Stories about: Dana-Farber/Boston Children’s

In Myanmar, oncology expertise travels from nurse to nurse

Image of global health team with nurses in Myanmar Through the Dana-Farber/Boston Children’s Global Health Initiative and World Child Cancer, oncology nurse Amy Federico, RN, CPNP, had the opportunity to travel to Yangon, Myanmar, to share her oncology expertise with the staff at Yangon Children’s Hospital. Amy’s interest in global health began eight years ago, but the trip to Myanmar in October 2017 strengthened her commitment to share her knowledge across borders. Amy, who is a nurse practitioner specializing in care of patients with solid tumors at the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, reflects on her experience abroad:

My interest in global health care has developed over the past eight years since I started attending the Society of International Oncology Pediatric annual conferences. So when Lisa Morrissey, MPH, MSN, RN, CPHON, asked me to join her and Kathryn Barrandon, MPH, BSN, CPN, on an educational trip to Myanmar, I enthusiastically accepted.

One of the pediatric oncologists at Yangon Children’s Hospital requested solid tumor nursing education so I knew this would be a wonderful opportunity to share my years of oncology experience, especially my expertise in caring for patients with solid tumors. The experience would also give me a better global perspective of health care delivery in another part of the world.

On October 27, we set off on our 22-hour, three-leg, 8,300-mile journey from Boston to Yangon. I realize now, more than ever, that access to health care depends upon where you are born and where you live.

The day after our arrival, Lisa, Katie and I toured the oncology ward. I was astounded by the overly crowded — yet oddly quiet — patient bays, ill-looking children and desperate-yet-hopeful parents. Occasionally, a parent or patient would poke his or her head out a door or up to a window, curious about the three of us visitors. Admittedly, I was saddened by the environment.

The next day, I was relieved when we returned and were greeted by 32 energetic and excited nurses from nine hospitals across four Myanmar states. In addition to providing oncology education, our goals were to advocate for specialty nursing practice and to provide collegial support to conference attendees. …Read More

Challenging cases: Managing chronic lung disease after stem cell transplant

Helping our patients survive and thrive after stem cell transplant.It’s Donate Life Month, and at Boston Children’s Hospital’s Division of Pulmonary and Respiratory Diseases, we’re focused on helping our lung transplant recipients survive and thrive year-round.

We give these most critically ill children the best chance by working across disciplines to develop a long-term care plan, using new and innovative therapies when available. We are one of the few pediatric centers to offer photopheresis, a therapy that has been beneficial in treating graft vs. host disease (GVHD) and graft rejection in lung transplantation.

Craig Gerard, MD, PhD and team manage a challenging case.
Craig Gerard, MD, PhD

“As many stem cell transplant (SCT) patients later battle chronic lung disease, they are well served by our integrated team approach involving specialists in pulmonology, endocrinology and dermatology as well as experts in oncology from Dana Farber/Boston Children’s Cancer and Blood Disorders Center,” says Craig Gerard, MD, PhD, chief of the Division of Respiratory Diseases and the Leila and Irving Perlmutter Professor of Pediatrics.

Read the case of a patient treated with a bilateral lung transplant for pulmonary complications after SCT for refractory acute lymphoblastic leukemia who is now thriving.

…Read More

Dispatch from the Dominican Republic: Partnering for cancer pain and palliative care education

nurses doctors clinicians palliative care pain medicine childhood cancer Dominican Republic
Lisa Morrissey (center, in blue) and clinicians from UHOP and Dana-Farber/Boston Children’s.

Pediatric cancer is curable when diagnosed early and treated appropriately; the survival rate for all childhood cancers surpasses 80 percent in most high-income countries. Yet in mid- to low-income countries, basic elements of pediatric oncology care are often lacking and outcomes are grim, with survival rates of 40 percent or less.

“Twinning” is a model where pediatric oncology programs in high-income countries partner with cancer centers in low-income areas to share expertise, resources and technology. One such example is the partnership Dana-Farber/Boston Children’s Cancer and Blood Disorders Center formed in 2011 with the Unidad Hemato-Oncologia Pediatrica (UHOP), the pediatric oncology program at the Hospital Infantil Dr. Arturo Grullon in Santiago, Dominican Republic. …Read More

Is the time right for pediatric precision cancer medicine?

precision cancer medicine personalized medicine pediatric oncology childhood tumors Vector
What is precision cancer medicine all about? See the full infographic at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.

Precision cancer medicine — an approach in which doctors treat a tumor based on its genetic profile, rather than where it is — has benefited a growing number of adults with cancer. It’s not yet a standard approach in pediatric oncology, but the times may be a-changing.

Our sister blog Vector reports on the results of the Individualized CAncer Therapy (iCat) trial, a four-center study led by Katherine Janeway, MD, PhD, clinical director of the Solid Tumor Center at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, that investigated the feasibility of clinical sequencing and precision medicine in patients with relapsed or refractory pediatric solid tumors. In 43 out of the study’s 100 participants, the iCat investigators made genetic findings suggesting a new treatment approach, a new diagnosis and/or a genetic predisposition to cancer.

The study joins a growing body of evidence in favor of incorporating sequencing into pediatric oncology care, at least among children with relapsed tumors.

“There’s a lot more going on than any one study would suggest,” Janeway says. “Every study, every paper is all part of one big story about bringing precision medicine to children with cancers.”

Read more about the iCat study on Vector. And visit the Thriving blog to read about a young patient who is now a brain tumor survivor thanks to precision cancer medicine.