Guidelines for the Pediatric Cancer Center and Role of Such Centers in Diagnosis and Treatment

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 916-917
Author(s):  
Keyword(s):  
Pediatric Oncology ◽  
Pediatric Cancer ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Tumor Board ◽  
Cancer Center ◽  
Pediatric Radiologist ◽  
Oncology Patient ◽  
Pediatric Oncology Patient

GUIDELINES FOR PEDIATRIC CANCER CENTERS The pediatric cancer center cannot be defined simply in terms of restriction by diagnosis and age group. It implies a multidisciplinary approach by a team of pediatric, surgical, radiologic, nursing, and paramedical specialists. The care of the pediatric oncology patient should be coordinated by a trained pediatric oncologist in a center that includes the following facilities and capabilities: (1) pediatric oncology nursing care in a specific area; (2) a pediatric intensive care unit; (3) pediatric radiologist and radiologic services that include lung tomography, computed axial tomography, ultrasonography, and angiography; (4) hematopathologic laboratory services capable of doing cell marker studies; (5) laboratories for the routine provision of drug levels; (6) blood cell component therapy; (7) a pharmacy familiar with antineoplastic agents; (8) clinical pharmacology services; (9) protective isolation; (10) personnel familiar with pediatric total parenteral nutrition techniques; (11) radiotherapist familiar with pediatric oncology problems and radiotherapy equipment which includes cobalt-60 or an accelerator with nominal beam energy of 6 meV or greater; (12) rapid section studies and operating room consultation at any time; (13) a multidisciplinary tumor board or its equivalent; (14) surgeons specializing in pediatric oncology; and (15) trained oncology social workers. ROLE OF CENTERS IN DIAGNOSIS AND TREATMENT Each year cancer is discovered in about 6,000 children in the United States. Fifty percent of these cancers are curable when the diagnostic and therapeutic techniques available today are instituted promptly. There are many reasons, some beyond any physician's control, for the failure to realize this potential cure rate, but among recognized factors are late detection, misdiagnosis, and inappropriate treatment.

scholarly journals Bezoar in a Pediatric Oncology Patient Treated with Coca-Cola

2015 ◽  
Vol 9 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Sara Naramore ◽  
Amy Virojanapa ◽  
Moshe Bell ◽  
Punit N. Jhaveri
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patient ◽  
Pediatric Oncology ◽  
Gastrointestinal Symptoms ◽  
Nausea And Vomiting ◽  
Diagnosis And Treatment ◽  
Intestinal Bleeding ◽  
Oncology Patient ◽  
Pediatric Oncology Patient ◽  
Gradual Onset

A bezoar is a mass of indigestible material. Bezoars can present with a gradual onset of non-specific gastrointestinal symptoms including abdominal pain, nausea and vomiting. However, bezoars can result in more serious conditions such as intestinal bleeding or obstruction. Without quick recognition, particularly in susceptible individuals, the diagnosis and treatment can be delayed. Currently resolution is achieved with enzymatic dissolution, endoscopic fragmentation or surgery. We describe, to our knowledge, the first pediatric patient with lymphoma to have had a bezoar treated with Coca-Cola.

scholarly journals Barriers to symptom management care pathway implementation in pediatric Cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
L. Lee Dupuis ◽  
Allison Grimes ◽  
Emily Vettese ◽  
Lisa M. Klesges ◽  
Lillian Sung
Keyword(s):  
Clinical Research ◽  
Pediatric Oncology ◽  
Pediatric Cancer ◽  
Symptom Management ◽  
Care Pathway ◽  
The United States ◽  
Care Pathways ◽  
Research Activities ◽  
Pediatric Cancer Patients ◽  
The Impact

Abstract Background Objectives were to describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation. Methods We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which the intervention encompassed care pathways for symptom management. A survey was distributed to site principal investigators prior to randomization to measure contextual elements related to care pathway implementation. Questions included the inner setting measures of the Consolidated Framework for Implementation Research (CFIR), study-specific potential barriers and the impact of the COVID-19 pandemic on clinical research. The Wilcoxon rank sum test was used to compare characteristics of institutions that agreed that their department supported the implementation of symptom management care pathways vs. institutions that did not agree. Results Of the 25 sites, one withdrew because of resource constraints and one did not respond, leaving 23 institutions. Among the seven CFIR constructs, the least supported was implementation climate; 57% agreed there was support, 39% agreed there was recognition and 39% agreed there was prioritization for symptom management care pathway implementation at their institution. Most common barriers were lack of person-time to create care pathways and champion their use (35%), lack of interest from physicians (30%) and lack of information technology resources (26%). Most sites reported no negative impact of the COVID-19 pandemic across research activities. Sites with fewer pediatric cancer patients were more likely to agree that staff are supported to implement symptom management care pathways (P = 0.003). Conclusions The most commonly reported barriers to implementation were lack of support, recognition and prioritization. The COVID-19 pandemic may not be a major barrier to clinical research activities in pediatric oncology.

Quality assessment of tumor boards across an academic and community cancer network.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 122-122
Author(s):  
Daniel Aaron Roberts ◽  
Robert Stuver ◽  
Igor Schillevoort ◽  
Jessica A. Zerillo
Keyword(s):  
Quality Assessment ◽  
Response Rate ◽  
Gynecologic Oncology ◽  
The United States ◽  
Tumor Board ◽  
Cancer Center ◽  
Measurement Tool ◽  
Tumor Boards ◽  
Assessment Survey ◽  
Cancer Network

122 Background: Cancer tumor boards (TB), or multidisciplinary team meetings are standard of care in oncology care worldwide. Specific components are described by the American College of Surgeon's Commission on Cancer Program. Most data show consistent improvement in outcomes including a change in diagnostic findings, treatment, and possibly improved survival with TBs. Methods: We adapted a performance assessment tool based on a validated survey implemented in the United Kingdom. An initial survey aimed at assessing tumor board structure and design was sent to 21 TB leaders, and subsequently a tumor board quality assessment survey was sent to 175 participants throughout an academic and community network. The quality assessment survey required participants to identify an answer on a 5-point Likert scale in the categories of "very poor, poor, average, good, and very good". Results: TB leaders representing 16 of 21 (response rate 76%) TBs responded to the structure/design survey. Twelve TBs were from the academic center and included diseases such as Gynecologic Oncology, Cutaneous Oncology, Genitourinary Oncology, and Sarcoma, while four were from community sites. TB leaders indicated that 55% of TBs did not receive CME credit and 60% did not document their recommendations. One hundred eleven TB participants of 175 (response rate 63%) responded to the quality assessment survey. Participants identified the following strengths: 1) all relevant subspecialties present for meetings, 2) respectful teamwork and culture, and 3) operating on an organized agenda. Areas for improvement included: 1) inconsistent tumor board recommendation documentation and 2) post-meeting coordination of care. Results were reviewed with network and cancer center leadership as well as with the Cancer Committee. Conclusions: We assessed our own tumor boards across our cancer network by utilizing an adapted version of a validated TB performance measurement tool for the first time in the United States. Through this assessment we identified key areas for improvement including the need for obtaining CME credit for TB attendance, and developed a policy, process, and template for documenting TB recommendations in an easily accessible centralized location.

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