about pediatric oncology:
Few words are as terrifying as the phrase, “Your child has cancer.” When you must hear those words, you want to be sure you are in the right place, surrounded by people who care. At Equipoise Healthcare, we are with you every step of the journey. We do not hesitate to seek a second opinion to confirm the diagnosis if there is any ambiguity or if the parent requests it. We read and research new results of clinical trials and new therapies. We spend a great deal of time performing patient education so that you understand what is happening with your child and what you can do to help. We want to treat you the same way we would want our own children to be treated. We love our children, and we love yours too.
People frequently ask us, “How can you handle working with children who have cancer?” For us, it is a calling and a vocation, never simply a job. Every child lives permanently in our hearts. We grieve the children we lose, and we also have much to be grateful for, as overall cure rates across various types of childhood cancer now approach 85%, a vast improvement from previous decades.
Nothing is more satisfying than seeing the smile on a child’s face when her life-threatening disease disappears and her body begins to heal. Bottom line: these kids are going to have cancer whether we are here or not, and we would far rather be here to take care of them than do nothing about it.
If your child is facing a cancer diagnosis, we stand with you.
childhood cancers:
- Leukemia
- Lymphoma (Hodgkin and non-Hodgkin)
- Brain tumors
- Medulloblastoma
- Glioblastoma
- Diffuse intrapontine glioma (DIPG)
- Atypical teratoid/rhabdoid tumor (ATRT)
- Osteosarcoma
- Ewing sarcoma
- Rhabdomyosarcoma
- Neuroblastoma
- Pleural pulmonary blastoma
- Hepatoblastoma
- Wilms tumor
- Ovarian and testicular germ cell tumor
- Teratoma
- Retinoblastoma
- Ganglioneuroma
- Ependymoma
- Vascular tumors
- Myelodysplastic syndrome
- Schwannoma
- Neurofibroma
- Benign tumors
and more...
cancer survivorship:
Curing cancer does not mean getting back to normal; it means embracing your new life.
If you are a survivor of childhood cancer, you need survivorship care! Survivorship is the journey that happens after cancer treatment is finished and relates to the chronic medical complications that can occur as a result of severe illness, cancer, chemotherapy, radiation therapy, and surgery. This is an area of research that blossomed in the past 20 years as, prior to that time, we didn’t have enough survivors living long enough to know what long-term problems they might face. Fortunately, we are now able learn from our patients and better tailor therapies to reduce long-term problems while providing better support for the journey that comes after cancer. At this time, we offer survivorship care up to the early adult years. Even if we didn’t treat you for your initial cancer, we can still support you as your body heals and minimize your long-term complications.
Some key facts about survivorship:
- 1 in 300 children will be a survivor of childhood cancer by age 20 years.
- 90% of survivor children will experience effects on their behavior, development, and psychological status, including depression, anxiety, ADHD, learning disabilities, and more.
- Chronic medical complications are common after cancer and can be improved with the help of a medical team familiar with survivorship care.
- Specific guidelines exist to mitigate the long-term effects of chemotherapy and radiation therapy.
cancer predisposition syndromes:
Solving a family tragedy: Dr. Stauffer's story
Decades ago, Dr. Stauffer’s mother and aunt were diagnosed with breast cancer in their 40’s. At that time, little was known about cancer predisposition syndromes, and breast cancer treatment was more toxic and less effective than it is now. Dr. Stauffer’s mother passed away, refusing treatment after the cancer relapsed. Dr. Stauffer was 13 years old, and this experience had a significant impact on her desire to be a physician. Dr. Stauffer’s aunt survived her first breast cancer only to develop another - not a relapse, but an entirely new cancer. At that time, the physician obtained genetic studies revealing a mutation in one of the BRCA genes - made famous after Angelina Jolie announced in 2013 that she has a BRCA mutation. In the meantime, Dr. Stauffer’s sister developed leukemia at the age of 31 years. Finding the mutation that was driving the development of cancer meant that survivors could get tested and take preventive steps to reduce risk.
