The Children's Cancer Hospital at MD Anderson Builds on a 50-year Record of Positive OutcomesMD Anderson Backgrounder 02/17/06
They’re among the most frightening words a parent can hear: Your child has cancer. Dismay, confusion, dread follow in quick succession. The search for quick solutions and instantaneous cures ensues. Finding none, families pray for the best, but prepare for the worst.
That good news could emerge from this darkest of clouds at this initial stage is light years from their minds. But the simple truth is, their child will likely be cured. More than 75 percent of children with cancer are alive five years after diagnosis, compared with 50 percent in the mid-1970s. Fundamental to this long-term success, however, are accurate diagnoses along with the best possible treatment and ongoing care for their child.
The Children’s Cancer Hospital at The University of Texas MD Anderson Cancer Center is delivering not just hope, but also positive outcomes for children with cancer and their families. Unlike most children’s hospitals, the Children’s Cancer Hospital has a single focus – treating cancer. It is home to one of the largest multidisciplinary pediatric cancer care programs in the nation. Just as important, the Children’s Cancer Hospital is positioned to leverage the extraordinary resources of MD Anderson, perennially ranked as one of the nation’s two best hospitals for cancer care by U.S. News and World Report. These resources include the new Proton Therapy Center, offering the most precise form of radiation oncology, and the BrainSUITE, an innovative technology for the diagnosis and treatment of complex brain tumors. Through a unique translational approach, innovative technologies and therapies like these are available to children and adolescents, as well as to adults.
With a history of more than 50 years of providing outstanding pediatric inpatient cancer care, the Children’s Cancer Hospital has never had a greater array of world-class resources at its disposal:
- A strong research program in which its own scientists work collaboratively with the faculty in the adult disease centers at MD Anderson (including neuro-spine, leukemia, blood and marrow transplantation, sarcoma and gynecology) to develop novel treatment strategies for cancers that afflict children, adolescents and young adults.
- One of the leading multidisciplinary cancer care programs, providing more than 1,200 young patients each year with a full range of clinical, nursing and support services tailored for children and adolescents to meet their physical, developmental, psychosocial and educational needs.
- A faculty of physicians and scientists who have distinguished themselves for pioneering and discovering new therapies for childhood cancer, including the first successful chemotherapy for inoperable Wilms’ tumor, developing a limb salvage procedure now used on about 80 percent of pediatric patients treated for malignant bone tumors, and the nation’s first infant screening program for the early detection of neuroblastoma.
- The addition in 2005 of 12 new pediatric oncologists from such prestigious institutions as The Children’s Hospital of Philadelphia, Mayo Clinic, St. Jude Children’s Research Hospital, the Klinik Hedwig (Germany) and the Children’s Hospital at Children’s National Medical Center.
- Revolutionary new technologies like that of the new Proton Therapy Center at
MD Anderson, which will offer patients of all ages – adults and children alike – treatments more precise and powerful than anything currently used to target and destroy cancer cells, while leaving nearby healthy tissue unscathed (see sidebar).
New Identity…Same Intense Focus
Underscoring the rapid and exciting pace of change at MD Anderson is a new identity for its pediatric cancer care program. On Feb. 10, 2005, nearly 50 years to the day MD Anderson opened its first pediatric inpatient unit, The University of Texas System Board of Regents approved naming it the Children’s Cancer Hospital at The University of Texas MD Anderson Cancer Center – or simply the Children’s Cancer Hospital.
The Children’s Cancer Hospital is not a separate hospital, nor is it a freestanding facility apart from MD Anderson. Rather, it is a hospital within a hospital. “Oftentimes, families reeling from a cancer diagnosis don’t immediately associate MD Anderson with children or young adults,” says Eugenie S. Kleinerman, M.D., head of the Division of Pediatrics.
“But with our new name, the Children’s Cancer Hospital will reach a much higher level of awareness among families and referring physicians in the communities. They will come to know that MD Anderson is world-class when it comes to treating younger patients as well as adults.”
