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Clinical and Research Efforts


Pediatric Oncology Services

Introduction

General Information

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Genetic Counseling and Testing Service

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  The University of Texas M. D. Anderson Cancer Center

For information on clinical trials at this NCCN Member Institution click here.

Celebrating more than six decades of Making Cancer History®, The University of Texas M. D. Anderson Cancer Center is located in Houston, Texas, on the sprawling campus of the Texas Medical Center. It is one of the world's most respected centers devoted exclusively to cancer patient care, research, education and prevention.

The Texas Legislature created M. D. Anderson Cancer Center in 1941 as a component of The University of Texas System. M. D. Anderson is one of the nation's original three Comprehensive Cancer Centers designated by the National Cancer Act of 1971 and is one of 39 National Cancer Institute-designated Comprehensive Cancer Centers today.

M. D. Anderson has ranked among the nation's top two cancer hospitals in U.S. News & World Report's "America's Best Hospitals" survey since the survey’s inception in 1990. M. D. Anderson has ranked No. 1 five times in the past eight years, including 2007.

Patient Care

Since 1944, nearly 700,000 patients have turned to M. D. Anderson for cancer care in the form of surgery, chemotherapy, radiation therapy, immunotherapy, or combinations of these and other treatments. This multidisciplinary approach to treating cancer was pioneered at M. D. Anderson. Because they focus only on cancer, experts here are renowned for their ability to treat all types of cancer, including rare or uncommon diseases.

In 2008, more than 83,500 people with cancer will receive care at M. D. Anderson, and about 27,000 of them will be new patients. About one-third of these patients come from outside Texas seeking the knowledge-based care that has made M. D. Anderson so widely respected. More than 11,000 patients participated in clinical research exploring novel therapies and diagnostic tests in 2006, making it the largest such program in the nation.

M. D. Anderson holds accreditation from the Joint Commission. In 2006, M. D. Anderson was awarded Magnet Nursing Services Recognition from the American Nurses Credentialing Center, an honor first received in 2001.

Research

At M. D. Anderson, important scientific knowledge gained in the laboratory is rapidly translated into clinical care. In 2005, the institution invested more than $410 million in research, an increase of about 95 percent in the past five years. M. D. Anderson ranks first in the number of grants awarded and total amount of grants given by the NCI. M. D. Anderson holds 10 NCI Specialized Programs of Research Excellence grants: bladder, breast, head and neck, leukemia, lung, melanoma, ovarian, pancreatic, prostate, uterine. The research program is considered one of the most productive efforts in the world aimed solely at cancer.

In September 2005, M. D. Anderson unveiled plans for the Red and Charline McCombs Institute for the Early Detection and Treatment of Cancer. The most aggressive expansion of research in M. D. Anderson’s history, the institute comprises six unique centers focused on genomics, proteomics, screening, diagnostic imaging and drug development. Located on the 116-acre University of Texas Research Park about 1.5 miles south of the main campus, the McCombs Institute will house about 25 percent of M. D. Anderson’s research activities.

Education

Each year, more than 4,300 students take part in educational programs, which include physicians, scientists, nurses and many health professionals. M. D. Anderson offers bachelor's degrees in seven allied health disciplines.

In addition, more than 1,000 clinical residents and fellows come to M. D. Anderson each year to receive specialized training in the investigation and treatment of cancer. More than 500 graduate students are working on advanced degrees at the Graduate School of Biomedical Sciences, which M. D. Anderson operates jointly with The University of Texas Health Science Center at Houston. More than 1,300 research fellows are being trained in M. D. Anderson's laboratories and clinics.Thousands more participate in continuing education and distance learning opportunities sponsored by M. D. Anderson, sharing knowledge around the globe. M. D. Anderson provides public education programs to teach healthy people about cancer symptoms and risk factors, giving them information that might one day aid them in making critical health care decisions.

Prevention

Recognizing that prevention is the best way to eliminate the threat of cancer, M. D. Anderson has initiated a multifaceted effort. Expanded research efforts in epidemiology and behavioral sciences complement achievements made in clinical cancer prevention. Laboratory activities support developmental and practical applications of cancer prevention. A new research program focuses attention on disparities in prevention and care among ethnic minorities and medically underserved populations. The Cancer Prevention Center provides comprehensive cancer screening services, including cancer risk assessment, screening exams based on age and gender, personalized risk reduction strategies, genetic testing, chemoprevention, tobacco cessation, and nutrition counseling.

Human Resources

M. D. Anderson employs more than 16,000 people, including nearly 1,400 faculty numbers. A volunteer corps of more than 1,600 people supplements its workforce; these volunteers provide more than 290,000 hours of service each year. Faculty, staff members and volunteers are dedicated to the core values of caring, integrity and discovery. Together they work toward fulfilling the M. D. Anderson mission of eliminating cancer as a major health threat.

Facilities

The institution’s size has increased about 50 percent in the past six years. The physical plant includes an inpatient hospital with 521 beds, five research buildings, two outpatient clinic buildings, a faculty office building, a proton radiation clinic building and a patient-family hotel. From 2005 to the present, the Mitchell Basic Sciences Research Building, the Mays Clinic, the Cancer Prevention Building, the Saberioon Molecular Markers Research Building and the Proton Therapy Center opened. The Pickens Academic Tower, currently under construction, will provide additional faculty and administrative space, while an upcoming expansion of Alkek Hospital will accommodate about 300 additional inpatient beds.

