Childhood Cancer: Best Advice for Parents

Robert I. Parker, MD, FAAP, Director of Pediatric Hematology/Oncology, discusses what parents need to know about childhood cancers.

What’s the first thing parents need to know about childhood cancers?

That it is not their fault. We don’t really know what causes childhood cancer, so there is nothing parents could have done differently to prevent it. As far as we know, for most childhood cancers, there are no identified environmental factors. We don’t really know what causes childhood cancer.  Further, the issue of “early detection” is relative.  The usual presenting signs of cancer in children are the same as for most common childhood illnesses and include fatigue, fever, loss of appetite, belly pain, swollen lymph nodes, etc.  Consequently, a diagnosis of cancer is generally not made until these complaints have persisted beyond what is usual for a typical illness.  So, just because the symptoms were there for a while, does not mean that either the parent or the pediatrician “missed” something.  In addition, the most common form of cancer in children, acute leukemia, is everywhere in the blood by the time it can be diagnosed and this fact has no impact on the cure-ability of the leukemia.

What kinds of decisions do parents face?

The first major one is where to pursue treatment. Often a parent’s first instinct is “We’ll go anywhere for the best treatment, even out of state.” While the sentiment is absolutely right, the reality is a little different. First, know that because of shared protocols and best practices, almost every pediatric oncology program delivers the same standard of care with similar outcomes. Instead, think about the level of support the hospital can deliver to you and your family. Consider the toll extended travel times can take on your sick child, as well as the rest of the family, especially if there are other small children at home. That’s why many times the best choice is a facility close to home. There are times, however, when it makes sense to travel for treatment, for instance if the child has a rare cancer for which only highly experimental therapy is recommended; or, if the child needs a complex surgical procedure that only a few pediatric surgeons can perform.

How should a parent evaluate a treatment facility?

In addition to the ease of access to the hospital and the expertise of your child’s medical team, there are two key things you need to look at in case your child has an emergency situation: the quality of the pediatric intensive care unit (PICU) and how sophisticated the blood bank is. Stony Brook’s blood bank is top notch and I believe our PICU is better than any in the New York area.

What else does Stony Brook offer?

Our innovative School Re-entry Program is a national model. Run by a nurse practitoner and a child life expert with an elementary education background, the program works with all schools in Suffolk and Nassau Counties to return children to school in the most productive setting possible. Our team makes classroom visits and presentations, answers questions, advocates for the child, coordinates services, works with faculty and administration, and generally helps the child get the education they need in a supportive environment.

For more information, call HealthConnect^® at (631) 444-4000.

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