Can my child play and be around others?
We encourage children to be as active as they can tolerate. Playing with other children is acceptable as long as those children do not have a contagious illness at the time. Approximately 7 to 10 days after a course of chemotherapy, when the blood cell count drops to its lowest point (nadir), it is important to take more precautions to avoid people who may be ill. It is better not to take your child to enclosed places (e.g., shopping malls, arenas, theaters). Instead, take your child to open air places such as parks. If your child has never had chickenpox and is exposed to chickenpox when playing with other children, notify the oncologist within 24 hours.

I still have questions concerning my child’s medical treatment plan. Who should I talk to?
Our nurses and physicians are always available to answer your questions. Your identified Case Coordinator can help you with any questions about your treatment plan.  If you do not know who your Case Coordinator is, please call the Cancer Clinic Charge Nurse, Christie Russell, at (714) 289-4799

My child is fearful and gets upset before a doctors visit (procedures, taking of medication). What can I do?
The Child Life staff at CHOC is trained to help children cope with these types of concerns. Also, the child life specialist is always in clinic and available on the floor if you are admitted.
Call: The Child Life Department at (714) 532-8473

My child will be returning to school and I need some assistance in preparing the school staff and working with them to develop an educational plan. Who can I call?
The CHOC School and Social Reintegration Program is designed to assist cancer patients and their families with returning to school. Grace Mucci, PhD, is the psychologist who would meet with you and provide the assistance you require.
Call: (714) 532-8481

Our family is faced with some financial difficulties, including housing and employment. Are there any agencies that can help?
Our Cancer Institute Social Services department can provide you with the most appropriate resources based on your needs.
Call: Jenee Areeckal (714) 532-8815, Claudia Begino (714) 532-7521 or Kristin Hawking (714) 532-8323

What can I do about the weight gain (or loss) my child is experiencing?
For children who are underweight, our physicians can refer you to our clinical dietitian who can develop a plan to promote healthy weight gain and growth. For children who need to lose weight and improve their fitness, please speak to your physician at your next scheduled clinic appointment.

What does a positive culture mean?
A culture may be performed on blood, urine or other tissues or body fluids. A positive culture means that some type of organism (bacteria, virus, yeast, fungus) has been identified. If a bacterial, viral, or fungal infection is present, it is treated with antibiotics, antivirals or antifungals.

What if a brother or sister becomes sick?
Call your physician’s office for specific information.

What is a protocol and a roadmap?
A protocol is the treatment plan designed for your child at the time of diagnosis. This protocol may be chosen from the Children’s Oncology Group (COG) protocols that are used across the nation. It outlines the course of therapy your child will receive.

A roadmap is a schedule listing all the days of your child’s treatment. The chemotherapy drugs are scheduled certain days. The roadmap may also indicate when lab work, X-rays, lumbar punctures, and bone marrow aspirations may need to be done. Dates may vary depending on blood test results or infections, which may result in chemotherapy delays.

What is a remission?
Remission is a term used when there is no evidence of disease. Remission only occurs after treatment of the cancer with chemotherapy and/or radiation therapy and/or surgery. Your child will undergo a number of tests on a scheduled basis to determine if there is any disease. Remission is not the same as a cure. A cure is said to have occurred when a child has been in remission and remains disease free for at least five years.

What is cancer, and is it contagious?
Cancer occurs when one or more of the body’s cells begin to divide in an uncontrollable way. Cancer can affect the cells of an organ (kidney, bone, brain), blood or lymphatic system. A collection of many of these abnormal cells is called a tumor. The causes of cancer are not yet known. Cancer is not a disease that is transmitted from one person to another like the flu or a cold.

What is metastasis?
Metastasis occurs when cancer spreads from one part of the body to another. The primary site is the location of the original tumor and the secondary site is the metastasis (spread of cancer cells to another place in the body).

What services are available to help with my child’s feeling or behavior (i.e., sadness, anger, anxiety)?
Nicole Vincent, PhD, a psychologist who is available to support the CHOC Cancer Institute patients and families, can schedule individual and family consultations to discuss specific concerns.
Call: (714) 532-8483

What should I do if my child is exposed to or comes down with chickenpox? What happens?
If your child has never had chickenpox and spends time with another child (in a class or play situation) who subsequently develops chickenpox, you should call the oncologist within 24 hours. Chickenpox is particularly dangerous to children receiving chemotherapy if they have not previously had the same disease. Chemotherapy and radiation therapy lowers your child’s defense to infection. Precautions must be taken to try to prevent or lessen the outbreak.

If an exposure has taken place, and your child has not had chickenpox, your child will receive an injection of varicella zoster immunoglobulin, which is given in an attempt to prevent your child from contracting the infection. If your child is hospitalized after an exposure to chickenpox, and has not previously had the disease, he/she will be isolated from the other children. This is done as a precaution against exposing other children to chickenpox. If your child has active chickenpox, he/she will be hospitalized in a negative pressure isolation room and will need to be on another floor. Chemotherapy will not be given until after he/she has recovered. The risk period is from one to three weeks after exposure.

If your child has already had chickenpox, he/she may break out with shingles, a painful, itchy rash that looks like chickenpox and is caused by the same virus. Shingles is usually isolated to one area of the body such as the chest or back. If your child has shingles, notify the oncologist immediately. Treatment with anti-viral drugs is necessary, and your child will be hospitalized in a negative pressure isolation room or on another floor.

Who are the Administrators I can contact regarding the care of my child?
Call: Lennie Sender, MD, Medical Director - assistant: Janice High (714) 456-8288
Melanie Patterson, RN, Clinical Director (714) 532-8784

Who can I talk to about the impact of cancer on my family? Are there support groups?
Our social workers can provide you with resources available.
Call: Jenee Areeckal (714) 532-8815, Claudia Begino (714) 532-7521 or Kristin Hawking (714) 532-8323

Who should we call to schedule a clinic appointment? What information do we need to provide the appointment desk?
You should begin by phoning the Clinic Appointment Desk at (714) 289-4592 before bringing your child into the clinic. The secretary will need to know why you are bringing your child to the hospital (i.e., chemotherapy only, a routine clinic visit, a lab admission, or for lab work only). For routine appointments, an assigned appointment time will be given to you. It is helpful if you can also tell the secretary at the time of your call whether or not your child is due for procedures (lumbar puncture, bone marrow), chemotherapy, or whether he/she needs to be scheduled for the Day Health Center. Regardless of whether your child is scheduled to be seen by a physician or to have tests done, a call must be made to the Clinic Appointment Desk prior to your coming into the clinic.

Why do clinic visits take so long?
Your child’s appointment for a clinic visit is the time for the lab work to be done. The doctors begin seeing patients at approximately 9 a.m. If chemotherapy is to be given, it is often necessary to receive the lab results before giving your child’s chemotherapy. This takes approximately 2 hours.

Will my child receive sedation prior to procedures?
If sedation is needed, your child may receive either an injection into the VAD or oral medication. Sometimes medication can be eliminated with the use of visual imagery and relaxation. The Psychology Department is available to assist with these techniques.