Solid tumors are what we traditionally think of when we think of cancer – a lump, swelling or a mass cancer – however, solid tumors in children are very different from solid tumors in adults. Treatment strategies will vary based on the size of the tumor and type of cell which because cancerous, as well as its location in your child's body.
Custom treatment plan
Treatment for solid tumors is highly individualized. We take into account the type of tumor, the stage, details about mutations which can be found in the tumor tissue, and your child’s age and size; we then combine all this information to identify the treatment with the highest cure rate and the fewest side effects known. Because cancer in children, adolescents and young adults is rare, all physicians who treat it look to colleagues around the world to help guide treatment decisions
Treatment for solid tumors is highly individualized. We take into account the type of tumor, the stage, details about mutations which can be found in the tumor tissue, and your child’s age and size; we then combine all this information to identify the treatment with the highest cure rate and the fewest side effects known.
The most successful treatment plans are the result of decades of continuous small improvements made by doctors around the world who treat childhood cancer.
Our specialists develop an individual plan for each child that includes initial treatment and follow-up care. These plans take into account the unique needs of each patient and their family, including quality of life.
Steps
Biopsy
Before effective treatment can start, your child’s team of doctors needs to know exactly what kind of tumor they are dealing with and whether it has spread to other areas of the body. A “biopsy”, an examination of tissue, allows pathologists to examine a piece of the tissue under the microscope to determine some of the important details we need to develop the best treatment. Childhood cancer is rare and there are dozens of different variations so most children’s hospitals rely on national or international experts to help us make the most accurate diagnosis possible. Your child’s biopsy may be sent to highly experienced pathologists around the country to confirm our first impression. This tissue will also be examined to see if there were common mutations in the DNA of the cancerous cells which may have allowed the tumor to grow and spread or which help us predict its future behavior.
Staging Work-up
A “staging workup” is the step in which we look at other areas of the body with CT scans, MRIs or biopsies to see if the tumor has spread. We also want to make sure that your child's body is healthy enough to receive the medication needed to treat the tumor. This step we will make sure their heart, lungs, kidneys, liver or other organs are healthy and in good shape.
Treatment
Surgery is the most common treatment. Some patients receive radiation therapy and/or chemotherapy, either in addition to surgery, or instead of surgery.
Research
Cancer in children, adolescents and young adults is rare. Doctors who treat childhood cancer, work with colleagues around the world to help guide treatment decisions. Because we want to improve our treatment, your child may be offered the opportunity to participate in clinical research if they are eligible. The Children's Oncology Group is a research organization made up of nearly all hospitals in the US who treat childhood cancer and many institutions in Europe, Canada, Australia and other countries. As a member, we share in the development and use of their successful treatment plans. Participation in research is completely optional but is common throughout the world. Whether you choose to sign on to research or not, your child’s treatment plan will be one that has been used in other children and proven to be effective.
Our team of specialists
We have a team of pediatric specialists to help you and your child during all the stages. There is a complex team of specialists to treat your child at the different stages of their cancer treatment. We are here to guide you through every step.
At the top of the list and of great importance to you – your nurses. Our highly trained nurses are the most caring individuals you are likely to meet on this cancer journey. You and your child will spend more time with your nurses than with most of the other specialists listed below.
Our care team is made up of many pediatric specialists:
- Oncologist - A pediatric oncologist ("cancer doctor") is responsible for gathering all the information about your child's tumor and developing a treatment plan and a plan for long term follow-up once your child completes treatment. Pediatric oncologists work closely with our pediatric oncology nurse practitioners. They also do checkups, order chemotherapy, look for, prevent and treat side effects. The oncologists also coordinate with other specialists on the cancer team.
In addition to your pediatric oncologist, many specialists may be involved in your child’s care if he or she has been diagnosed with a solid tumor.
- Anesthesiologists are very important in the care of children with cancer, allowing us to perform many possibly painful or long procedures while the child is safely sedated.
- General pediatric surgeon may help us with a biopsy or do the surgery that removes the tumor, if that is possible.
- Neurosurgery may be brought in for brain or spinal cord tumors.
- Orthopedic surgeons may provide surgery for tumors in bone or large muscles.
- Otolaryngologists (ENT, or Ear, Nose and Throat surgeons) might be requested to biopsy certain tumors in the head and neck.
- Interventional radiologists are specially trained imaging doctors who use CT scans or ultrasound to guide a biopsy.
- Radiation oncologist - A radiation oncologist is a highly specialized physician who helps plan and administer radiation therapy for those children who may need it.
- Radiologists - Radiologists are critically important for looking at the extent of a tumor and helping us follow its response to treatment. They may specialize in nuclear medicine, ultrasound or imaging of the brain and spinal cord (neuroradiologists). You and your child may never meet them in person, but they are critical team members “backstage”.
- Pathologists - Pathologists are scientists who examine samples of tissue for diagnostic purposes.This helps us make the initial diagnosis and help with transfusion medicine.
- Urologists may be brought in to assist with diagnoses involving the bladder or testes.
Because treating cancer is complicated, we have other pediatric specialists that may be called upon during your child's care, depending on complications or reactions to treatment and medication.
- Cardiologists – for problems with the heart
- Emergency doctors – for after-hours emergent care
- Endocrinologists – for diabetes or hormonal problems
- Gastroenterologists – for stomach and intestinal problems
- Geneticist – for children with cancer predisposition
- Hospitalists – general pediatricians who work exclusively in the hospital
- Infectious disease doctors – for unusual or serious infections
- Intensivists – for children who become very ill in intensive care
- Nephrologists – for kidney or blood pressure problems
- Neurologists – for seizures or headaches or other neurological problems
- Ophthalmologist- for eye complications
- Palliative care physician – for relief of symptoms of cancer or its treatment
- Physiatrists – for rehabilitation of children with severe complications
- Pulmonologist – for severe lung problems
- Psychiatrist – for serious mental health disorders
- Rheumatologist – for certain kinds of pain
Other members of the care team:
- Pharmacologist
- Dentist
- Audiologist (hearing testing)
- Dietitian
- Physical Therapist
- Occupational Therapist
- Speech/Language Therapist
- Respiratory Therapist
Care for the whole child
We know that children need emotional, spiritual and educational support, too.
- Psychologists
- Art therapist
- Music therapist
- Child Life specialist
- A social worker providers emotional and practical support and resources for patients and families
- A child life therapist and teacher works with each child
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