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Oncology

BC Children’s Hospital works collaboratively with the BC Cancer Agency and the Children’s Oncology Group to provide recommendations for investigation, treatment and follow-up for children with cancer.
Guidelines

Flu vaccination guidelines

2016-2017 Flu Vaccination Guidelines

Long-term follow-up guidelines

As new therapies are employed, our knowledge concerning the risks of recurrence and late effects of cancer and its treatment is changing.  We have developed disease-specific long-term follow-up guidelines. These guidelines can be modified on an individual basis to provide optimum care for survivor. 

Clinical Tools

Additional survivorship guidelines  can be found on the Children's Oncology Group website.

Disclaimer & copyright

These guidelines and educational materials, policies and procedures were developed for use only within BC Children's Hospital. There are support systems at BC Children's Hospital that may not exist in other clinical settings and therefore any adoption of these materials cannot be the responsibility of BC Children's Hospital. 

Agencies other than BC Children's Hospital should use this information as a guideline for reference purposes only. All materials are the property of BC Children's Hospital and may only be reprinted in whole or in part with our expressed permission.

Resources

All oncology patients on chemotherapy should be regarded as immunocompromised regardless of their neutrophil count.


It is only necessary to mask and gown when patients are suspected of having a contagious or communicable disease.


Good hand hygiene (washing) is the simplest and most effective way of reducing the risks of infection.


 

Information on most chemotherapy agents can be found on the BC Cancer Agency website.  


Practice guidelines for chemotherapy administration in children

Sedation

  • Procedural Sedation and Analgesia Standards and Guidelines for physicians


Lumbar punctures

It is strongly recommended that only physicians who have had specific teaching and been supervised in administration of intrathecal chemotherapy perform lumbar punctures.


Central venous access

Venous access is crucial for administration of chemotherapy and supportive care in children. 

Peripheral IVs may be used but many of the chemotherapy drugs and antibiotics cause sclerosis of the veins and ultimately lack of venous access.


Only nurses certified and familiar with central line care should access central lines. 


 

Principles

Immunization of pediatric oncology clients is suspended at treatment initiation; the exception to this is inactivated influenza vaccine, which may be given at any time during or after treatment. 


Catch up or booster doses are recommended for pediatric oncology patients who have completed treatment. Live attenuated vaccines (MMR, Varicella) may be given after 12 months off therapy with approval from the oncologist at BC Children’s hospital.


Guidelines 


Immunization Schedules (Section IIA) can be found in the Immunization Manual from BC Centre for Disease Control.  There is also information for Immunization of Special Populations (immunosuppressed patients) in this manual (Section III).

 

Complementary Medicine Education and Outcomes (CAMEO) Program

CAMEO is a research program that transforms complementary medicine (CAM) research into user-friendly information that can be shared with patients and health professionals. CAMEO currently offers a range of CAM support programs and resources, all within the context of research to allow these services to be evaluated.


Pediatric Oncology Education Module (POEM)

POEM provides basic information about important aspects of pediatric oncology for Health Care Providers (HCPs) and students. 
 

National Cancer Institute

The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH), which is one of 11 agencies that compose the Department of Health and Human Services (HHS). The NCI, established under the National Cancer Institute Act of 1937, is the Federal Government's principal agency for cancer research and training.

C17

The C17 Council is an organization composed of the institutionally appointed heads of the sixteen pediatric hematology, oncology, and stem cell transplant programs across Canada. We represent the interests of children and adolescents with cancer and blood disorders and act as an authoritative Canadian voice.

St. Jude Children's Research Hospital

St. Jude Cure4Kids is a Web site dedicated to improving health care for children with cancer and other catastrophic diseases in countries around the globe. Cure 4 Kids provides continuing medical education focusing on cancer, pediatrics, oncology, and global communication tools to health care professionals and scientists worldwide.Cure4Kids Website for professionals - Registration is free, but limited to doctors, nurses, health care professionals and researchers involved in the care of children with catastrophic diseases.


Pediatric Oncology Group of Ontario (POGO) Education Portal

The POGO Education Portal is a resource for professionals seeking continuing education to facilitate familiarity with recent advances in childhood cancer and to ensure that care is focused on the whole child and family.

 

The Hope Portal

The HOPE Portal is a site developed by Children's Hospital Los Angeles for finding resources and information about childhood cancer, blood disorders and other rare diseases or conditions.Developed by Children's Hospital Los Angeles


 


Managing Late Effects in Adult Survivors of Childhood Cancer

Recorded webcast presented April 16, 2015 by Drs. Karen Goddard and Chris Fryer 


The following 2 presentations can be viewed here 

click on BC Children's Hospital/Sunny Hill Hospital (side bar)

scroll down and click on Oncology


Brain Tumour Foundation Education Seminar 2010

A Morning of Hope and Support - Opening Remarks, Sue Ruypers 

  1. Survivor Story: Liz Higgs, mother of pediatric brain tumour survivor 
  2. Late Effects of Brain Tumour Treatment
  3. Advocacy and Transitioning in the School System

Pediatric Oncology/Hematology Education Day 2009

Presentations on current management of pediatric oncology/hematology patients from experts in the field...

  1. Advances in the Management of Brain Tumours
  2. Oncologic Emergencies
  3. Management of Thrombosis
  4. Work-Up and Management of Bleeding in Children
  5. Diagnosis and Treatment of Fungal Infections in the Immunosuppressed Child
  6. Long Term Outcomes and Surveillance Guidelines for Survivors of Childhood Cancers
 
Health-care teams

Health care teams

A significant contribution to the successful treatment of children with cancer and blood disorders comes from adopting a team approach to patient care. 

The team includes doctors specializing in childhood cancer (oncologist) and blood disorders (hematologist), nurses with expertise in the field, pharmacists, nutritionists, physiotherapists, occupational therapists, psychologists, social workers, child life specialists, patient and parent advocate, clinical research assistants, family physician, pediatrician, parents and the child.
 
One of our pediatric oncologists or hematologists is the primary physician responsible for directing the care of the child. This physician, a nurse clinician and a social worker form the primary care team and liaise with the local community-health-care professionals. 

BC Children's Hospital teams

  • Contact information for the multidisciplinary staff members of the oncology/hematology/BMT department.

In order to provide safe chemotherapy administration to pediatric oncology patients in the community, “Levels of Care” have been defined and resources requirements identified. Level IV care is delivered at BC Children’s Hospital (BCCH). Levels I, II and III care may be provided in the community depending on available resources.

Level I:  simple outpatient chemotherapy
Level II:  complex outpatient chemotherapy
Level III:  complex inpatient chemotherapy
Level IV:  tertiary pediatric oncology referral centre

Community care teams

Many of our patients receive portions of their treatment in their local community.  The following is a list of some of our community partners and available resources in the different communities.

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