PEDIATRICS Vol. 77 No. 6 June 1986, pp. 916-917
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Guidelines for the Pediatric Cancer Center and Role of Such Centers in Diagnosis and Treatment

Section on Oncology-Hematology

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.


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