For more information about M. D. Anderson, visit our Web site at www.mdanderson.org or call 877.MDA.6789.


The University of Texas M. D. Anderson Cancer Center
Adult Oncology Services


Introduction

The mission of The University of Texas M. D. Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research, and prevention, as well as through education for undergraduate and graduate students, trainees, professionals, employees, and the public.

  • Patient Care: M. D. Anderson pioneered this multidisciplinary approach to treating cancer by providing cancer care in the form of surgery, chemotherapy, radiation therapy, immunotherapy, or combinations of these and other treatments.
  • Education: More than 4,300 students take part annually in educational programs for physicians, scientists, nurses, and other health professionals.

M. D. Anderson is one of the nation’s original three Comprehensive Cancer Centers designated by the National Cancer Act of 1971 and is one of 41 Comprehensive Cancer Centers today. M. D. Anderson has ranked among the nation’s top two cancer hospitals in U.S. News & World Report’s “America’s Best Hospitals” survey since the survey’s inception 18 years ago, ranking number one five times in the last eight years.


General Information

General Information and New Patient Referrals

877.MDA.6789

Office of Physician Relations

800.252.0502
713.792.2202

Provides assistance with patient referral process and clinical trial search.

Location

Houston, TX

Facility

The physical plant includes an inpatient pavilion with 521 beds, five research buildings, two outpatient clinic buildings, a faculty office building and a patient-family hotel. From 2005 to the present, the George and Cynthia Mitchell Basic Sciences Research Building, the Lowry and Peggy Mays Clinic, the Cancer Prevention Building, a new research building and the Proton Therapy Center on the South Campus opened. In late 2007, M. D. Anderson begins construction to add nine floors atop the 12-story Albert B. and Margaret M. Alkek Hospital.

Patients receive advanced care in a relaxed environment that doesn’t feel like a hospital. The goal is to provide easy access to patient services in a cheerful, uplifting atmosphere in the hope of making cancer treatment less stressful so patients can focus all their energies on recovery.

Travel Assistance

M. D. Anderson has negotiated discounts with airlines, hotels, and ground transportation agencies for patients and their caregivers. Additionally, a full-service, on-site travel agency provides patients with access to these discounts. Patient Travel Services can be reached at 888.848.9992.

Also, M. D. Anderson is proud to be a partner with Angel Flight, a national nonprofit charitable organization providing free air transportation to medical patients. Angel Flight's volunteer pilots donate their time, aircraft, and fuel to fly patients for treatment. For more information, call Angel Flight toll free at 877.AIRLIFE (877.247.5433).

Lodging

Various types of lodging are available to M. D. Anderson patients and families.

  • Apartments—Patients who find they need long-term housing options can choose various furnished and unfurnished apartments in the Texas Medical Center (TMC).
  • Rotary House—The Jesse H. Jones Rotary House International Patient Hotel is an M. D. Anderson-owned, Marriott-managed, full-service hotel conveniently located across the street from the Main Building and linked by an overhead walkway. Some rooms are equipped with refrigerators, dishwashers, and microwave ovens (must be requested at the time of reservation).
  • Hotels—The Texas Medical Center has several nearby hotels and motels, many of which provide discounts to M. D. Anderson patients.
  • Hostels—There is a hostel located near the TMC that is open at various times throughout the year.
  • RV/Trailer Parks —There are RV/Trailer Parks located near the TMC that are readily accessible to M. D. Anderson patients.

Additional housing options from churches and community organizations may be available. Contact the Department of Social Work,, 713.792.6195, for help in accessing these resources.


Treatment

Multidisciplinary Teams

Clinicians in all oncologic and supporting specialties work together to plan and implement multimodality therapies. Most patients meet with their treatment team members and receive their ambulatory care in one location. The multidisciplinary care center concept was a driving force in the architectural design of the M. D. Anderson complex.
Multidisciplinary care centers incorporate physical locations and organizational concepts, which were created to provide patient care services for a particular disease site. This organization greatly reduces the time needed for initial evaluation, diagnosis, and treatment planning, and increases convenience for patients

M. D. Anderson has 26 multidisciplinary care centers that provide integrated cancer care.

Disease Center

Phone

Ambulatory Treatment Center

713.745.4516

Blood and Marrow Transplantation Center

713.745.6969

Brain and Spine Center

713.792.7728

Nellie B. Connally Breast Center

713.792.4124

Julie and Ben Rogers Breast Diagnostic Center

713.792.2702

Cancer Prevention Center

800.438.6434

Cardiopulmonary Center

713.792.4015

The Children's Cancer Hospital

888.543.2435

Diagnostic Imaging

713.792.6120

Endocrine Center

713.563.7600

Eye Clinic

713.792.6523

Gastrointestinal Center

713.792.4796

Genitourinary Center

713.745.7020

Gynecologic Oncology Center

713.792.8340

Head and Neck Center

713.745.5146

Internation Cancer Assessment Center

713.745.0450

Internal Medicine Center

713.563.4400

Leukemia Center

713.563.2000

Lymphoma and Myeloma Center

713.745.5640

Melanoma and Skin Center

713.563.9716

Orthopedic Center

713.792.6235

Pain Management Center

713.792.6070

Pathology and Laboratory Medicine

713.792.3100

Plastic Surgery Center

713.792.5291

Proton Therapy Center

866.632.4782

Radiation Treatment Center

713.792.3440

Sarcoma Center

713.563.9701

Stem Cell Transplantation and Cellular Therapy Center

713.745.6969

Supportive Care Center

713.792.6072

Thoracic Center

713.745.5353

 