In addition to the research laboratories, which are located at the R.E. “Bob” Smith Building, the Children’s Cancer Hospital also includes three specialized components to meet the needs of young patients:
- The George E. Foreman Pediatric and Adolescent Inpatient Unit is a 26-bed facility for children and adolescents on the ninth floor of the Albert B. and Margaret M. Alkek Hospital. This self-contained unit with two nursing pods provides a nurturing environment for all children who need to be hospitalized, including those receiving bone marrow, stem cell or umbilical cord blood transplants. The unit also contains primary and secondary school classrooms, counseling rooms, neuropsychology testing rooms, playrooms, a teen lounge, a large recreational area with a basketball hoop, a library, a laundry room and a kitchen. Children requiring critical care are moved two floors below to the four-bed pediatric intensive care unit staffed by faculty and nurses who specialize in caring for of the critically ill children with cancer.
- The Robin Bush Child and Adolescent Clinic, where young patients come for outpatient visits and therapy comprises 10 examination rooms, a playroom, a large waiting area and a 10-bed ambulatory treatment center. It is named in memory of the daughter former President George H.W. Bush and Barbara Bush lost to leukemia in 1953.
- Kim’s Place is a colorful and upbeat recreation area decorated with comfortable couches and restaurant-style booths. Amenities include a pool table, a jukebox, a mini kitchen, video games and basketball free-throw machines. This warm oasis welcomes adolescent and young adult patients between the ages of 15 and 25. Kim’s Place was created as a tribute to Kim Perrot, a guard for the four-time champion WNBA Houston Comets. Perrot waged a brave battle against cancer before succumbing in 1999 at the age of 32. A generous grant from the Houston Comets, the Houston Rockets and businesses and individuals made it possible to open Kim’s Place in 2003.
Meeting an Extraordinary Range of Psychosocial Needs
Dr. Kleinerman captures the spirit and personality of the Children’s Cancer Hospital perfectly when she says, “Our new name not only helps us roll out the welcome mat for young patients and their families, but also emphasizes what we have known and practiced for years: that kids with cancer are still kids.”
Indeed, while providing the best in research-driven care, the hospital also caters to the emotional, familial, developmental and educational needs of young patients, enabling them to progress through the normal milestones in life. Kid-friendly rooms, alive with bright colors, toys and special blankets from home, make hospital stays just a little easier. The parties, summer camps, ski trips, art and music classes, exercise programs and other activities that kids love add another dimension. Many of these activities are funded by the Children’s Art Project, which has turned the original artwork of young cancer patients into a thriving business.
Family members are an integral part of the healing environment at the Children’s Cancer Hospital. Because the whole family may need emotional and psychological support, a team of psychologists, psychiatrists, social workers and child life staff are available to all at the Children’s Cancer Hospital.
Follow-up and support for cancer survivors have become more critical given the dramatic increases in cure rates for childhood cancers. The Children’s Cancer Hospital provides extended care to help patients better cope with the emotional, social and physical difficulties that result from cancer and its treatment. To ease each patient’s transition back to school, for example, teachers and childlife specialists from the Children’s Cancer Hospital visit the school to educate the teacher and students about the child’s disease and to prepare them for what to expect. Adolescents receive vocational counseling, college planning and more through MD Anderson’s Adolescent and Young Adults Program.
Skilled Physicians and Nurses Round Out the Team
The multidisciplinary care approach at the Children’s Cancer Hospital includes a growing team of 27 professionals, including pediatric oncology physicians, pediatric intensive care specialists, behavioral medicine specialists and faculty investigators with a laboratory research focus. These professionals work closely with specially trained nurses and support care specialists to ensure that the child’s physical, developmental, psychological and educational needs are met. For example, a multidisciplinary brain-tumor team evaluates each case and plans the child’s treatment, which may include surgery, chemotherapy, radiation therapy or a combination. The team monitors the child from diagnosis through therapy and follow up care.
Unsurpassed Surgical Expertise and Clinical Resources
At the core of the professional team approach is a group of dedicated cancer surgeons who give the Children’s Cancer Hospital a breadth and depth of expertise found in few other medical centers. These surgeons specialize in treating pediatric cancer patients, and each has extensive expertise in a particular type of tumor such as bone, brain, soft tissue and lung.
