Pediatrics Rotation
Residents will rotate with Drs. Howard and Mehta to evaluate pediatric patients, including benign and malignant tumors. These patients will be seen primarily in a multidisciplinary context, together with pediatric oncologists, radiologists, pathologists, endocrinologists, neurologists and other support personnel. Patients will be seen and evaluated as inpatients at UW Children's Hospital. Additional learning opportunities within this clinic include participation and/or observation of the surgical principles in the management of pediatric oncology patients with Drs. Go and Lund. As the presentation of patients with pediatric malignancies is unpredictable, these patients are seen as needed. The rotation will provide opportunities in enhancing the multidisciplinary knowledge in the management pediatric malignacies. In addition, since the vast majority of these patients are treated with advanced radiotherapy techniques such as 3-D radiotherapy, radiolabled antibodies, radiolabled isotopes etc, residents will have ample opportunity to and are highly encouraged to become proficient in the application of all of these technologies. In order to truly appreciate the multidisciplinary management of pediatric patients, all children with malignancies seen at UW Children's Hospital are discussed at the weekly combined modality Pediatric Oncology Conference, attendance at which is required; this will include radiology and pathology review of all newly diagnosed patients and those patients with ongoing management issues.
Typically, in an average 3-month rotation, residents will have contact with approximately 10-15 new patient problems within pediatric oncology, and over 20-25 follow-up contact opportunities. In addition, in an average 3-month time span, residents will have the opportunity to participate in over 10 treatment planning procedures using with advanced radiotherapy techniques such as 3-D radiotherapy.
Goals and Objectives
Observe and understand the etiology, epidemiology, molecular genetics, pathophysiology, clinical presentation, natural history, treatment options, risks and benefits of various options and long-term sequalae of treatment, including functional and neurocognitive outcome for patients with various pediatric oncologic conditions as listed above. Understand the educational, social, societal, quality of life and cost-effectiveness issues surrounding the management of the above patients. Understand the multimodality approaches to these conditions, and learn an appropriate physician behavior pattern that optimizes multidisciplinary interaction. Become proficient in the technical aspects of radiotherapeutic management of pediatric conditions, including routine radiotherapy, as well as specialized applications such as 3-D radiotherapy, the use of multimodality imaging, IMRT (once implemented) and Tomotherapy (once implemented). It is also expected that a basic foundation in the radiobiologic concepts underpinning these approaches will be developed. Become proficient in the application of palliative radiation therapy techniques, including, but not limited to brain metastases, leptomeningeal dissemination, cord-compression, cauda-equina syndromes, nerve root entrapment syndromes, skeletal metastases, etc. Understand the relative merits and application of other palliative modalities in these context. Learn to make appropriate decisions regarding resource utilization for these patients. Learn the value of and utilize Hospice services appropriately for such patients. Understand and appreciate the opportunities for clinical and translational research in this patient population.