After Dr. Stauffer tested positive for the same mutation that had been found in her aunt and sister, she felt grateful she had the chance to be more proactive. At the age of 42, similar to when her mother developed breast cancer, a pre-cancerous mass was found thanks to an annual screening MRI of the breast, and the choice was simple: Dr. Stauffer chose to undergo a mastectomy with reconstructive surgery. “Getting this news was scary, and I felt nervous at the time, but mostly I felt so grateful that the relentless disease that killed my mother could be handled just like that, and now I have confidence - as much as one can, knowing the uncertainties of life - that I’ll get to see my children grow up, and my children will grow up with their mother. I would do anything to prevent my children from experiencing the pain that I went through at that age.” says Dr. Stauffer. Dr. Stauffer undergoes a regular screening program recommended for patients with BRCA mutation, and she plans additional preventive steps down the road. Knowing her genetic status has allowed her to break the generational cycle of heartbreak, disease, disability, and early death. It’s also given her some closure about why this happened to her mother. “Understanding my mother’s genetics, (which wasn’t tested at the time, but we put the puzzle pieces together and figured it out) has helped me to understand and accept why such a terrible thing happened to such a beautiful person,” says Dr. Stauffer. “It wasn’t her fault. It wasn’t my fault. It wasn’t God’s fault. It was just a result of the gene that had been passed through our family, and now we have the opportunity to do something about it.”
about cancer predisposition syndromes
Many cancers have been linked to genetic cancer predisposition syndromes. A cancer predisposition syndrome is a genetic change (mutation) that drives the body towards a tendency for cancer. When we diagnose one of these syndromes, we often discover multiple affected family members as well. These syndromes are more common than previously thought, and there is much we can do to prevent, prepare, and treat. Some red flags that a cancer predisposition syndrome might exist are revealed by a family history that includes:
- Childhood cancer
- Cancer in young adults
- Hematologic cancers (cancers related to the blood, bone marrow, or immune system, including leukemia, lymphoma, myelodysplastic syndrome)
- Unusual cancers
- Breast or ovarian cancer before age 50
- Cancers involving endocrine (hormone) systems, i.e. thyroid cancer, pancreatic cancer, ovarian cancer
- Syndromic or genetic disorders associated with a known risk of cancer (see list below)
- Unexplained cytopenias (low blood cell counts of any type, and especially low white blood cells)
There are many cancer predisposition syndromes, and specific syndromes are associated with different patterns of cancer development, as well as other findings specific to the gene, for example, certain congenital anomalies (birth defects) or unusual skin changes. If your family history includes 1-2 of the red flags, then a genetic work-up for predisposition syndromes may be warranted.
For adults who are wondering if they have a cancer predisposition syndrome, we recommend contacting the University of Kansas Cancer Center for genetic testing in Kansas City. They offer virtual appointments to make the process more convenient for families. The best way to work-up a concerned family is to test the person who has or had cancer, as relatives without cancer may not have inherited the gene but that does not mean the gene mutation isn’t in the family. The link to their website is here:
https://www.kucancercenter.org/outreach/prevention/genetic-counseling-testing.
For children who are at risk of a cancer predisposition syndrome, we can evaluate them in our clinic. Call us today at 316-330-9700.
If your family has a known genetic mutation, then please bring a copy of the mutation to your first visit so we can test your child for this.
cancer predisposition syndromes:
- BRCA mutation
- Bloom syndrome
- Li Fraumeni syndrome (p53, TP53)
- Neurofibromatosis, types I and II
- Down syndrome (Trisomy 21)
- Job syndrome (Hyper IgE syndrome)
- Noonan syndrome
- Lynch syndrome
- Gorlin syndrome
- Cowden syndrome
- Multiple endocrine neoplasia, types I, II, III, IV (MEN)
- Peutz-Jeghers syndrome
- von Hippel-Lindau diseasea
- Tuberous sclerosis
- Beckwith-Weidemann syndrome
- WAGR
- Denys-Drash syndrome
- Frasier syndrome
- Juvenile polyposis syndrome
- Ataxia telangiectasia
- Xeroderma pigmentosum
- Nijmegen breakage syndrome
- Fanconi anemia
- Diamond-Blackfan anemia
- Schwachman-Diamond syndrome
- Dyskeratosis congenita
and more...
