Optimizing leukemia/lymphoma care with a multidisciplinary team

Having a team follow the patient over their treatment course allows us to know the patient well and the patient to have the comfort of seeing the same providers over time.

The most effective way to optimize patient care revolves around a combination of physicians, nurses, pharmacists, nurse practitioners, social workers and case managers. Members of the team work together to help with decision-making in each child’s care.

Having a team follow the patient over their treatment course improves patient continuity and patient experience. Not only will we know the patient well, but the patient will know us and have a comfort level from seeing the same providers over time.

Every leukemia and lymphoma patient at Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine, has a team dedicated to their care. The team consists of an oncologist, a nurse practitioner, a nurse clinician and a member of the Pediatric Psychosocial Program. In addition, there are multidisciplinary discussions regarding management options with a pathologist, surgeons, radiologists and other pediatric subspecialists.

Knowing patients, and patients knowing their providers

A team that really knows patients and their families well affects their experience in ways big and small.

As the quarterback of the team, our oncologists work with other subspecialists to craft an individualized care plan for each child. The psychosocial team talks to the patient and the patient’s family about their life-changing experience and can address a child’s anxiety. The nurses, who have the most day-to-day contact with the patients, know each patient’s preferences and quirks, such as how they would prefer to their port accessed.

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To refer a patient to Norton Children’s Cancer Institute, visit Norton EpicLink and choose EpicLink referral to Pediatric Hematology/Oncology.

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Not every patient reacts the same to every medicine. Because we know our patients, we can customize the antiemetic regimen for each of them. We know whether they breeze through intravenous immunoglobulin (IVIg) or have burdensome side effects, how they respond to contrast and whether they need sedation during scans.

When treating somebody with cancer, a major aspect of their care revolves around managing toxic side effects from chemotherapy. Many organ systems can be affected by different treatments. Knowing how each specific patient reacts allows for better care.

New treatment options for our patients include immunotherapy. We are now offering CAR-T cell immunotherapy for relapsed B-cell leukemia. Leukemia is the most common cancer in children and teens, with the vast majority either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML).

Once a diagnosis is made, we work closely with each child’s pediatrician and update them throughout the course of treatment. We work hard to integrate each child back with their pediatrician.

With our team-based approach, we hope to provide thorough and collaborative care to each child by using each member’s knowledge base, skill set and available resources.

Jun Zhao, D.O., is a pediatric hematologist/oncologist and medical director at Norton Children’s Cancer Institute.

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