Alternative/Complementary Medicine

The goals of M. D. Anderson’s Complementary and Alternative Medicine service are:

  • to discover CAM approaches used by patients
  • to distinguish between harmful treatments, beneficial treatments, and treatments that can be safely integrated with conventional treatment
  • to encourage communication between patients and providers 
  • to educate both patients and health care providers with current and accurate information

to promote ongoing professional growth through networking in a setting where complementary medicine and conventional cancer treatments can be examined together

Place...of wellness

More than 75 complementary therapy programs work in concert with mainstream care to manage cancer-related symptoms, relieve stress, and enhance quality of life. Most programs are free of charge, except acupuncture and full body massage, which are provided for a nominal fee. Place...of wellness is open to anyone touched by cancer, their family members, and caregivers, whether or not they were treated at M. D. Anderson. No physician referral is required. For more information about Place…of wellness, call 713.794.4700.

Education

  • Touch Therapy for Caregivers, Family, Friends, and Loved Ones
  • "Chemobrain"—Is it Real?
  • Weight Management Class
  • Reiki, Healing Touch for Self & Others
  • Guest Chef, Nutrition Classes, Herbal Lecture Series
  • P.I.K.N.I.C weekly educational forum
  • The Learning Center
  • Living Fully with Cancer — an annual patient conference that draws nearly 1,000 patients and caregivers from around the world

Expressive Arts
Expressive Arts Classes

  • Journaling: The Healing Power of Story
  • Songwriting Workshop: Music Therapy

Meditation & Prayer

  • Centering Prayer, Inner Joy, The Art of Living,The Road Less Traveled: Cancer Path and Spiritual Journey,Tibetan Meditation

Movement

  • Awareness Through Movement, Pilates, Chi Kung (Qigong), Tai Chi, Yoga (Hatha and Kundalini), Body Energizer

Relaxation & Stress Management

  • Aromatherapy & Self-Massage, Brief Relaxation Massages, Guided Imagery for Healing, Relaxation Exercise, Fatigue & Self-Hypnosis, Self-Hypnosis for Relaxation, Stress Management Techniques

Acupuncture & Massage

Place…of wellness. For details or for an appointment, call 713.794.4700.

 

Late Effects and Survivorship

Childhood Cancer Survivor Clinic

This clinic helps childhood cancer survivors overcome physical, psychological, and developmental problems that may result from cancer or its treatments. We help anyone who was diagnosed with cancer before the age of 18 and has been out of treatment and cancer-free for at least three years, regardless of the person's current age. For more information, call the Pediatric Patient Access Center at 713.792.5410.

Medical Clinic for Cancer Survivors

Provides care for survivors of adult and childhood malignancies. We collaborate with your primary care physician to implement most follow-up procedures or interventions. For more information, contact askMDAnderson at 1-877-MDA-6789 or call 713.563.4400.

Life After Cancer Care

A medical program focusing on potential health problems that may arise from cancer or its treatments. Specialists can anticipate, recognize, and manage these effects, collaborating with you and your primary care physician. Researchers are examining data from our cancer survivor survey of more than 8,000 patients to help build a better understanding of the unique health needs and health profiles of cancer survivors. For more information, contact askMDAnderson at 877.MDA.6789

Breast Cancer Survivorship Clinic

This clinic is focused on the ongoing health and well-being of M. D. Anderson patients who are breast cancer survivors — not just through regular breast cancer screening, but by proactively addressing their medical and psychosocial needs in areas such as osteoporosis, lymphedema and sexuality. For more information, contact askMDAnderson at 877.MDA.6789

Beth Sanders Moore Young Breast Cancer Survivors’ Program

Approximately 13 percent of women in the United States diagnosed with breast cancer are younger than 45 (about 28,000 per year). These women often voice educational needs and concerns that differ from those of older women. This program provides a venue for sharing concerns and receiving information. Educational needs are assessed and addressed through focus groups, interactive forums, workshops, lectures, a newsletter and Internet site. Call 713.792.8208.

 


Cancer Prevention and Screening

Expanded research efforts in epidemiology and behavioral sciences complement achievements made in the clinical cancer prevention arena. Laboratory activities support developmental and practical applications of cancer prevention. A new research program is focusing attention on health disparities in prevention and care among ethnic minorities and medically underserved populations.

The Cancer Prevention Center provides comprehensive cancer screening services, including cancer risk assessment, screening exams based on cancer risk, age and gender, personalized risk-reduction strategies, genetic testing, chemoprevention, tobacco cessation, and nutrition counseling.

