Childhood Cancer

Childhood Cancer

Standard treatment

The standard treatment (or standard of care) for each type and stage of tumor is the treatment that has worked best for the most children up to that point in time. The current standards of care are the result of decades of clinical research studies. As researchers analyze the results from ongoing or completed clinical trials, they accumulate knowledge and make changes in standard treatments. For example, in the first decade of the 21st century, most children with high-risk neuroblastoma received a standard treatment that included chemotherapy, surgery, radiation therapy, stem cell transplantation, and a 6-month course of 13-cis-retinoic acid. Carefully controlled clinical trials during that time demonstrated that the overall survival rate increased dramatically by adding courses of immunotherapy drugs at the end of treatment. As a result, the standard of care for children with high-risk neuroblastoma was changed.

To learn about the standard of care for your child’s type and stage of tumor, contact the National Cancer Institute’s (NCI) Physician Data Query (PDQ) by calling (800) 422-6237 (800-4-CANCER) or by going to the pediatric section of its website at www.cancer. gov/cancertopics/pdq/pediatrictreatment. PDQ provides information about pediatric solid tumors, state-of-the-art treatments, and ongoing clinical trials. Two versions are available online:

•  One for families—uses simple language and contains no statistics; and

•  One for professionals—is technical, thorough, and includes citations to scientific literature.

The study that our institution was participating in at the time of my daughter’s diagnosis was attempting to lessen the treatment to reduce toxicity yet still cure the disease. My family began a massive research effort on the issue, and we had several family friends who were physicians discuss the case with the heads of pediatric oncology at their institutions. The consensus was that since my daughter was at the high end of the high-risk description, it was advisable to choose the standard treatment, which was more aggressive than one of the parts of the proposed clinical trial.

If a cancer is very rare, extensive research may not have been done to determine a standard treatment. If your child is diagnosed with one of these tumors, the medical team will consult with other experts to create a treatment plan best suited to the type, stage, and location of your child’s cancer.