebsstiftung.de\/en\/about-retinoblastoma\/artificial-eyes\/\"><span class=\"ha-btn-text\">Learn more<\/span><\/a>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-5fd39e1 e-con-full e-flex e-con e-child\" data-id=\"5fd39e1\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9696137 ha-infobox-media-dir-top ha-has-bg-overlay elementor-invisible elementor-widget elementor-widget-ha-infobox happy-addon ha-infobox\" data-id=\"9696137\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"ha-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div class=\"ha-infobox-body\">\n\t\t\t<h3 class=\"ha-infobox-title\">  Consulting<\/h3>\n\t\t\t\n\t\t\t<a class=\"ha-btn ha-btn--link\" href=\"https:\/\/kinderaugenkrebsstiftung.de\/en\/about-retinoblastoma\/consulting\/\"><span class=\"ha-btn-text\">Learn more<\/span><\/a>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b76764f e-con-full e-flex e-con e-child\" data-id=\"b76764f\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;_ha_eqh_enable&quot;:false}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f63245a ha-infobox-media-dir-top ha-has-bg-overlay elementor-invisible elementor-widget elementor-widget-ha-infobox happy-addon ha-infobox\" data-id=\"f63245a\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"ha-infobox.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\n\t\t\n\t\t<div class=\"ha-infobox-body\">\n\t\t\t<h3 class=\"ha-infobox-title\">  Early support<\/h3>\n\t\t\t\n\t\t\t<a class=\"ha-btn ha-btn--link\" href=\"https:\/\/kinderaugenkrebsstiftung.de\/ueber-das-retinoblastom\/fruehfoerderung\/%20\"><span class=\"ha-btn-text\">Learn more<\/span><\/a>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Aftercare Why? Follow-up care is essential to ensure that long-term effects and relapses are detected and treated as early as possible. One of the KinderAugenKrebsStiftung&#8217;s main concerns is to ensure that our children remain healthy and well cared for in the long term. To this end, we regularly attend conferences and training sessions to stay [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":12285,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-12328","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/pages\/12328","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/comments?post=12328"}],"version-history":[{"count":0,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/pages\/12328\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/pages\/12285"}],"wp:attachment":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/media?parent=12328"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}