Procedure in Pediatric Oncology

Introduction

Pediatric oncology is a specialized field focused on diagnosing and treating cancer in children, adolescents, and young adults. Unlike adult cancers, childhood cancers behave differently and often require distinct approaches to treatment. When a child is diagnosed with cancer, it marks the beginning of a long and carefully coordinated medical journey. The procedures involved in pediatric oncology are complex and multidisciplinary, aiming to eliminate cancer cells while preserving the child’s quality of life and development.

Procedure in Pediatric Oncology

1. Initial Consultation and Medical History Review :- The procedure in pediatric oncology begins with a detailed initial consultation. During this phase, the pediatric oncologist collects a thorough medical history of the child. This includes information about symptoms, family history of cancer or other genetic diseases, prior illnesses, and any exposure to risk factors. Parents play a critical role in conveying the child’s medical background, and emotional support is equally emphasized at this stage.
2. Physical Examination and Baseline Tests :- Following the consultation, a comprehensive physical examination is conducted to detect physical signs such as swelling, bruising, abnormal growths, or changes in vital signs. At the same time, baseline blood tests, urine analysis, and imaging studies may be ordered. These tests are crucial for identifying any abnormalities in the body’s systems and setting the foundation for further investigation.
3. Diagnostic Imaging :- Imaging plays an essential role in identifying and locating tumors or malignancies. Common diagnostic imaging methods include MRI (Magnetic Resonance Imaging), CT (Computed Tomography) scans, PET (Positron Emission Tomography) scans, ultrasound, and X-rays. These imaging techniques help oncologists visualize internal structures and assess the spread or severity of the disease. Often, contrast dyes are used to enhance the clarity of images, especially in MRI or CT scans.
4. Biopsy and Pathology Evaluation :- A definitive diagnosis of cancer usually requires a biopsy, in which a small sample of tissue is taken from the suspected tumor and examined under a microscope. In pediatric oncology, biopsy procedures are performed under sedation or anesthesia to minimize discomfort. The pathology team analyzes the sample to determine the type of cancer, its aggressiveness, and specific genetic or molecular markers that may influence treatment decisions.
5. Genetic and Molecular Testing :- Modern pediatric oncology often includes advanced genetic and molecular testing to gain deeper insights into the cancer’s biology. Techniques like FISH (Fluorescence In Situ Hybridization), PCR (Polymerase Chain Reaction), and next-generation sequencing help detect chromosomal abnormalities and gene mutations. These tests guide oncologists in choosing targeted therapies or predicting response to specific drugs.
6. Staging of Cancer :- Once a diagnosis is confirmed, the cancer is staged to determine how far it has spread in the body. Staging is a critical step in the treatment planning process. It typically involves a combination of imaging, lumbar puncture (in cases of leukemia or lymphoma), and bone marrow biopsy. The staging process helps stratify children into low, intermediate, or high-risk groups, which influences the intensity and type of treatment required.
7. Treatment Planning and Multidisciplinary Coordination :- A personalized treatment plan is created for each child based on the cancer type, stage, age of the patient, and overall health. The plan is developed through a multidisciplinary tumor board comprising pediatric oncologists, hematologists, radiologists, surgeons, pathologists, radiation oncologists, psychologists, and nutritionists. The treatment plan is discussed in detail with the family, and informed consent is obtained before initiating therapy.
8. Chemotherapy Administration :- Chemotherapy is one of the most common and vital treatment methods in pediatric oncology. Drugs are administered either orally, intravenously, through intrathecal injections (into the spinal fluid), or via implanted ports. The chemotherapy schedule varies in duration and intensity depending on the cancer type. Pediatric teams ensure close monitoring of side effects like nausea, low blood counts, or infections, and supportive care is provided accordingly.
9. Surgical Intervention :– In some cases, surgery is required to remove tumors, particularly solid tumors like neuroblastoma, Wilms tumor, or osteosarcoma. Pediatric surgical oncologists perform tumor resections while preserving as much normal tissue as possible. Surgeries are carefully planned to avoid complications and may be followed by chemotherapy or radiation for complete disease control.
10. Radiation Therapy :- Radiation therapy uses high-energy rays to destroy cancer cells. In pediatric patients, this method is used cautiously due to the potential risks to growing tissues. Modern techniques such as proton beam therapy, intensity-modulated radiation therapy (IMRT), and image-guided radiation help minimize damage to surrounding healthy cells. Radiation may be used alone or in combination with other therapies.
11. Bone Marrow Transplantation :- For certain blood cancers like leukemia or lymphoma, bone marrow or stem cell transplantation may be recommended. This involves replacing diseased bone marrow with healthy donor cells, either from a matched sibling, unrelated donor, or autologous transplant (using the patient’s own cells). The procedure is preceded by high-dose chemotherapy or radiation to eradicate existing cancer cells.

Conclusion

The procedures in pediatric oncology involve a well-coordinated sequence of diagnostic, therapeutic, and supportive steps tailored to the unique needs of children with cancer. From the moment of diagnosis through to long-term follow-up, each phase is handled with precision and compassion. With advancements in medical science and multidisciplinary care, survival rates in pediatric oncology have significantly improved, giving many children a chance at a healthier and brighter future. Early diagnosis, specialized treatment, and strong family support remain the pillars of success in this journey.