Cancer Prevention Center
To determine which services are best for you, call 800.438.6434. Services include:

  • Comprehensive cancer screening
  • Site-specific cancer screening
  • Risk assessment and risk reduction
  • Genetic testing and risk counseling
  • Chemoprevention
  • Nutrition counseling
  • Tobacco cessation counseling
  • Diagnostic evaluation services
  • Breast Evaluation Clinic:comprehensive clinical and diagnostic evaluation of breast abnormalities, including a lump or other breast changes.
  • Undiagnosed Dermatology Clinic: diagnostic evaluation of skin abnormalities, including a change in a mole or freckle or other skin changes.

Tobacco Cessation
For M. D. Anderson patients, free comprehensive medical treatment for tobacco cessation is offered to all patients who smoke or have recently quit. For more information, call 713.792.QUIT.  

For smokers who are not receiving cancer care at M. D. Anderson, there are numerous tobacco-cessation studies available that provide free treatment. Call the Tobacco Research and Treatment Program at 713.792.2265.

Free Prostate Cancer Screenings
Held every other Wednesday at M. D. Anderson from 8:30 AM to 10:30 AM. Call 713.792.8924 for an appointment. Additionally, a mobile prostate screening van provides free prostate cancer screening in underserved areas in Houston. 


Support Services

Department of Social Work

People affected by cancer often find this to be a trying time. To assist you, the Department of Social Work has licensed clinical social workers available to support you and your family. Call 713.792.6195 for information.

Psychiatry

M. D. Anderson's Psychiatry Service helps patients deal with depression, sleep problems, anxiety, personality changes, problems with memory, family issues, and more. Behavioral techniques include counseling, relaxation and guided imagery, management of pre-existing emotional problems, and medication management for emotional problems.

Counseling

Skilled and professionally trained in counseling, clinical social workers provide short-term counseling free of charge. Individual and family counseling, special programs (e.g., bereavement, relaxation) and help with resources (e.g., lodging, financial support programs) are available.

Support Groups

  • Breast Cancer Support Group
  • Cancer Patients and Families
  • Caregivers: "I've Got Feelings, Too"
  • CLIMB: Children’s Lives Include Moments of Bravery
  • Circle of Hope Bereavement Support Group
  • Genitourinary Lunch and Learn
  • Houston Area Brain Tumor Network
  • Lung Cancer Network
  • Melanoma Patient and Caregivers Support Group
  • Men Only
  • Ovarian Cancer Support Group
  • Pediatric Parents' Support Group
  • Protective Environment Education Support Group
  • Sarcoma Discussion Group
  • Stem Cell Transplant Caregivers Support Group
  • Well Wives: For Any Woman Whose Husband Has Cancer

 


Supportive Care

Pain Management

The Postoperative Pain Section uses the latest in epidural and intravenous patient-controlled analgesia techniques for patients experiencing pain after surgery. Phone: 713.792.6911.

The Section of Cancer Pain Managementprovides consultation and care of patients experiencing pain related to their particular cancer. Pain Help Line: 713.745.7246.

The Department of Symptom Researchis a group of health care professionals dedicated to improving the assessment and treatment of the symptoms experienced by cancer patients through research and education.

Cancer Pain Treatment Guidelines were created by and for M. D. Anderson experts in pain treatment.

Palliative/Supportive Service

The Palliative Care and Rehabilitation Medicine Department houses the largest cancer rehabilitation program in the nation, with medical oncologists, anesthesiologists, and physical medicine specialists working together to assess and manage severe cancer-related symptoms. Our research programs strive to find new ways of assessing and managing severe physical or psychosocial symptoms in advanced and terminal cancer patients. For more information, call 713.792.6085.

 

Department of Clinical Nutrition
Provides comprehensive nutrition care for our patients and cancer-related nutrition education for the public. We work with M. D. Anderson’s medical team to pinpoint opportunities for nutritional intervention or support.

Services include education, assessment, and counseling in cancer prevention; therapeutic diets; nutrition build-up prior to and during therapy; management of treatment side effects; management of specialized feeding regimens like tube feedings and IV parenteral support; nutrition education for patients, families, caregivers, and the general public; and presentations on nutrition and cancer for other healthcare professionals at M. D. Anderson, professional organizations, universities, and in the community.

Cancer Prevention Center Nutrition Counseling

A dietary evaluation with personalized counseling for cancer risk reduction is available for the general public. Call 713.745.8040.

Cooperative Group Membership

Cooperative Group Membership List

  • National Surgical Adjuvant Breast and Bowel Project
  • Southwest Oncology Group
  • Gynecologic Oncology Group
  • Radiation Therapy Oncology Group

Average Number of Adult Clinical Trials

1,000

 


Clinical and Research Efforts

Clinical Trials

M. D. Anderson is a leader in pioneering targeted therapies and developing new drugs to treat cancer.. More than 11,000 patients participated in therapeutic clinical research exploring novel treatments in 2006, the largest such program in the nation. M. D. Anderson is nationally known for translational research, taking knowledge from the lab to the patient bedside.

Investigators are examining genetic, cellular, and novel combination therapies, as well as conducting epidemiologic, behavioral science, quality of life, and complementary medicine research.

Clinical Trials in Integrative Oncology

Researchers are investigating how complementary approaches can affect cancer care and quality of life. About a dozen studies currently are under way.

