Understanding childhood cancer
The treatment plan
When to call your treatment team
Home care recommendations (activity and rest, school, chicken pox exposure, taking temperatures, immunizations, etc.)
Digestive system side effects (mouth sores, diarrhea, constipation, nausea and vomiting, dehydration)
Bone marrow side effects (blood counts, bleeding)
Preventing infection
Pain
Body image changes
The treatment plan
Making the diagnosis
The initial evaluation by the doctor includes a health history, physical examination
and blood tests. Several other tests, depending on the location and the type of suspected cancer, may need to be done. These may include:
- Bone marrow aspiration and/or biopsy - a test to diagnose leukemia or abnormalities of the bone marrow. A needle is placed through a hard bone, (usually the back of the hip), into the bone marrow. A tiny bone marrow specimen is taken out with a syringe. The bone marrow looks like blood. The test takes about 5 minutes. Medicine is usually given before the test to lessen the pain.
- Lumbar puncture (LP, spinal tap) - The doctor or nurse inserts a needle into the back between 2 spinal bones to remove a sample of clear fluid that surrounds te brain and spinal cord. The fluid is examined under a microscope to look for cancer cells or infection. Medicines may be given through the needle if necessary.
- Tissue biopsy
- X-rays
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Bone scan - an X-ray test that uses a short-lived radioactive dye injected intravenously to find tumors or other abnormalities in the bones. The test does not hurt. The patient must lie stil for extended periods of time.
Other tests may need to be done once the diagnosis is made. Your doctor or nurse
will explain the necessary tests or scans according to your treatment plan.
Treatments
There are many ways to treat cancer. The type of cancer will determine which
of the following treatments will be used. More about treatment here »
A treatment plan may combine several different treatment methods. Your doctor and nurse will discuss the treatment plan with you for the patient’s specific disease. Additionally, you
may be asked to give consent for the patient to take part in a research treatment protocol.
This type of treatment plan provides the most up-to-date care for a disease. A protocol may be a study of a new treatment plan, and usually outlines the tests and treatments the patient will receive. These protocols are also referred to as clinical trials. We are committed to working with you to provide the best care possible. We recognize complementary and alternative therapies (e.g. aromatherapy, herbal or vitamin supplements, acupuncture, massage, hypnosis, modified diets, etc.) as health care options which you may choose to integrate with treatment the patient will receive at Children’s Memorial.It is possible that at times, complementary and alternative therapies might be of some benefit. More about complementary and alternative therapies here »
However, some of these therapies may not be advised during treatment. For this reason, it is important for you to let your health care team know of any other treatments the patient may be receiving so that we can safely and compassionately provide care tailored to your needs.
When to call your treatment team
Notify your treatment team immediately about any of the following symptoms:
Fever
- A temperature greater than or equal to 101º F once, OR
- Two temperatures greater than or equal to 100.5º F, taken at least one hour apart, within 24 hours.
Always take the patient’s temperature under the tongue or under the arm. NEVER take a temperature in the bottom (rectally), as it may cause bleeding or infection.
Difficulty breathing
- Coughing that does not stop
- Fast breathing
- Very slow breathing
- Shortness of breath
- Chest pain
Bruising or bleeding
- A nosebleed that does not stop after squeezing the nostrils firmly together for 10 minutes
- Bleeding gums
- Blood in the urine or stool (bowel movement)
- Bruising or tiny red spots (petechiae, caused by a shortage of platelets) on the skin
Exposure
Inform your treatment team of any exposure of the patient or anyone in contact with
the patient to chicken pox, shingles, measles, german measles, tuberculosis, or other
contagious diseases (diseases that are easily passed from one person to another).
Headaches
- Headaches that occur in the morning
- Headaches that do not go away
Pain
Rash
Changes in vision, hearing, balance or energy levels
Changes in normal behavior
Constipation
- No stool (bowel movement) in 3 days
- Pain with stool (bowel movement)
Diarrhea (loose stools that happen more than 3 times per day)
Nausea or vomiting
Inability to take fluids or medicine
Difficulty urinating
- Pain or burning with urination
- Decreased amounts or frequency of urine
If any of these symptoms occur, or if you are worried about the patient, call the hospital operator at 773.880.4000. If you are calling Monday through Friday, during the day, ask the operator to page your outpatient oncology nurse. If you are calling on evenings, nights, weekends or holidays, have the operator page the oncology doctor on call.