Hematology and oncology - Frequently asked questions
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To Make an Appointment
- Your child’s physician will make arrangements for an appointment with a hematology or oncology specialist.
- After hours, weekends and holidays, call (916) 734-2011. Ask for the pediatric hematology-oncology doctor on call.
- What is anemia?
- What are bleeding disorders?
- What is hepatitis?
- What is histiocytosis?
- What is neutropenia?
- What is sickle cell disease?
- What is thalassemia?
- What is cancer, and how are children treated for it?
- What is Ewing’s sarcoma?
- What is lymphoma?
- How are leukemia and myeloma related?
- What is medulloblastoma?
- What is neuroblastoma?
- What is Wilms’ tumor?
- What is rhabdomyosarcoma?
- How are bone and soft-tissue cancers treated?
Anemia, which can occur in a wide range of types, is indicated by a decrease in the amount of hemoglobin, which is the colored material in red blood cells that transports oxygen to the tissues of the body. Severe anemia can be harmful when it reduces oxygen levels in organs. Anemia, which may be caused by disease or nutritional deficiencies, can be treated with medication.
Bleeding disorders encompass a wide range of medical problems involving inadequate blood clotting or extended or uncontrolled bleeding. The condition may originate with abnormalities in the blood vessels or in the blood itself. Proper blood clotting, called “coagulation,” is a complex process by which specific proteins are triggered to control bleeding. If those proteins are deficient or don’t function properly in blood vessels, excessive bleeding results, potentially leading to anemia—a low red blood cell count. One predominant bleeding disorder, hemophilia, can be treated and controlled by medication to supplement inadequate clotting proteins.
Hepatitis, numerous types of which exist, is an inflammation of the liver. It can be caused by consumption of alcohol, poisonous mushrooms or drugs, infections, bacteria or viruses. Untreated, hepatitis can cause liver damage. While complete recovery can occur, damage to the liver may take months to heal.
What is histiocytosis?
Histiocytosis is an uncommon blood disease that occurs only once in every 200,000 births annually in the United States. Patients with histiocytosis develop an excessive number of white blood cells called “histiocytes.” Clumps of histiocytes can attack organs, including the lungs, ears, eyes, liver or the central nervous system. It is often treated with chemotherapy and radiation, even though it is not a form of cancer.
Neutropenia, also known as agranulocytosis, is characterized by an insufficient number of neutrophils or granulocytes—white blood cells. It can occur when the bone marrow does not produce enough neutrophils or when disease kills large number of white blood cells. Loss of significant numbers of neutrophils increases susceptibility to infections.
Sickle-cell disease is the result of genetic abnormalities in hemoglobin, the most important component of red blood cells. Sickle cells contain a chemical variation of the hemoglobin protein. Instead of being round and flexible like regular blood cells, sickle cells are distorted into a rigid crescent or “sickle” shape, restricting their ability to squeeze through the smallest blood vessels, which are called capillaries. When sickle cells become trapped in capillaries, they can block the flow of blood and deprive tissues and organs of oxygen. The acidity of sickle cells also can divert water and potassium from cells, resulting in dehydration. Sickle cells have a significantly shorter life span than regular red blood cells, and as they die off, the red blood cell count declines. That’s why sickle-cell disease is commonly known as sickle-cell anemia.
Thalassemia, also known as Cooley’s anemia, is an inherited disorder that suppresses the body’s ability to manufacture a sufficient number of red blood cells. Because severe anemia can result, must be treated to avoid potentially fatal damage to the heart or liver. Severe thalassemia is treated with blood transfusions and medication, and sometimes with bone marrow transplantation. Milder forms of the disease do not pose as great a survival threat.
What is cancer, and how are children treated for it?
Cancer is an uncontrolled growth of abnormal cells. As cancer cells clustered in “tumors” grow, they cause damage by replacing normal tissue. Cancer can take many different forms, some of which attack specific organs. Different types of cancer can grow at widely varying rates and respond to differing treatments. Early treatment improves the chances for arresting the disease.
Ewing’s sarcoma is a cancerous bone tumor that arises most commonly during puberty, during rapid growth of the bones. Treatment may include any combination of surgical removal of the tumor, chemotherapy or radiation therapy.
Hodgkin’s and non-Hodgkin’s lymphomas are the most common cancers that appear in young people from their late teens to their early 30s. Lymphoma is a malignancy in the lymph system. With proper treatment, about 90 percent of Hodgkin’s disease cases can be cured, and 50 to 80 percent of non-Hodgkin’s lymphoma cases are curable. Treatment for lymphomas include chemotherapy, radiation and other techniques. The UC Davis Cancer Center is among a small number of institutions nationwide experimenting in the use of monoclonal antibodies to treat lymphomas. When lymphomas absorb these antibodies, which are charged with radioactive iodine, dramatic regressions in the tumors can result. Medical and radiation oncologists work closely with pathologists to determine an accurate diagnosis and the most appropriate course of treatment.
Leukemia and myeloma are both characterized by uncontrolled growth of cells that have similar functions. Leukemia afflicts blood and bone marrow, while myeloma specifically targets a type of white blood “plasma” cells. These diseases are not inherited, but instead result from a genetic injury to the DNA of a cell, triggering abnormal growth that multiplies. Rapid spread of malignant cells interferes with production of healthy blood cells and weakens ability to protect against infections. Leukemia survival rates have more than tripled during the past four decades. The survival rate for children with acute lymphocytic leukemia—one of four forms of the disease — has reached 85 percent.
Medulloblastoma, a cancerous tumor that begins within the brain, usually afflicts only children and young adults. Diagnosis of cancer may be confirmed by either of two tests: a computed tomographic (CT) X-ray scan, or a magnetic resonance imaging (MRI) scan. A biopsy—surgical removal of a small amount of tissue — also may be necessary. Treatment effectiveness depends upon the size and location of the tumor and the age of the child.
Neuroblastoma is a malignant tumor that is composed of immature neurons—nerve cells. Because it attacks the nervous systems of infants and children, it can trigger movements of the eyes, erratic muscular jerks or even chronic diarrhea. The disease disappears in some infants when the tumors die spontaneously. In older children the malignant underdeveloped cells sometimes mature into normal ganglion cells, halting the progression of the disease.
Wilms’ tumor affects abdominal organs, most commonly the kidneys. Children of about 3 years of age are most susceptible, and it is rarely seen in children older than age 8. These tumors often can be removed surgically, but treatment may include radiation or chemotherapy as well. The cure rate for the disease is about 90 percent with proper and timely treatment.
Rhabdomyosarcoma is a rare malignant tumor that can occur in the soft tissue of Children's bodies—typically in the neck, nose, throat, urologic tract, arms, legs or muscles. With comprehensive treatment, long-term survival of rhabdomyosarcoma is achievable.
For most bone and soft tissue cancers, a combination of surgery using innovative artificial joints and various types of bone replacement materials combined with chemotherapy and radiation can help salvage limbs and preserve function 85 percent of the time. At UC Davis Children's Hospital, orthopaedic surgeons collaborate with radiation therapists and medical oncologists in treatments to kill tumors, remove damaged tissue and restore function.
What if my child needs hospitalization?
Patients needing inpatient care are hospitalized either in the general pediatrics unit, the adult oncology unit or the bone marrow transplant unit, depending upon their age and treatment needs.