Cancer Treatment and Management in Children

Cancer Treatment and Management

• Zoster immune globulin may be administered to children who have not been immunized against varicella and are exposed to chickenpox during chemotherapy.
• Chemotherapy causes changes in body appearance, and open discussion with children and their parents can help maintain self-esteem.

Stem Cell Transplantation

• Stem cells from a healthy person's bone marrow can be transplanted to a child with cancer to help kill remaining cancer cells.
• Types of transplants include:
  • Allogenic transplant: stem cells are donated by someone who is histocompatible with the child.
  • Autologous transplant: the child's own cord blood is used.
  • Syngeneic transplant: stem cells are donated by a twin.

Transplantation Process

• The new stem cells enter the bone marrow and begin to function after about 3 weeks.
• The child is at extreme risk for infection during this time, and infection control precautions must be maintained.
• Blood products may be transfused to maintain functional blood components until the transplanted marrow begins to function.

Remission

• There are two types of remission:
  • Partial remission: the cancer is still present, but the tumor has decreased in size or the cancer has decreased throughout the body.
  • Complete remission: all signs of cancer are gone, but it does not mean the child is cured.

Leukemia Classification and Prognosis

• Leukemia is classified to define subgroups of cells and predict the usual response to treatment.
• B-lymphocyte cell types account for about 85% of instances of ALL, while T-lymphocyte cell involvement accounts for about 15%.

Cure as Goal

• The goal of therapy for leukemia is complete cure, based on the use of chemotherapeutic agents.

Anemia and Nutrition

• Anemia, leukopenia, and elevated liver enzymes are potential side effects of chemotherapy.
• Nutritional support is crucial, including reestablishment of dietary intake to restore physical health.

Scabies

• Scabies is usually spread by direct prolonged skin-to-skin contact with an infested person.
• Scabies mites can live on a person for up to 1-2 months and off a person for up to 48-72 hours.
• The female mite lays up to three eggs per day for the duration of her 30-60 day lifetime.

Nephroblastoma

• A nephroblastoma is usually discovered early in life (6 months to 5 years) and arises from an embryonic structure present in the child before birth.
• Symptoms include a firm, nontender abdominal mass, hematuria, and a low-grade fever.
• Diagnosis is made through CT scan or ultrasound, and kidney function studies are performed before surgery.

Therapeutic Management of Nephroblastoma

• The tumor is removed by nephrectomy, followed by radiation therapy and chemotherapy.
• A second surgical procedure may be scheduled after 2-3 months to remove any remaining tumor.