Children Diagnosed With Cancer: Understanding the Health Care System

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What is a Comprehensive Cancer Center?

The National Cancer Institute (NCI) identifies certain medical centers as Comprehensive Cancer Centers because they meet certain requirements. These centers must:

  • Take part in clinical trials (carefully controlled human studies of new treatments)
  • Study cancer prevention and control in large groups of people
  • Have doctors that do basic laboratory research (studies on cells or animals)
  • Offer cancer information services
  • Have mental health and social services (psychosocial support services) available

The NCI also identifies certain hospitals as Cancer Centers. These centers must also meet certain NCI standards, although not quite as many as the Comprehensive Cancer Centers. Studies have shown that outcomes (such as survival rates) are better for children treated at hospitals like these, which are staffed by childhood cancer specialists.

Clinical trials for children with cancer

Most major centers in the United States that treat childhood cancers are members of the Children’s Oncology Group or COG. This is a clinical trials group devoted only to childhood and adolescent cancer research. It’s supported by the National Cancer Institute.

Treatment centers must follow strict guidelines to ensure that patients and families are fully informed about the potential value and risk of each clinical trial. After they have been given detailed information about the clinical trial, parents have the chance to ask questions. If they agree to have their child take part in the clinical trial, they must sign the consent form. This is called giving informed consent. Patients then are randomly assigned (randomized) by computer to get either the new treatment being studied or the standard treatment (standard treatment is defined as the best treatment we have so far). Families do not have to enroll their child in a clinical trial and can choose instead to get the standard treatment. You can learn more about this in Clinical Trials: What You Need to Know, which you can read on our Web site or get a free copy by calling us at 1-800-227-2345.

Where are children and teens treated?

Most children with cancer are treated at large pediatric cancer centers. And most take part in clinical trials sponsored by the National Cancer Institute (NCI) through the Children’s Oncology Group (COG). The NCI also supports Comprehensive Cancer Centers and Community Clinical Oncology Centers. Several medical facilities in the United States and abroad are members of COG and treat pediatric cancer patients. You can learn how to find a COG hospital near you in our document called Pediatric Cancer Centers. You can read it on our Web site or call us for a copy.

When hospitalized, children and teens are treated in inpatient units in medical centers or community hospitals. Outpatient treatment (when the child is not in the hospital) may take place in hospital clinics, doctor’s offices, or at home. When they are treated at home, patients usually get services from a home health agency. These services can include checking vital signs, giving chemo or medicines by vein, and other types of care. Home care staff may also teach family members to give drugs, manage equipment, and handle certain health problems.

Local pediatricians or family practice doctors may be involved in giving chemo, too. They may also take part in evaluating and treating symptoms, with guidance from the pediatric oncologist who is managing the child’s cancer treatment. This helps avoid long stays in the hospital. Every effort is made to have children go to school and continue their normal activities as much as possible while they are being treated.

How are children and teens treated?

Treatment depends on the type of cancer the child has, the stage of the cancer, the child’s age, overall health, and other factors. Treatment may be chemo, radiation, surgery, or some combination of these. The doctor and other members of the cancer team will explain the treatments they recommend and answer questions before treatment starts.

Keep in mind that the parent(s) or guardians must consent for the child’s treatment, which is why they usually want to learn all they can about the child’s cancer. If you would like to know more about the type of cancer your child has, and about the treatments used, please call us. Or, you can find this information and more on our Web site at

Late effects

The survival rate for children with most cancers tends to be very good. But the treatments that allow these children to live can cause health problems that may not show up until months or even years after treatment. These are called late effects, and may include things like problems with learning, coordination, hearing, growth, and fertility. Treatment might affect organs like the heart, lung, eyes, muscles, or brain. Some of these effects can persist into adulthood or even throughout the child’s entire life. Late effects vary by type of treatment, age at the time of treatment, and other factors. Ask about possible late effects when planning your child’s treatment with the doctor and the other members of the cancer team. You can also learn more about them in our document called Childhood Cancer: Late Effects of Cancer Treatment.

Last Medical Review: 07/02/2012
Last Revised: 07/02/2012