Research

At M. D. Anderson, important scientific knowledge gained in the laboratory is rapidly translated into clinical care. In 2006, the institution spent more than $409 million in research, an increase of approximately 95 percent in the last five years. 

M. D. Anderson now ranks first for the number of grants awarded and total amount of grants given by the National Cancer Institute. M. D. Anderson holds 10 National Cancer Institute Specialized Programs of Research Excellence (SPORE) grants:lung, bladder, prostate, ovarian, head and neck, pancreatic, breast and endometrial cancers; leukemia; and melanoma. The research program is considered one of the most productive efforts in the world aimed solely at cancer.

 


 

The University of Texas M. D. Anderson Cancer Center
Pediatric Oncology Services

 


Introduction

The Children’s Cancer Hospital at The University of Texas M. D. Anderson Cancer Center offers comprehensive care to children with cancer within the environment of the No. 1-rated cancer hospital in the nation. Pediatric cancer patients receive treatment through the Children’s Cancer Hospital’s inpatient facility (where caregivers can room-in with their children), outpatient clinic, day hospital, and the pediatric intensive care unit. Full supportive services are provided, including child and adolescent life, psychological services, education and vocational guidance, music and art therapy, an in-hospital school with classrooms for grades 1 through 12, extracurricular programs including camps, an annual ski trip for visually and physically challenged patients, and a long-term follow-up clinic. Facilities in the Children’s Cancer Hospital also include a designated “Teen Room,” play space and an area for ages 15-25 years with pool, arcade games, movies and more. Recreation therapy and language assistance are also services offered. The Children’s Cancer Hospital operates with family-centered cancer care in mind, and is recognized worldwide for its expertise in treating children with cancer. Here, pediatric oncologists have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below:

Special Expertise

  • Bone Marrow Transplant and Cell Therapy
  • Bone Tumors
  • Brain Tumors/Neural Tumors
  • Leukemia and Lymphoma
  • Neuropsychology and Psychology
  • Soft Tissue Sarcoma

 


General Information

General Information

877.MDA.6789

888.543.2435 – Patient Access Center

Referring Physician Line

713.792.5410

Location

Houston, Texas

Travel Assistance

M. D. Anderson offers travel assistance.

Lodging

Social workers provide counseling to parents from diagnosis through end of treatment as well as practical information to make the logistics of cancer treatment go more smoothly.  The Jesse H. Jones Rotary House International is a full service hotel exclusively dedicated to serving the needs of M. D. Anderson patients and their families and is connected to the hospital and clinics by an overhead walkway. Call 800.847.5783. The Ronald McDonald House is close by to the facility.

Social Support

The Children’s Cancer Hospital Behavioral Pediatrics Section emphasizes normal development of children while they are in treatment for cancer. Social workers see all parents, and psychologists provide support groups, counseling services, and psychological support. Child Life Specialists are available to all pediatric patients and also staff the inpatient and outpatient playrooms and engage in medical play. An education program is designed to prevent academic declines during treatment and offers daily classes. Translation services are available to assist patients and their families during medical meetings.

Home Health Care

Home health care is arranged.

Ages Treated

Children, adolescents and young adults up to age 25 are treated in the Children’s Cancer Hospital. Patients 16 to 18 years of age have the option of being treated on the adult units. 

 


Clinical and Research Information

Pediatric Oncology Chairman

Eugenie S. Kleinerman, M.D.

Operate Multidisciplinary Teams

M. D. Anderson uses a multidisciplinary approach to cancer treatment. The diverse health care team includes physicians, nurses, social workers, physical and occupational therapists, radiation therapy specialists, nutritionists, psychologists, and others.

Cooperative Group Membership

Children’s Oncology Group (COG)—Joann Ater, M.D., COG CCH PI Note: COG now also includes CCG, POG, PBMTC, Intergroup Rhabdo and Wilms’ Tumor Study groups.

Activities in Cooperative Group

Participation in COG committees includes:

  • Bone Tumor Strategy
  • Brain Tumor Strategy
  • Bone Marrow Transplantation
  • Epidemiology & Cancer Control
  • Executive
  • Leukemia Strategy
  • New Agents Strategy
  • Soft Tissue Tumor Strategy
  • Leadership and participation in various administrative, scientific, and discipline committees.

Oncologists are principal investigators on numerous studies.

Average Number of Pediatric Clinical Trials

55

Pediatric Clinical Trial Coordinator

Jean Johnston
713.794.4968


Special Expertise

Cell Therapy (Bone Marrow Transplant)
M. D. Anderson is the largest BMT center in the United States, which includes the Children’s Cancer Hospital’s BMT Program. M. D. Anderson is FACT-accredited and designated by COG and the National Marrow Donor Program as a transplant center qualified to perform matched and unrelated donor transplants as well as autologous transplants. The unrelated transplantation program at the Children’s Cancer Hospital uses umbilical cord transplant and is one of the few places in Texas that performs cord blood pediatric transplants. The program includes expertise in graft manipulation including T-depletion and investigational therapies based on selection of CD133. Active transplant protocols are underway for several types of malignancies: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), myelodysplasia, lymphoma, neuroblastoma, brain tumors, and other solid tumors of childhood. In addition to undertaking transplants, the program has an active translational research program developing new therapies based on infusion of T cells and NK cells.

