Pediatric Cancer Diagnosis and Treatment

A child calmly looks through a window in a colorful waiting area at Doernbecher Children’s Hospital.

At Doernbecher, your child’s oncologist (cancer doctor) can consult with other experts and specialists to make sure your child gets the best possible care.

You’ll find:

  • Specialists who treat only children and young adults, so they understand your child’s specific needs.
  • Providers who work as a team. We engage with you and support your family from diagnosis through treatment and survivorship.
  • Doctors with deep experience handling side effects from cancer treatment.
  • Experts in surgery techniques for pediatric cancer.
  • Access to clinical trials that test new treatments.

Diagnosis

Our experts may recommend tests to check for cancer and learn more about your child’s condition.

These tests use sound waves, X-rays or radioactive dyes to capture images inside your child’s body.

The imaging itself is painless. It may be uncomfortable for kids, though. They may need to lie still, sometimes in a semi-enclosed space, for 30 minutes to an hour.

We may use an IV to give anesthesia (medication to reduce pain or put your child to sleep) to help young children get through the scans. If we use radioactive dye, we will also use an IV.

Our imaging technology includes:

  • Ultrasound, which uses sound waves to create a picture of soft tissue. It can help us see a tumor’s location.
  • CT (computed tomography) scans make more detailed images of the body than ultrasounds. They can show the size, type and location of a tumor.
  • MRI (magnetic resonance imaging) scans use magnets and radio waves to create detailed images of structures inside the body.
  • PET (positron emission tomography) scans use a low-level radioactive dye called a tracer, and a special camera. The tracer is injected into your child’s bloodstream to make cancer cells easier to see.
An illustration of a boy lying down getting a PET Scan.
Cancer cells are more visible in a PET scan. They show up brighter in this type of scan because cancer cells consume more of the sugary material used in a tracer than normal cells do.

Doernbecher follows the guidelines of the international Image Gently Alliance. For your child’s safety, Image Gently recommends using the lowest amount of radiation possible.

In a biopsy, we take a small piece of a tumor or other tissue from your child’s body to look for cancer cells. We may use a needle or an incision. Your child will have local or general anesthesia during the biopsy.

Your child’s biopsy may be done by a surgeon or by a radiologist (a doctor who specializes in imaging). Our surgeons and radiologists have many years of experience doing biopsies on children. We use the safest and least invasive methods.

After the biopsy, a doctor called a pathologist looks at the tissue under a microscope. The pathologist looks for cancer cells and gathers information about the tumor to help us plan the best treatment.

Treatment overview

Every family’s experience with cancer is different. Our team will meet with you and your child to understand your child’s overall health and to talk about options.

We seek parents’ input on everything, including treatment plans and side effects. We’ll listen to your concerns, answer any questions and help you prepare for treatment.

We’ll also get to know your child — what grade they’re in, what they like to do — and introduce you to a cancer social worker. Your family’s social worker is part of your care team, offering continual support.

Some important things to know:

  • Our team will create a treatment plan tailored to your child. We strive to limit short-term side effects and to avoid long-lasting ones.
  • Your child’s oncologist will talk with your family and lead overall treatment. They work with an experienced team, including specialists such as surgeons and radiation oncologists.
  • Experts on our team meet at least once a week to discuss cases. This gathering is called a tumor board. Your child benefits from our providers’ decades of combined experience to shape each treatment plan.
  • Specialists in our Bridges and Child Life programs are an important part of your child’s team. They support your child’s and family’s physical, emotional, social and spiritual needs during treatment and beyond.

Chemotherapy drugs are powerful medications used to treat many childhood cancers by killing cancer cells. Chemotherapy can:

  • Be used alone or with other treatments, like surgery or radiation.
  • Stop a tumor’s growth.
  • Shrink a tumor before surgery.
  • Destroy cancer cells that might remain after surgery.

Different kinds of chemotherapy medicines are used for different types of cancer. They can be given as a pill, as a shot or through an IV.

Our cancer doctors treat only children and young adults. They are experts at knowing the best chemotherapy medications for your child’s specific cancer.

Chemotherapy drugs attack fast-growing cancer cells, but they also can damage normal cells. This may cause side effects such as fatigue, nausea and hair loss. At Doernbecher, we have deep expertise in reducing and treating these side effects.

Some side effects may take a while to show up. Our team works with experts in fertility, audiology (hearing) and other specialties to lower your child’s risk of long-term issues.

Radiation therapy aims high-energy beams, such as X-rays, directly at cancer cells to kill them. Unlike chemotherapy, radiation therapy damages cells only near the area where it is directed. Cells in other parts of the body are not affected.

Radiation therapy is sometimes used to shrink a tumor so it’s easier to remove during surgery. In other cases, we may use it to shrink or eliminate a tumor without surgery.

Our radiation oncologists are experts at treating children. We understand the least amount of radiation therapy needed to be safe and effective.

Radiation can be difficult for kids because they cannot move during treatment. We use sedation for very young children. Our team is also skilled in helping children stay still.

Radiation treatment can cause fatigue, skin irritation and other side effects. Our team has the expertise needed to help your child reduce or avoid short- and long-term side effects.

We often use surgery to remove a tumor. We may recommend having chemotherapy or radiation therapy first to shrink the tumor and make it easier to remove.

Our surgeons and other experts will review all the options to help you choose the one that’s most effective and least invasive.

For example, if your child has bone cancer, our team includes orthopedic surgeons who specialize in making sure their arm or leg still works well after removing the tumor.

Targeted therapies

Doernbecher providers and our colleagues at the OHSU Knight Cancer Institute are pioneers in targeted therapies.

These therapies take aim at genes and proteins to stop cancer cells from growing or surviving. They are called “targeted” because they attach directly to a specific type of tumor.

For example, we treat the childhood cancer neuroblastoma with targeted therapy. Neuroblastomas begin in certain nerve cells, often near the spine or in the adrenal gland.

Neuroblastoma Locations

A medical illustration of the various neuroblastoma locations.
Neuroblastoma is a type of cancer that can be found in the adrenal glands and in nerve tissue along the spine, from the neck to the hips. OHSU’s neuroblastoma treatments include targeted therapies and immunotherapy.

Immunotherapy

Immunotherapy treatments help the body’s own immune system fight cancer. Some types may treat neuroblastomas. A type called CAR T-cell therapy offers a powerful new option for a hard-to-treat leukemia.

OHSU researchers are working to develop new targeted therapies and immunotherapies. They’re also working to treat more cancers with these therapies.

Support services

Doernbecher and OHSU offer many ways to support your child and family during and after cancer treatment. You’ll find:

  • Cancer social workers
  • Survivorship programs
  • Palliative care experts
  • Help with physical and emotional effects of cancer care
  • Programs for teens and young adults with cancer

See our full range of resources for patients and families.

For families

Call 503-346-0640 to:

  • Request an appointment.
  • Seek a second opinion.
  • Ask questions.

Find resources and support.

Location

Parking is free for patients and their visitors.

Doernbecher Children’s Hospital
700 S.W. Campus Drive
Portland, OR 97239
Map and directions

Find other locations across Oregon and in southwest Washington.

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‘They can tell in an instant that you care’

Doernbecher child life specialist Jan Crider helps ease the anxiety of a hospital stay with toys, humor and a gentle touch.