Childhood Non-Hodgkin Lymphoma Treatment (PDQ®)
NCI PDQ® Summaries for Patients
General Information About Childhood Non-Hodgkin Lymphoma
Stages of Childhood Non-Hodgkin Lymphoma
Recurrent Childhood Non-Hodgkin Lymphoma
Treatment Option Overview
Treatment Options for Childhood Non-Hodgkin Lymphoma
To Learn More About Childhood Non-Hodgkin Lymphoma
Get More Information From NCI
Changes to This Summary (10/01/2009)
About PDQ
Childhood Non-Hodgkin Lymphoma Treatment
General Information About Childhood Non-Hodgkin Lymphoma
Childhood non-Hodgkin lymphoma is a disease in which
malignant (cancer) cells form in the lymph system.
The lymph system
is
part of the immune system
and is
made up of the following:
- Lymph
: Colorless, watery fluid
that travels through the lymph system and carries white blood cells
called lymphocytes
. Lymphocytes protect the body against infections
and the growth of tumors
.
- Lymph vessels
: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.
- Lymph nodes
:
Small, bean-shaped structures that filter lymph and store white blood cells that help fight
infection and disease. Lymph nodes grow along the network of lymph vessels
found throughout the body. Clusters of lymph nodes are found in the underarm,
pelvis
, neck, abdomen
, and groin
.
- Spleen
: An organ
that makes lymphocytes, filters the
blood
, stores blood cells, and destroys old blood cells. The spleen is on the
left side of the abdomen near the stomach
.
- Thymus
: An organ in which lymphocytes grow and multiply. The
thymus is in the chest behind the breastbone.
- Tonsils
: Two small masses of lymph tissue
at the back of the throat. The
tonsils make lymphocytes.
- Bone marrow
: The soft, spongy tissue in the center of
large bones. Bone marrow makes white blood cells, red blood cells
, and
platelets
.
Anatomy of the lymph system, showing the lymph vessels and lymph organs including lymph nodes, tonsils, thymus, spleen, and bone marrow. Lymph (clear fluid) and lymphocytes travel through the lymph vessels and into the lymph nodes where the lymphocytes destroy harmful substances. The lymph enters the blood through a large vein near the heart.
Because lymph tissue is found throughout the body, childhood
non-Hodgkin lymphoma
can begin in almost any part of the body. Cancer
can spread to the
liver
and many other organs and tissues.
Non-Hodgkin lymphoma can occur in both adults and children. Treatment for children is different than treatment for adults.
(See
the PDQ
summary on Adult Non-Hodgkin
Lymphoma Treatment for more information.)
There are four major types of childhood non-Hodgkin
lymphoma.
The specific type of lymphoma
is determined by how the cells
look
under a microscope. The 4 major types of childhood non-Hodgkin lymphoma
are:
There are other types of lymphoma that occur in children. These include the following:
- Lymphoproliferative disease
associated with a weakened immune system.
- Rare non-Hodgkin lymphomas that are more common in adults than in children.
Possible signs of childhood non-Hodgkin lymphoma include
breathing problems and swollen lymph nodes.
These and other symptoms
may be caused by childhood non-Hodgkin lymphoma. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems
occur:
- Shortness of breath.
- Trouble breathing.
- Wheezing.
- High-pitched breathing sounds.
- Swelling of the head or neck.
- Trouble swallowing.
- Painless swelling of the lymph nodes in the neck, underarm,
stomach, or groin.
- Fever
for no known reason.
- Weight loss for no known reason.
- Night sweats.
Tests that examine the body and lymph system are used to detect (find)
and diagnose childhood non-Hodgkin lymphoma.
The following tests and procedures may be used:
- Physical exam
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Biopsy
: The
removal of cells or tissues so they can be viewed under a microscope by a pathologist
to check for
signs of cancer. One of the following types of biopsies may be done:
- Excisional
biopsy
: The removal of an entire lymph node or lump of tissue.
- Incisional
biopsy
: The removal of part of a lump, lymph node, or sample of tissue.
- Core biopsy
: The removal of tissue or part of a lymph node using a wide needle.
- Fine-needle aspiration (FNA) biopsy
:
The removal of tissue or part of a lymph node using a thin needle.
- Bone marrow aspiration
and biopsy
: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone.
Bone marrow aspiration and biopsy. After a small area of skin is numbed, a Jamshidi needle (a long, hollow needle) is inserted into the patient’s hip bone. Samples of blood, bone, and bone marrow are removed for examination under a microscope.