Solid Tumors – including DSRCT, Sarcomas and Bone Tumor Cancers (Osteosarcoma, Ewing’s Sarcoma)
The M. D. Anderson Children’s Cancer Hospital is an active treatment center for the many varieties of childhood solid tumors such as Wilms tumor, hepatoblastoma, desmoplastic small round cell tumor, melanoma, tumors of the head and neck, and sarcomas – especially rhabdomyosarcoma, osteosarcoma, and Ewing’s sarcoma. Patient evaluation results in an individualized approach that may or may not result in protocol therapy, depending on the specific circumstances of the patient and family. M. D. Anderson uses diagnostic imaging resources including PET-CT fusion imaging consultation to sort out important issues for not only best survival outcome, but also quality of life issues. Since most solid tumors require at least two and sometimes all three major modalities (e.g. surgery, chemotherapy, radiation), the coordination of care between experienced specialists for treatment of rare and/or difficult situations (e.g. metastatic or recurrent disease) is expected and routine. This group has pioneered and now routinely uses a number of innovative approaches in treatment of these cancers, including outpatient chemotherapy (e.g. high-dose methotrexate, ifosfamide, cisplatin, doxorubicin liposomes, dexrazoxane then doxorubicin, gemcitabine + docetaxel), radiation with concurrent outpatient chemotherapy, use of bone-seeking radiopharmaceuticals (samarium) for osteosarcoma, aerosol chemotherapy (L9NC, gemcitabine), and novel use of immune modulators (e.g. L-MTP-PE, MTher, aerosol cytokines including IL-2 and GM-CSF) in the treatment of bone tumors. For regional disease such as peritoneal spread of desmoplastic small round cell tumor (DSRCT), pleural lesions and disease in the mediastinum, coordinated care between surgical specialties, innovative chemotherapy, radiation oncology, and other services such as interventional radiology plastic surgery is common. Examples include improved enteral nutrition, surgery followed by continuous hyperthermic peritoneal perfusion of chemotherapy (CHPP) for DSRCT, intrapleural chemotherapy and/or chemotherapy for radio sensitization. Many treatment paradigms involve reduced likelihood of hospitalization. 

Brain and Neural Tumors
The Pediatric Neural Tumor Section provides consultation, evaluation, and treatment for children with central nervous system tumors, neuroblastoma, and neurofibromatosis. For all common types of newly diagnosed brain tumors or neuroblastoma, therapeutic protocols form the basis for treatment with either institutional protocols or collaborative studies through the Children’s Oncology Group. Phase I and II studies provide therapeutic options for children with recurrent tumors. M. D. Anderson pioneered an oral chemotherapy regimen for children with certain types of brain and spinal cord tumors, thus eliminating the need for radiation therapy and decreasing hospital stays. Oral chemotherapy treatments for these cancers have been found to be as effective as radiation.

Leukemias
The Pediatric Leukemia and Lymphoma Section has unique expertise in the care of patients with relapsed or refractory disease. This section works closely with our adult leukemia and lymphoma colleagues, the Children’s Oncology Group (COG) and the POETIC consortium to obtain new or innovative drugs or treatment approaches for patients whose original therapy has failed. The pediatric section was largely responsible for the only new drug, Clofarabine, to obtain FDA approval for childhood leukemia since 1990.

Neuropsychology
The neuropsychology team assesses patients for difficulties in language, memory, intellectual, visual perceptual, and attention skills.   All children with brain tumors are evaluated as well as children undergoing bone marrow transplantation and others undergoing chemotherapy or radiation treatments to the brain.  The neuropsychology team works closely with the education team to evaluate a child’s strengths and weaknesses to ensure that they can attain their maximum academic potential, in spite of their cancer treatment.  Our Cognitive Training research program provides a 20-week course for patients who are at-risk for cognitive difficulties associated with their treatment. 


Statistics

Percent of children treated in each age range

Age Range

0-4

5-9

10-14

15-20

Percent Treated

13.8%

20.6%

28.1%

37.5%

Pediatric Oncology Program, 2006

No. of Inpatient Beds

No. of Admissions

Average Length of Stay(days)

No. of New Outpatients

Total Outpatient Visits

No. of Bone Marrow Transplants

No. of Oncologists

26 + 4 PICU

1,042

5.76

506

13,703 (does not include lab or nurse visits)

30

27


The University of Texas M. D. Anderson Cancer Center
Genetic Counseling and Testing Service


Introduction

The University of Texas M. D. Anderson Cancer Center offers cancer genetic counseling and testing services through the Clinical Cancer Genetics Program. M. D. Anderson patients are seen in genetic counseling clinics within the Breast, Gynecology, Gastrointestinal, Endocrinology, and Cancer Prevention Centers. These programs all provide comprehensive risk assessment and genetic counseling services to individuals and their family members. Persons affected with cancer as well as those unaffected by cancer are counseled. The services include risk assessment and counseling; discussion of options for risk management, cancer screening, and surveillance; and when appropriate, genetic testing, reproductive risk counseling, coordination of patient care, and opportunities to participate in research protocols. The clinical services are provided by a multidisciplinary team, which includes board-certified and board-eligible genetic counselors as well as physicians with expertise in gynecology, gastroenterology, surgery, oncology, and endocrinology. Individuals found to be at high risk for cancer are offered follow-up in high risk cancer screening clinics at M. D. Anderson.

