Pediatric Hematologist-Oncologist: You’re Childhood Cancer Specialist

What is a Pediatric Oncologist?

A pediatric oncologist specializes in researching, diagnosing, and treating blood disorders and cancers in children. Pediatric oncologists care for children with blood conditions, such as anemia and bleeding disorders, and cancers, such as brain cancer and leukemia. They often work as part of a health care team that includes surgeons, radiologists, pathologists, nurses, and social workers.

A pediatric oncologist usually:

• Diagnoses and treats childhood cancer and acute and chronic diseases and conditions affecting children's blood, including problems with blood cell production and blood clotting.

• Provides a care plan for cancer treatment, which may include recommending surgery to remove cancerous and precancerous cells, radiation therapy, or bone marrow transplant

• Prescribes medicines

• Orders or provides medical treatment to eliminate cancer, such as drug therapy, chemotherapy, radiation therapy, and immunotherapy

• Orders or provides palliative treatments, such as medications and physical therapy, to manage pain and symptoms

A pediatric oncologist may also be known by the following names: pediatric oncologist and pediatrician.

Who should see a pediatric oncologist?

Any child who is diagnosed or suspected of blood disease or childhood cancer should seek care from a pediatric oncologist. Children with cancer or chronic blood disorders, such as hemophilia, should see their pediatric oncologist regularly to monitor and treat their condition. Children whose family members have an inherited blood disorder or condition should see a pediatric oncologist for appropriate screening.

When should you see a pediatric oncologist?

You should seek care from an experienced pediatric oncologist when your child's primary care doctor or other doctor has diagnosed or suspects he or she has cancer or a blood disorder. The doctor who diagnosed your child should help you choose a pediatric oncologist with whom you can consult about further tests, reach a final diagnosis and design a treatment plan.

You can also request a referral to a pediatric oncologist second opinion about cancer or blood disorder diagnosis and a recommended treatment plan.

What conditions and diseases does a pediatric oncologist treat?

A pediatric oncologist treats childhood cancers and blood conditions and diseases that affect children including:

• Anemia and red blood cell disorders including sickle cell disease, chronic anemia of anemia, hemolytic anemia, pernicious anemia, aplastic anemia, thalassemia (abnormal hemoglobin), polycythemia (too many red blood cells), and nutritional anemias such as iron Deficiency include anemia.

• Bleeding disorders including hemophilia, von Willebrand's disease, and idiopathic thrombocytopenic purpura (ITP), a condition in which you don't have enough platelets to clot normally, and bleeding under the skin can cause bruises and small red bumps make purple spots.

• Blood clotting conditions including thrombophilia and childhood stroke

• Childhood cancers including brain cancer, neuroblastoma, Ewing sarcoma, Wilms' tumor, leukemia, and lymphoma

Human immunodeficiency virus (HIV/AIDS), including AIDS-related lymphoma and anemia

• Malaria, is a mosquito-borne disease. The malaria parasite infects red blood cells and causes high fever and shivering.

• Neutropenia (inadequate white blood cells) including Kostmann syndrome and other congenital neutropenia, autoimmune neutropenia, neonatal neutropenia, and idiopathic neutropenia

What tests do pediatric oncologists perform or order?

A pediatric oncologist may order or perform a wide variety of diagnostic and screening tests including:

• Blood plasma and platelet tests including prothrombin time (PT), partial thromboplastin time (PTT), and thrombin time to evaluate bleeding and clotting disorders; and examine the blood.

• Genetic testing for sickle cell anemia, hemophilia, and other inherited blood disorders

• Imaging studies including ultrasound, X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI)

• Laboratory tests including complete blood count (CBC), urinalysis, erythrocyte sedimentation rate (ESR, a measure of inflammation), and other blood tests to diagnose anemia, infection, and cancer.

What procedures and treatments do pediatric oncologists perform or order?

Pediatric oncologists order or perform a variety of procedures and treatments to manage childhood blood diseases and cancers. Many pediatric oncologists are trained in both medical and surgical treatment. However, your pediatric hematology-oncologist can provide referrals to other specialists in the field of pediatric hematology-oncology. For example, if your child needs this type of procedure, you may be referred to a doctor who specializes in stem cell transplantation. Common procedures and treatments include:

• Anemia treatment includes blood transfusions, vitamin and nutritional therapy, antibiotics and immune-suppressive drugs to treat hemolytic anemia, and drugs to increase blood cell production

• Bleeding treatments including medications, platelet transfusions, and clotting factor transfusions

• Blood cancer treatment including chemotherapy, radiation therapy, biological therapy, and stem cell transplantation

• Bone marrow transplants to treat leukemia, aplastic anemia, and certain immune deficiency diseases

• A surgeon inserts a semi-permanent catheter or port through which your child receives chemotherapy and other medicines as part of cancer treatment.

Clotting treatments include anti-clotting medications (anticoagulants such as warfarin), clot-busting drugs, and catheter-guided thrombolysis, which is a minimally invasive procedure to destroy blood clots.

• Medical treatment, including chemotherapy and immunotherapy, to cure or prevent cancer from spreading

• Palliative treatment, including medications and physical therapy, to manage pain and other symptoms

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