- Thoracentesis
: The removal of fluid
from the space between the lining of the chest and the lung
, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.
- Chest x-ray
: An x-ray
of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan
(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
Certain factors affect prognosis (chance
of recovery) and treatment options.
The prognosis
(chance of recovery) and treatment options depend on:
- The
stage
of the cancer.
- The number of places outside of the lymph nodes to which the cancer has spread.
- Whether the lymphoma has spread to the central nervous system
(brain and spinal cord
).
- The type of lymphoma.
- The patient’s general health.
Stages of Childhood Non-Hodgkin Lymphoma
After childhood non-Hodgkin lymphoma has been diagnosed,
tests are done to find out if cancer cells have spread within the lymph system
or to other parts of the body.
The process used to find out if cancer
has spread within the
lymph system
or to other parts of
the body is called staging
. The
information gathered from the staging process determines the stage
of the
disease. It is important to know the stage in order to plan treatment.
Some of the tests that are used to diagnose
childhood non-Hodgkin lymphoma
are also used to stage the disease. The following tests and procedures may be used in the staging process:
- Physical exam
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Complete blood count
(CBC): A procedure in which a sample of blood
is drawn and checked for the following:
Complete blood count (CBC). Blood is collected by inserting a needle into a vein and allowing the blood to flow into a tube. The blood sample is sent to the laboratory and the red blood cells, white blood cells, and platelets are counted. The CBC is used to test for, diagnose, and monitor many different conditions. - Blood chemistry studies
: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs
and tissues
in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
- Chest x-ray
: An x-ray
of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- CT scan
(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye
may be injected
into a vein
or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Ultrasound
exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram
. The picture can be printed to be looked at later.
- Gallium scan
: A procedure to detect areas of the body where cells
, such as cancer cells, are dividing rapidly. A very small amount of radioactive
material, gallium, is injected into a vein and travels through the bloodstream. The gallium collects in the bones or other tissues (organs) and is detected by a scanner.
- Bone marrow aspiration
and biopsy
: The removal of bone marrow
, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist
views the bone marrow, blood, and bone under a microscope to look for signs of cancer.
- Lumbar puncture
: A procedure used to collect cerebrospinal fluid
from the spinal column
. This is done by placing a needle into the spinal column. This procedure is also called an LP or spinal tap.
Lumbar puncture. A patient lies in a curled position on a table. After a small area on the lower back is numbed, a spinal needle (a long, thin needle) is inserted into the lower part of the spinal column to remove cerebrospinal fluid (CSF, shown in blue). The fluid may be sent to a laboratory for testing. - Bone scan
: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
- MRI
(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Endoscopy
: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope
is inserted through an incision
(cut) in the skin or opening in the body, such as the mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node
samples, which are checked under a microscope for signs of disease.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue
. Cancer invades
the surrounding normal tissue.
- Through the lymph system
. Cancer invades the lymph system and travels through the lymph vessels
to other places in the body.
- Through the blood
. Cancer invades the veins
and capillaries
and travels through the blood to other places in the body.
When cancer cells
break away from the primary
(original) tumor
and travel through the lymph
or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis
. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer
spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer
.
The following stages are used for childhood non-Hodgkin
lymphoma:
Stage I
Stage I childhood non-Hodgkin lymphoma. Cancer is found in one group of lymph nodes or one area outside the lymph nodes, but no cancer is found in the abdomen or mediastinum (area between the lungs).
In stage I childhood non-Hodgkin lymphoma
, cancer
is found:
- in one group of lymph nodes
; or
- in one area outside the lymph nodes.
No cancer is found in the abdomen
or mediastinum
(area between the lungs
).
Stage II
Stage II childhood non-Hodgkin lymphoma. Cancer is found in one area outside the lymph nodes and in nearby lymph nodes (a); or in two or more areas above (b) or below (c) the diaphragm; or cancer started in the stomach, appendix, or intestines (d) and can be removed by surgery.
In stage II childhood non-Hodgkin
lymphoma
, cancer
is found:
- in one area outside the lymph nodes
and in nearby lymph nodes; or
- in two or more areas above or below the diaphragm
, and may or may not have spread to nearby lymph nodes; or
- to have started in the stomach
or intestines
and can be completely removed by surgery
. Cancer may or may not have spread to certain nearby lymph nodes.
Stage III
Stage III childhood non-Hodgkin lymphoma. Cancer is found in at least one area above and below the diaphragm (a); or cancer started in the chest (b); or cancer started in the abdomen and spread throughout the abdomen (c); or in the area around the spine (not shown).