Location

Houston, Texas

Directors, Clinical Cancer Genetics Program

Banu Arun , MD

Karen Lu, MD

Schedule Appointments

713.745.7391

 

M. D. Anderson provides a full range of genetic counseling, testing, screening, and research. The components of our comprehensive genetic counseling and genetic testing program include:


Intake Process

Physician and Community Awarenes

Members of the M. D. Anderson Clinical Cancer Genetics program provide continuing education for physicians, nurses, and other health care providers on topics related to hereditary cancer identification, risk assessment, and management. Continuing education is provided through grand rounds, in-services, and presentations given throughout Texas through physician and nurse oncology education programs. Presentations on hereditary cancer are also given to cancer support groups and other community organizations.

Patient Education

M. D. Anderson operates The Learning Center, a free consumer health information center that offers high-tech computer databases and traditional information sources to help patrons learn about reducing cancer risks.

Referral

Individuals interested in genetic counseling and testing services may self-refer by calling Clinical Cancer Genetics at 713.745..7391. In addition, referrals are made via healthcare professionals within the institution and from those outside of the institution. All inquiries to the M. D. Anderson system for genetic counseling services are reviewed by Clinical Cancer Genetics and triaged to the appropriate team.

Identify Eligible Subjects

Multidisciplinary teams with expertise in inherited breast and ovarian cancer syndromes, hereditary colorectal cancer syndromes, multiple endocrine neoplasia syndromes, and other cancer syndromes are available to provide comprehensive services. Each team obtains initial intake information and a comprehensive medical/social and family history. The family history is often obtained prior to the first appointment via telephone or using a family history questionnaire. Clients may be requested to bring medical records or pathology reports prior to initial visit.

Pre-test Counseling and Risk Assessment

Comprehensive risk assessment and cancer genetic counseling services are provided by physicians and master’s-level trained genetic counselors who are experts in hereditary cancer. Individuals and families are educated about the risk of developing cancer based on their personal and family history. Discussion includes a review of the benefits and risks of genetic testing when appropriate, surveillance measures, and available options for prevention. When the option of genetic testing is pursued, a thorough informed consent process is followed (see below).

Informed Consent Procedures

The informed consent process is incorporated into the counseling session. Discussions include:

  • the type of test involved
  • the purpose of the test
  • the specific implications of positive, negative, and inconclusive test results
  • potential benefits of testing
  • options and limitations of cancer surveillance and prevention following testing
  • potential risks and limitations of genetic testing (confidentiality, adverse psychosocial sequelae, and discrimination issues)
  • cost and availability of testing


Testing

Confidentiality Standards

Genetic consultation reports and genetic test results are documented in patients’ M. D. Anderson medical record. All medical records at M. D. Anderson are confidential, and the institution strictly adheres to all relevant federal and state laws regarding the confidentiality of medical records.

Testing

Genetic tests for mutations in cancer susceptibility genes, which are ordered for M. D. Anderson patients, are generally performed by either licensed commercial labs or institutional labs with CAP/CLIA accreditation. Relevant tumor studies (microsatellite instability and immunohistochemistry) are done in-house by the Department of Pathology. Occasionally, testing is done in research laboratories. Should such research laboratory testing identify a mutation, clinical confirmation through a CLIA-certified lab is recommended.

Available Testing at or Through MDACC

Cancer/Syndrome

Gene

Hereditary Breast & Ovarian Cancer

BRCA1 & BRCA2

Li-Fraumeni Syndrome

TP53

Hereditary Retinoblastoma

RB

Familial Adenomatous Polyposis (FAP)

APC, MYH

Lynch Syndrome/HNPCC

MLH1, MSH2, MSH6

Multiple Endocrine Neoplasia (MEN2)

RET

Multiple Endocrine Neoplasia (MEN1)

MEN1

Hereditary Pheochromocytoma /
   Paraganglioma

SDHB, SDHC, SDHD

Neurofibromatosis

NF1, NF2

von Hippel-Lindau Syndrome (VHL)

VHL

Cowden Syndrome

PTEN

Peutz-Jeghers Syndrome

STK11/LKB1

Juvenile Polyposis Syndrome

BMPR1A/SMAD4

 

Other relevant hereditary cancer predisposition genetic tests may be ordered as appropriate and when clinically available.

Laboratory Quality Assurance

M. D. Anderson clinical laboratories are CAP/CLIA accredited.

Test Result Interpretation

The multidisciplinary genetics team interprets the laboratory test results in the context of the client's personal and family history. Current literature and specific mutation databases are used in estimating the individual's risk for developing cancer.


Post-Test Counseling and Follow-Up

Post-test Counseling

Test results are generally disclosed in a face-to-face follow-up counseling visit. The client's risk for developing cancer and options for managing the risk are reviewed and discussed. The counseling team assists the client in coping with test results; discusses decisions and approaches to communication of test results to other health care providers, family members, and others; and helps the client develop a plan for follow-up.

