Center for Cancer & Blood Disorders

What to Expect

Cancer is a broad term for many diseases that affect different parts of the body. Cancer means that certain cells in the body are growing too fast. These cells don’t look or act like normal cells. Normal cells in the body grow, divide and die in an orderly way. Cancer cells do not know when to stop growing and dividing. This abnormal growth may cause normal tissue to die or all the cancer cells can group together in a lump (called a tumor).

Anyone can get cancer—adults, children, dogs, cats, and even trees. There are more than 100 types of cancer, and they are grouped by where the cells come from.

Cancers are different in how fast they grow, where they spread, and how they respond to treatment. An effective treatment for one type of cancer may have no effect on a different type. For this reason, your child’s cancer treatment is made specifically for her type of cancer. It is important to learn as much as possible about your child’s type of cancer and all the places it occurs within the body at the time of diagnosis.

Cancers & Treatments

In general, cancer can be divided into two categories: liquid tumors (leukemias) and solid tumors. There are many medical treatments and procedures that may be a part of a child's multidisciplinary cancer treatment, however, there are three main courses of treatment for most cancers - chemotherapy, radiation therapy, and surgery. Our doctors and care team decide the best course of treatment for each individual patient.   

Clinic Appointment

At our clinic you will be checked in with the front desk staff. Then our technicians will call you back and get a set of vital signs. You will then see a clinic nurse who will collect labs from a central line or access a port and collect labs. Then you may return to the waiting room while your labs are resulted or be taken to a room. Once in the room you will be seen by a clinic nurse, APP/Fellow Physician, and your Primary Oncologist where the team will answer all questions, do a thorough exam and explain the treatment plan for that day. If you need an infusion or transfusion you may then be taken to your infusion area. 

Inpatient Care

You will check in with admitting and then come to the 4th floor where they will tell you your assigned room. An admission nurse will collect labs from a central line or access a port and collect labs, and a health care technician will get your child’s vital signs. Your child will then be seen by an APP/Resident physician who will ask you all about symptoms, histories, and medications. This provider will put in admission orders and communicate with the attending physician rotating through the hospital service who will then see you. If you are coming for chemo you will be hydrated, and your child’s urine will be monitored and once it is dilute enough (indicating they are well hydrated) they will receive their scheduled chemotherapy. While you remain in the hospital your vitals and appropriate labs will be monitored to ensure your child is tolerating chemotherapy safely. Supportive medicines for nausea, pain, and any other symptoms your child might have will be given throughout their hospital stay. 

Chemotherapy

Before receiving chemotherapy, your child will usually need to be hydrated with fluids. Most chemotherapy regimens give you several chemotherapy medicines each day. During the chemotherapy infusion it is typically anticlimactic and feels no different than an infusion of fluids. Then many chemotherapies will have an insidious onset of nausea a few hours later that may last up to several days. We will give anti-nausea medicines frequently as often as every 2 hours. The patient then often needs post hydration and sometimes other supportive care medicines. This may occur from 1-8 days depending on your planned treatment. Then you will usually be sent home taking scheduled anti-nausea meds for 2-4 days at home. Most chemotherapy cycles are given every 2-4 weeks for multiple rounds over several months. Labs and symptoms are followed regularly between cycles. 

Radiation Therapy

Radiation therapy is a form of x-ray treatment. The type of ray used in radiation therapy is different from the x-rays used to take pictures of the body. It stops cancer cells from growing and making more cancer cells. Radiation therapy is usually done on the specific body part that has a tumor. It is very important that children hold still when they are receiving this therapy so that no other body parts receive radiation. Children usually have to remain still for 5 to 15 minutes, and the care team may help your child relax with medicines or relaxation techniques if they need it.

Surgery

Surgery may be used to take a tiny piece of tissue from your child’s cancer area. This process is called a biopsy. The biopsy helps doctors know your child’s type of cancer. Surgery may also be used to remove a tumor. This may be done before any other treatment or after chemotherapy has had a chance to shrink it.

Your care team will completely explain surgery to you and your child. Sometimes children need medicine to help them relax or sleep. Other times, a procedure is very simple and they can be awake. Don’t be afraid to ask your care team any questions you have about surgery. 

Patient and Family Centered Care 

We want this to be the best possible experience. We want you to write down questions or concerns you might have, and we know these will come up throughout treatment please ask so we can keep the lines of communication open. Feel comfortable talking about all types of treatments you think might benefit your child. We want to treat your child as a whole person and have a fantastic supportive care and integrative medicine team to facilitate that. We may ask about family medical history especially regarding blood disorders/cancer, please bring that information if you know of any family members with these types of conditions. 

Hollywood and the internet have painted a terrible picture of cancer treatment with constant vomiting, pain, and other discomforts. We want our families to know that we care deeply about making this process as effective, comfortable, and safe as is possible. We have many supportive care medicines to help with side effects so that our patients are typically able having minimal vomiting, little to no pain, and nutrition support.  

Your child can expect: 

  • Comfortable and state of the art consultation rooms, imaging areas and inpatient care facilities 
  • Compassionate delivery of diagnosis and treatment procedures 
  • Complete support services including social work, patient education, chaplaincy programs and other resources. 
  • Coordinated care from highly trained specialists in pediatric blood disorders and childhood cancer 
  • Cutting edge basic and translational research studies in pediatric oncology and hematology aimed to improve health and long term survival 
  • Specialty comprehensive clinics for children and adults with hemophilia