For information on clinical trials at this NCCN Member Institution click here.

Profile

Since 1996, three world-renowned Harvard Medical School-affiliated institutions—Dana-Farber Cancer Institute, Brigham and Women's Hospital, and Massachusetts General Hospital Cancer Center have worked together to provide the best possible treatment of adult cancers. Through the Dana-Farber/Brigham and Women’s Cancer Center and the Massachusetts General Hospital Cancer Center these institutions provide comprehensive, multidisciplinary care to more than 12,000 new cancer patients.

Multidisciplinary Treatment

• Adult cancer care is organized into more than 12 multidisciplinary treatment programs including breast cancer, endocrine cancer, gastrointestinal cancer, genitourinary cancer, gynecological cancer, head and neck cancer, hematology, hematologic malignancies (leukemia, lymphoma & multiple myeloma) , melanoma, neuro-oncology, sarcoma, and thoracic oncology. Through each treatment program, patients have access to specialized cancer physicians, surgeons, radiation oncologists, nurses, social workers, and other staff. These clinicians work with patients and referring physicians to develop care plans. All aspects of diagnosis and treatment are available, from genetic and molecular testing to a full array of support services, including individual and group counseling.

Clinical Research

• Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Massachusetts General Hospital Cancer Center are leaders in cancer research and rank as the top three independent recipients of National Institutes of Health research funding in the United States. Their collaboration brings together each institution's diverse capabilities in research to help speed the transition of new discoveries into effective patient therapies. Together, Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center activate more than 10 new cancer trials each month and now have more than 350 active clinical trials underway. Currently, more than 2,000 patients a year are enrolled in clinical research trials that offer them access to promising new therapies and, at the same time, provide valuable information that may lead to better treatments for all cancer patients.
• Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Massachusetts General Hospital Cancer Center are each members of Dana-Farber/Harvard Cancer Center, a National Cancer Institute-designated Comprehensive Cancer Center.

Dana-Farber Pediatric Oncology Services

888.PEDI.ONC
www.danafarberchildrens.org

For 60 years, Dana-Farber Cancer Institute and Children's Hospital Boston have worked together to provide the best care available for children with cancer. Known as Dana-Farber/Children’s Hospital Cancer Care, these neighboring institutions provide a spectrum of services, from diagnosis to long-term management of all types of childhood cancers. Dana-Farber/Children’s Stem Cell Transplantation Program is one of the oldest and largest programs in the nation and its Pediatric Brain Tumor Program is the largest in the region. Both programs remain at the forefront of research and technology and are among the most accomplished in the world. Furthermore, the David B. Perini, Jr. Quality of Life Clinic has helped thousands of survivors of childhood cancers cope with the long-term effects of the disease.

Dana-Farber/Brigham and Women’s Cancer Center
Massachusetts General Hospital Cancer Center
Adult Oncology Services

Introduction

Since 1996, the adult oncology collaboration of Dana-Farber Cancer Institute, Brigham and Women’s Hospital and Massachusetts General Hospital Cancer Center has enabled some of the world’s leading specialists to coordinate research, training, and patient care. These Harvard Medical School-affiliated hospitals are members of Dana-Farber/Harvard Cancer Center, a National Cancer Institute-designated Comprehensive Cancer Center.

Patient care is provided at Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center. At each site patients are offered the highest standard of care and innovative treatments.

General Information

Treatment

Stem Cell Transplant Program

Bone marrow transplantation (BMT) has been performed by specialists at the Dana-Farber/Brigham and Women’s Cancer Center for 30 years, making it one of the nation's oldest transplant programs. It is also one of the largest and busiest BMT units, with more than 4,000 transplants to their credit, and approximately 300 cases annually. All types of blood stem cell and marrow grafting are performed, including matched and mismatched transplants from family members or unrelated donors, cord blood transplants, autologous transplants, and identical twin transplantation. The physicians in this program have made major advances in graft-versus-host disease prevention and therapy and in graft-versus-leukemia.

Since 1993, the Bone Marrow Transplant Program at the Massachusetts General Hospital Cancer Center has been committed to developing leading-edge strategies for autologous and allogeneic bone marrow and peripheral blood stem cell transplantation. It has been particularly successful in HLA-mismatched transplant strategies and for patients with multiple myeloma and kidney failure, having performed the world's first successful simultaneous kidney and bone marrow transplants from a genetically matched, living donor.