In stage III
childhood non-Hodgkin lymphoma
, cancer
is found:
- in at least one area above the diaphragm
and in at least one area below the diaphragm; or
- to have started in the chest; or
- to have started in the abdomen
and spread throughout the abdomen, and cannot be completely removed by surgery
; or
- in the area around the spine
.
Stage IV
Stage IV childhood non-Hodgkin lymphoma. Cancer is found in the bone marrow, brain, or cerebrospinal fluid (CSF). Cancer may also be found in other parts of the body.
In stage IV childhood
non-Hodgkin lymphoma
, cancer
is found in the bone marrow
, brain, or cerebrospinal fluid
. Cancer may also be found in other parts of the body.
Childhood non-Hodgkin lymphoma is also described as localized or disseminated.
Treatment for childhood non-Hodgkin lymphoma
is based on whether the cancer
is localized
or disseminated
. Localized lymphoma has not spread beyond the area in which it began. Disseminated lymphoma has spread beyond the area in which it began. Stage I
and stage II
are usually considered localized. Stage III
and stage IV
are usually considered disseminated.
Recurrent Childhood Non-Hodgkin Lymphoma
Recurrent
childhood
non-Hodgkin lymphoma
is
cancer
that has recurred (come back)
after it has been treated. Childhood non-Hodgkin lymphoma may come
back in the lymph system
or in other parts of the body.
Treatment Option Overview
There are different types of treatment for children with
non-Hodgkin lymphoma.
Different types of treatment are available for children with
non-Hodgkin lymphoma
. Some
treatments are standard
(the currently used treatment), and some are being
tested in clinical trials
. A treatment clinical trial is a research study meant to help improve
current treatments or obtain information on new treatments for patients with
cancer
. When clinical trials show that a new treatment is better than the
standard treatment, the new
treatment may become the standard treatment.
Because cancer in children is rare, taking part in a clinical trial
should be considered. Some clinical trials are open only to patients who have not started treatment.
Children with non-Hodgkin lymphoma should have their
treatment planned by a team of doctors with expertise in treating childhood
cancer.
Treatment will be overseen by a
pediatric
oncologist
, a doctor who specializes
in treating children with cancer. The pediatric oncologist works with other health care providers who are experts in treating children
with non-Hodgkin lymphoma and who specialize in certain areas of medicine.
These may include the following specialists:
Some cancer treatments cause side effects months or years
after treatment has ended.
Side effects
from cancer treatment that begin during or after treatment and continue for months or years are called late effects
. Late effects of cancer treatment may include the following:
- Physical problems.
- Changes in mood, feelings, thinking, learning, or memory.
- Second cancers
(new types of cancer).
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the effects cancer treatment can have on your child. (See the PDQ
summary on Late Effects of Treatment for Childhood Cancer for more information.)
Three types of standard treatment are used:
Chemotherapy
Chemotherapy
is a cancer treatment that uses drugs
to stop the growth of cancer cells
, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy
). When chemotherapy is placed directly into the spinal column
(intrathecal chemotherapy
), an organ
, or a body cavity
such as the abdomen
, the drugs mainly affect cancer cells in those areas. Intrathecal
chemotherapy may be used to treat
childhood non-Hodgkin lymphoma that has spread, or may spread, to the brain. When used to prevent spread to the brain, it is called CNS prophylaxis
. The way the chemotherapy is given depends on the type and stage
of the cancer being treated.
Intrathecal chemotherapy. Anticancer drugs are injected into the intrathecal space, which is the space that holds the cerebrospinal fluid (CSF, shown in blue). There are two different ways to do this. One way, shown in the top part of the figure, is to inject the drugs into an Ommaya reservoir (a dome-shaped container that is placed under the scalp during surgery; it holds the drugs as they flow through a small tube into the brain). The other way, shown in the bottom part of the figure, is to inject the drugs directly into the CSF in the lower part of the spinal column, after a small area on the lower back is numbed.
Combination chemotherapy
is treatment using 2 or more anticancer drugs.
Radiation therapy
(in certain patients)
Radiation therapy
is a cancer treatment that uses high energy x-rays
or other types of radiation
to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy
uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy
uses a radioactive
substance sealed in needles, seeds
, wires, or catheters
that are placed directly into or near the cancer. When radiation therapy is used to prevent spread to the brain, it is called CNS prophylaxis. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
High-dose chemotherapy with stem cell transplant
This treatment is a way of giving high doses of chemotherapy
and then replacing blood
-forming cells destroyed by the cancer treatment. Stem cells
(immature blood cells) are removed from the bone marrow
or blood of the patient or a donor and are frozen and stored. After the chemotherapy is completed, the stored stem cells are thawed and given back to the patient through an infusion
. These reinfused stem cells grow into (and restore) the body’s blood cells.
