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Annual Report - 2007-2008 - Cancer Care Cycle

Annual Report - Winter 2009

Momentum in Pediatric and Young Adult Care

Leukemia – Novel Process Could Improve Immune Therapy
Osteosarcoma, Certain Leukemias and Neuroblastoma – Marrying Two Therapies Creates Kinder Treatment
Proton Therapy – Child-Centered Approach Calms Young Fears
Profile: Caring For Patients, Caring for Families

Original research continues to flourish as MD Anderson’s pediatric and young adult program grows in size and stature with the establishment of the Children’s Cancer Hospital. A new program also seeks to involve the whole family in every aspect of care.

Leukemia – Novel Process Could Improve Immune Therapy

Tree sculptureResearchers have found a new way to keep natural killer “NK” cells active, while increasing their number from umbilical cord blood, then using them to kill human leukemia cells in mice.

“Cord blood is a promising source of natural killer cells because these cells have enhanced sensitivity to stimulation and decreased potential to cause graft-versus-host disease, and they are available off-the-shelf from cord banks throughout the world,” says Patrick Zweidler-McKay, M.D., Ph.D., assistant professor in the Division of Pediatrics, about work performed with Elizabeth Shpall, M.D., professor in the Department of Stem Cell Transplantation.

Reported at the May 2008 annual meeting of the American Society of Pediatric Hematology/Oncology.

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Osteosarcoma, Certain Leukemias and Neuroblastoma – Marrying Two Therapies Creates Kinder Treatment

A combination therapy has the potential to treat several types of childhood cancer without adding much toxicity. “Traditional chemotherapy kills fast-growing cells like cancer, but also kills healthy, fast-growing cells, like hair, bone marrow and mucous membranes, making the drugs very toxic,” says Dean Lee, M.D., Ph.D., assistant professor in the Division of Pediatrics in the Children’s Cancer Hospital.

“A newer class of epigenetic drugs, called histone deacetylase inhibitors, affects gene expression in a cell without directly affecting the gene itself. We found that some of these drugs can make cancer cells more recognizable and vulnerable to natural killer cells. Combining these drugs with administration of natural killer cells from a donor could be used in patients who can’t tolerate more toxic therapies.”

Reported at the May 2008 annual meeting of the American Society of Pediatric Hematology/Oncology.

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Proton Therapy – Child-Centered Approach Calms Young Fears

MD Anderson’s Proton Therapy Center is the only one in the country to treat children of all ages. Because the precision of the therapy requires them to remain perfectly still, children younger than 8 years old are sedated. To ease their fears and anxieties during the treatments, Vivian Porche, M.D., head of the PTC anesthesia service, and Cynthia Williams, the lead nurse anesthetist and coordinator of the service, have devised a program that includes making sure parents and their children feel as comfortable and secure as safely possible.

This approach includes pre-treatment meetings, hanging toys from the gantry, singing their favorite songs and even letting children push the buttons to start the anesthesia. The hopes are that the proton therapy — a pencil-thin beam of radiation that accurately targets a specific area, causing little damage to adjacent normal tissue — will provide the children a better quality of life with fewer side effects as they age.

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Caring for Patients, Caring for Families

By Gail Goodwin

Patty Wells

Patty Wells, director of family-centered care in the Children’s Cancer Hospital at MD Anderson, is a pediatric nurse who has become an expert in the field.

“Family-centered providers acknowledge that involving families in hospital planning, evaluation and policymaking improves children’s care and that best practices are shaped by families and professionals working together,” Wells says.

It takes collaboration beyond the clinical level and creates advisory roles for patients and families.

Wells has been a nurse and administrator in several medical facilities and has always focused on pediatrics. Before coming to MD Anderson, she established the Family Resource Center and then the first Family Advisory Council and Patient Advisory Council at Cincinnati Children’s Hospital Medical Center. She discovered that family-centered care was a philosophy and practice she believed in.

At MD Anderson, she is helping incorporate family-centered care into the operations of the Children’s Cancer Hospital from the ground up. “It’s a lot of common sense and a lot of work that will require the efforts of everyone, but the payoff will be an improved patient and family experience that is safe and more efficient and energized,” she says. “Faculty and staff here are working past a fear of transparency and are turning patients and their families into partners who contribute to their own health care.

“We have a long way to go,” she adds. “We must incorporate the family-centered care language into all job descriptions, continue to educate everyone and celebrate and market what we have already accomplished. Family-centered care actually means including patients and families in every aspect of the medical experience, from bedside to policy making and everywhere in between.”

Family needs are consistent, Wells has discovered, but their experiences and perceptions are very different. “It’s my hope that as we move forward with family-centered care, everyone will discover that this is a win-win proposition for patients, families and everyone working at the Children’s Cancer Hospital.”

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