Both programs participate in the International Bone Marrow Transplant Registry (IBMTR), are fully accredited with the National Marrow Donor Program (NMDP), are members of the Cancer and Leukemia Group B (CALGB), are accredited by the Foundation for the Accreditation of Cellular Therapy (FACT), and are charter members of the Blood and Marrow Transplantation Clinical Trials Network of the National Institutes of Health (NIH).

The transplantation units at both centers are specially designed facilities that include standard and enhanced HEPA-filtration, positive air flow pressure, and laminar air flow units. Patients receive world-class care by a team of specialists, including a medical oncologist, radiation oncologist, hematopathologist, infectious disease specialist, oral surgeon, nutritionist, and social worker. The programs at both sites of care have the advantage of being part of highly regarded general acute hospitals that are capable of addressing any complication or specific consultative need that might arise with stem cell patients. Patients and family members have access to support groups and educational programs; complementary therapies; and low-cost, short- and long-term housing.

Advanced Radiation Therapies at Dana-Farber/Brigham and Women’s Cancer Center

The Department of Radiation Oncology at the Dana-Farber/Brigham and Women’s Cancer Center offers patients a comprehensive approach to radiation therapy with a team of expert physicians, physicists, nurses and radiation therapists who develop individualized care plans as part of a multi-specialty approach to each form of cancer, while constantly advancing treatment modalities through laboratory, translational and clinical research.

In addition to traditional approaches, the Dana-Farber/Brigham and Women’s team has led in the development of:

Image-guided Radiation Therapy
Radiation oncologists at Dana-Farber/Brigham and Women’s Cancer Center use a range of imaging techniques, including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound to guide radiation treatment while minimizing risk of damaging normal surrounding tissues. Image-guided radiation therapy is used for many forms of cancer, including prostate, gynecologic, and breast cancers.

Image guidance also enables precise placement of radioactive sources used in brachytherapy treatment for cancer. Specialists at the Center are among few in the world to offer real-time, MR-guided radiation implant therapy for the treatment of prostate and gynecologic cancers.

Intensity-Modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy provides precise, high-dose radiation treatment to optimize cancer treatment, while minimizing radiation exposure and damage to normal surrounding tissues. IMRT is used to treat a wide range of cancers, including the treatment of brain, head and neck, prostate and breast tumors.

Accelerated Partial Breast Irradiation
Offering an alternative to six weeks of standard external beam radiation treatment for select patients with breast cancer, brachytherapy specialists at the Center offer accelerated partial breast irradiation using the temporary insertion of radioactive sources to destroy cancer cells. This treatment is performed in the Center’s high dose rate (HDR) brachytherapy suite, which features a CT scanner for image-guided seed placement.

Stereotactic Radiosurgery (SRS) and Stereotactic Radiation Therapy (SRT)
Specialists at the Center are providing image-guided, stereotactic radiosurgery and radiation therapy to deliver intense, highly focused and precisely targeted irradiation for better outcomes and quality-of-life for patients with malignant and benign brain tumors.

Image-guided Brachytherapy
Brachytherapy specialists at the Center offer both high dose rate (HDR) and low dose rate brachytherapy using 3-dimensional image-guided techniques for gynecologic and prostate cancers. HDR brachytherapy delivers a high dose of radiation therapy in a short period of time. The Center’s dedicated brachytherapy suite is designed for safe and efficient delivery of brachytherapy treatment. The suite is equipped with a CT scanner for real-time, image-guided radioactive source placement.

4-Dimensional (4D) PET CT
4D PET-CT enhances the already powerful imaging technology of PET/CT by introducing the ability to do metabolic imaging and also evaluate tumor motion within a single session.  A 4D imaging component can be added to either or both of the PET and CT portion of the imaging study and both imaging modalities are potentially enhanced by the addition of 4D. 