New types of treatment are being tested in clinical
trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web
site.
Targeted therapy
Targeted therapy
is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. One type of targeted therapy being studied in the treatment of childhood non-Hodgkin lymphoma is monoclonal antibody
therapy
.
Monoclonal antibody therapy is a cancer treatment that uses antibodies
made in the laboratory from a single type of immune system
cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins
, or radioactive material directly to cancer cells.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial
may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring
(coming back) or reduce the side effects
of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's
clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose
the cancer or to find out the stage
of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred
(come back). These tests are sometimes called follow-up
tests or check-ups.
Treatment Options for Childhood Non-Hodgkin Lymphoma
A link to a list of current clinical trials
is included for each treatment section. For some types or stages
of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Localized Non-Hodgkin Lymphoma in Children and Adolescents
Standard treatment
of localized
non-Hodgkin lymphoma
in children and adolescents is usually surgery
followed by combination chemotherapy
.
New treatments are being studied in clinical trials
for localized non-Hodgkin
lymphoma in children and adolescents.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I childhood large cell lymphoma, stage I childhood small noncleaved cell lymphoma, stage I childhood lymphoblastic lymphoma, stage I childhood anaplastic large cell lymphoma, stage II childhood large cell lymphoma, stage II childhood small noncleaved cell lymphoma, stage II childhood lymphoblastic lymphoma and stage II childhood anaplastic large cell lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Disseminated Childhood B-cell Non-Hodgkin Lymphoma
Standard treatment
for disseminated
B-cell
(Burkitt
and Burkitt-like) non-Hodgkin lymphoma
in children and adolescents is usually combination chemotherapy
with CNS prophylaxis
(intrathecal chemotherapy
).
Monoclonal antibody
therapy
combined with chemotherapy
is being studied in clinical trials
for disseminated B-cell non-Hodgkin lymphoma in children and adolescents.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood large cell lymphoma, stage III childhood small noncleaved cell lymphoma, stage IV childhood large cell lymphoma and stage IV childhood small noncleaved cell lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Disseminated Childhood Lymphoblastic Lymphoma
Standard treatment
of disseminated
lymphoblastic lymphoma
in children and adolescents is usually combination chemotherapy
with or without radiation therapy
to the brain.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood lymphoblastic lymphoma and stage IV childhood lymphoblastic lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Disseminated Childhood Anaplastic Large-cell Lymphoma
Standard treatment
of disseminated
anaplastic large-cell lymphoma
in children and adolescents is usually combination chemotherapy
with or without CNS prophylaxis
(intrathecal chemotherapy
).
New combinations of chemotherapy
are being studied in clinical trials
for disseminated anaplastic large-cell lymphoma in children and adolescents.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III childhood anaplastic large cell lymphoma and stage IV childhood anaplastic large cell lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Recurrent Childhood Non-Hodgkin Lymphoma
Standard treatment
of recurrent
childhood non-Hodgkin lymphoma
in children and adolescents may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent childhood non-Hodgkin lymphoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Lymphoproliferative Disease Associated with a Weakened Immune System
Standard treatment
of lymphoproliferative disease
in children and adolescents with weakened immune systems
may include the following:
Some of the treatments being studied in clinical trials
include the following:
To Learn More About Childhood Non-Hodgkin Lymphoma
For more information from the National Cancer Institute
about childhood non-Hodgkin lymphoma, see the following:
For more childhood cancer
information and other general cancer resources from the National Cancer Institute, see the following:
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There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
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The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237).
Changes to This Summary (10/01/2009)
The PDQ
cancer
information summaries are reviewed regularly and updated as
new information becomes available. This section describes the latest
changes made to this summary as of the date above.
Editorial changes were made to this summary.
About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." In the United States, about two-thirds of children with cancer are treated in a clinical trial at some point in their illness.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. For additional help in locating a childhood cancer clinical trial, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
The PDQ database contains listings of groups specializing in clinical trials.
The Children's Oncology Group (COG) is the major group that organizes clinical trials for childhood cancers in the United States. Information about contacting COG is available on the NCI Web site or from the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).
Date last modified: 2009-10-01