Cancer Screening

The genetic counseling team offers recommendations to the client regarding appropriate screening and surveillance approaches based on his or her specific risk. Discussions include the recommended frequency for the given procedure/test and the data available to show efficacy and potential risks of the screening modality. Clients are offered follow-up, as appropriate, in the M. D. Anderson high-risk breast, ovarian, and/or GI screening clinics.

Medical and Surgical Management

Medical and surgical options such as chemoprevention studies or prophylactic surgery for management of increased risk for developing cancer are reviewed at length with clients. These services are readily available within the institution and there are also mechanisms to refer clients to other NCCN institutions as appropriate.

Psychological and Supportive Services

Mechanisms for referrals for psychological and supportive counseling as well as specialized medical services are in place. For some individuals, referral to a support or peer group is beneficial.


Research

M. D. Anderson also offers ongoing clinical trials to answer important questions related to genetic testing, prevention, and early detection of cancer. Please visit www.mdanderson.org for more detailed information on all of these studies.

Identifying New Genes

Mutation in Childhood Cancer: Implications of a Model—a clinical research study aimed to find out why some people develop cancers and tumors, why some families have more cancers than others, and whether certain genes or regions of DNA affect a person's risk of getting cancer.

Improving Counseling Methods

M. D. Anderson is embarking on multiple efforts to extend genetic counseling and genetic testing to both rural and county hospital populations.

Improving Testing Methods

Clinical and Predictive Genetic Testing for Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome—The goal of this research study is to confirm a diagnosis of MEN1 in individuals through genetic testing. Researchers also want to find out if there are patterns between specific changes in genes and the severity of the disease.

Running Chemoprevention Trials

HNPCC and Endometrial Cancer: Chemoprevention Using the Oral Contraceptive vs. Depo-Provera—The goal of this randomized clinical research study is to study the effects of these agents on the endometrial lining in women with HNPCC after three months of using the oral contraceptive Lo-Ovral or Depo-Provera.

A Two-Arm Phase II Chemoprevention Trial in Adenomatous Polyposis Coli Patients—The goal of this clinical research study is to compare the effects of Celebrex (celexocib) alone with celecoxib plus DFMO on the growth of polyps in patients with familial adenomatous polyposis (FAP). The safety of combining the two drugs will also be studied.

Discovering Clinical Treatments for Genetic Disorders

A Phase 2 study of SU011248 in von Hippel-Lindau Syndrome. The goal of this clinical research study is to learn if sunitinib malate (SU011248) can help to control VHL. The safety of this drug will also be studied.

Tracking Long-Term Results of Prophylactic Surgeries, Medical Surveillance Choices, and Preventative Interventions

Prospective Follow-Up of Women Who are at Increased Risk for Developing Breast Cancer—A follow-up research study that monitors women who have developed breast cancer or who are at increased risk to develop breast cancer and checks for any changes in their breast-related health. The aim of this study is to identify certain factors that may play a role in breast cancer development in high-risk women.

Prospective Study of Risk-Reducing Salpingo-Oophorectomy and Longitudinal CA-125 Screening Among Women at Increased Genetic Risk of Ovarian Cancer—The goal of this clinical research study is to learn more about how to care for women who are at increased risk of ovarian cancer. BRCA1 and BRCA2 are the two genes that cause most of the genetic forms of ovarian cancer, and women with changes (mutations) in these genes are more likely to get ovarian cancer than women without changed BRCA1 or BRCA2 genes.

Familial and National Registries

Prospective Follow-up of Women Who are at Increased Risk for Developing Breast Cancer—A follow-up research study that monitors women who have developed breast cancer or who are at increased risk to develop breast cancer and checks for any changes in their breast-related health. The aim of this study is to identify certain factors that may play a role in breast cancer development in high-risk women.


Other Components of Genetic Services

Quality Assurance

Hereditary cancer services are provided through established M. D. Anderson clinical centers, and adhere to all relevant quality control procedures. Multidisciplinary case conferences are held weekly to allow for input from all members of the multidisciplinary team.

Training

M. D. Anderson has been in existence for over 65 years. It offers opportunities for advanced training and collaborative research including molecular genetics, genetic epidemiology, behavioral and psychosocial issues related to cancer, cytogenetics, clinical genetics, and cancer pain management. Graduate training in genetic counseling is provided at M. D. Anderson through its collaboration with The University of Texas Graduate School for Biomedical Sciences.

Last updated: 2/20/2008

 

 

Educational Opportunities

NCCN 1st Annual Forum: Innovative Diagnostics & Therapeutics in Cancer Care™

September 4, 2008
New York Marriott at the Brooklyn Bridge
New York, New York

NCCN 3rd Annual Congress: Hematologic Malignancies™

September 5 – 6, 2008
New York Marriott at the Brooklyn Bridge
New York, New York


Exhibitor Information


NCCN Regional Guidelines Symposia

NCCN Breast Cancer Guidelines Symposium
Washington, D.C. (Monday, May 12, 2008)

NCCN Colon, Rectal, & Anal Cancers Guidelines Symposia
Seattle, Washington (Wednesday, June 11, 2008)

NCCN Breast Cancer Guidelines Symposium
Palo Alto, California (Friday, June 20, 2008)

NCCN Kidney Cancer Guidelines Symposium
Birmingham, Michigan (Friday, June 20, 2008)

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