The bone marrow transplant facility, staffed with experts in transplantation procedures, is a designated transplant center for the National Marrow Donor Program and one of the first to use cord blood for transplantation in children. The Pediatric Hematology clinic provides blood transfusions, hydroxyurea treatments for sickle cell anemia and therapies to correct iron overload in chronically transfused children.
Making Cancer History means not just treating but also eradicating the disease. Despite the progress that’s been made, the American Cancer Society reports that in the United States, cancer kills more children ages 1 to 14 each year than any other disease – more than asthma, diabetes, cystic fibrosis and AIDS combined. The Children’s Cancer Hospital is committed to discovering and implementing new therapeutic approaches to improve cure rates.
No one better epitomizes these goals than Kleinerman, who has worked tirelessly over the past 25 years to develop novel therapeutic approaches for pediatric cancer based on her laboratory research. Her research on how osteosarcoma cells spread from the bone to the lung as well as the technique she discovered for treating bone cancers that have spread to the lung have gained Kleinerman an international reputation.
As MD Anderson’s first female clinical division head, Dr. Kleinerman has become a passionate advocate for including children in new drug clinical trials so they can derive the same therapeutic benefits as adults. To that end, she is attempting to generate greater interest among federal agencies to fund pediatric cancer research, as well as encouraging pharmaceutical companies to open drug trials to children under age 18.
“We know that research can be very successful, yet few clinical trials exist with new targeted agents for children,” says Dr. Kleinerman. “With the growing recognition of pediatric oncology, we’re hopeful that more and more young patients will be brought into the early phases of drug and treatment protocols.”
At the Children’s Cancer Hospital, however, patients don’t have to be enrolled in large national cooperative group clinical trials to reap the therapeutic rewards. They can benefit quickly from the findings and insights of MD Anderson’s adult clinical research program, which conducts more clinical trials than any other cancer care center in the country. “Our researchers and clinicians are constantly monitoring and sharing these studies, then incorporating them into the therapies of young patients as soon as it can be done safely and efficaciously,” explains Kleinerman. “This is a major advantage for children and their families that most hospitals aren’t able to provide.”
The results speak for themselves. Over the past decade, the Children’s Cancer Hospital has pioneered numerous anticancer or supportive care treatments for children and adolescents. The Children’s Cancer Hospital is a leader in using umbilical cord blood for transplantation. Children’s Cancer Hospital investigators initiated studies that established the effectiveness of clofarabine in relapsed childhood leukemia. They also conducted the first clinical trials in the United States using oral antibiotics to treat low-risk fever and neutropenia, thus opening the door to outpatient therapy.
Landmark research by Kleinerman led to the development of the immunotherapy Liposomal MTP, which, when combined with chemotherapy, increased the cure rates for children with osteosarcoma. Liposomal MTP activates the body’s immune system to destroy drug-resistant cancer cells in the lungs. Kleinerman and Peter Anderson, M.D., Ph. D., are investigating aerosol chemotherapy to treat tumors that have spread to the lungs.
This new administration approach employs a hand-held nebulizer that can easily be used at home under the direction of a nurse. It is currently in clinical trials exclusively at MD Anderson.
For Kleinerman and her team of scientists, the job is just beginning. As part of the hospital’s expanding research platform, trials are under way to:
- uncover the genetic alteration in tumors
- determine why tumor cells are resistant to chemotherapy
- develop more effective transplant therapies
- investigate gene therapy and aerosol chemotherapy for treating lung metastases
- understand what causes learning disabilities in children with brain tumors and neurofibromatosis.
Though childhood cancers are relatively rare, they are very real to the children and families dealing with them. The Children’s Cancer Hospital is committed not only to treating cancer but also to advancing researchers’ understanding of molecular abnormalities and identifying new therapeutic approaches for children. Fifty years after opening its first pediatric inpatient unit, the Children’s Cancer Hospital is meeting that challenge with state-of-the-art research and patient care programs and a single-minded dedication to Making Cancer History – for children and adolescents.