Stereotactic Body Radiation Therapy (SBRT) for Liver Lesions
Patients with solitary liver metastases who are not candidates for surgery may benefit from SBRT to liver metastases.  This treatment modifies the techniques and principles of intracranial stereotactic radiation therapy for treating areas outside of the brain.  Using three to five high-dose fractions of radiation therapy, multiple highly conformal beams coupled with immobilization techniques are designed to deliver a high dose of radiation therapy to the tumor while minimizing the dose to the surrounding liver and other normal structures.

Stereotactic Spine Radiotherapy
Patients with primary and metastatic tumors involving the spinal may benefit from stereotactic spine radiotherapy.  Stereotactic spine radiotherapy uses image guidance with robotic patient positioning at the time of treatment to accurately target tumor.  This highly precise form of radiation treatment can deliver focused radiation therapy to tumors of the spine while minimizing dose to uninvolved spinal cord.

Advanced Radiation Therapies at Massachusetts General Hospital Cancer Center
The Massachusetts General Hospital Cancer Center has long been at the forefront of radiation therapy. The radiation oncologists coordinate patient care with their subspecialty counterparts in Surgical Oncology, Medical Oncology, Pathology and Diagnostic Radiology. Special equipment and facilities including the Francis H. Burr Proton Therapy Center, richly complement this sub specialization of medical talents. Our radiation oncologists work with clinical physicists to bring the latest technological developments from industry to our patients. Treatment plans are created using the most advanced computing and imaging techniques. Clinicians, Radiation Oncologists, and Physicists have access to a complete array of devices to carefully administer radiation to “target tissues” while minimizing radiation exposure to uninvolved tissue.

Proton Beam Therapy
As the site of the only proton beam therapy center in the Northeast, Massachusetts General Hospital Cancer Center offers cancer patients the most precise and advanced form treatment available. Protons have unique physical characteristics that enable their energy to be very precisely controlled to target the tumor while sparing healthy tissue. In addition, the dose of proton beams can be conformed to the tumor shape with the use of devices that are custom-made for each patient.

4-D CT Imaging
Organ motion is problematic when using radiation therapy to treat cancers such as lung and liver. Radiation oncologists and physicists at Massachusetts General Hospital Cancer Center developed sophisticated software technology that takes into account the movement of organs over time. Called 4-D CT imaging (the four dimensions being width, height, depth, and time), this technology provides clinicians with far more precise information on tumor motion with which to plan and administer radiation therapy.

Respiratory Gating
Respiratory gating is another technology developed by Massachusetts General Hospital Cancer Center’s

radiation physics team in collaboration with industry partners. In simple terms, respiratory gating means that the therapeutic beam from the linear accelerator is automatically synchronized with the tumor’s motion and is turned off (or “gated”) when the tumor is not in the desired position, achieving better tumor control; having fewer complications; and using higher, potentially more effective, doses of radiation.

High-Dose Rate Brachytherapy
Another technology available to patients­---primarily those with gynecologic cancers—is high-dose rate (HDR) brachytherapy. Innovative use of HDR brachytherapy at Massachusetts General Hospital Cancer Center includes treatment to skin and soft tissue cancers. HDR brachytherapy can be delivered on an outpatient basis, with each treatment taking only about 15-minutes. HDR brachytherapy uses a tiny, very highly radioactive source, called Iridium-192, which is housed in a lead-lined device called an afterloader. During treatment, the computer-controlled afterloader delivers the radiation source, which is on the tip of a flexible cable, via a tube or tubes that have been placed in the appropriate positions within the patient’s body. With HDR brachytherapy, the radiation oncologist controls where the source is placed and for how long. This makes it possible to conform the doses precisely to the tumor.

Surgical Care at Dana-Farber/Brigham and Women’s Cancer Center
Surgeons are an integral part of the solid organ oncology multi-specialty disease centers at Dana-Farber/Brigham and Women’s Cancer Center. Consistently at the forefront of minimally invasive approaches to care, the surgical team has led in the development of:

Robotic Surgery
Surgeons specializing in robotic surgery at Dana-Farber/Brigham and Women’s Cancer Center have performed hundreds of procedures using the da Vinci Surgical System® to provide highly-advanced, minimally invasive surgical treatment for prostate, cervical, endometrial, uterine, and other cancers. Robot-assisted surgery offers outstanding benefits for patients, including a dramatically reduced recovery time and significantly less pain and discomfort compared with open procedures. Cancer treatment and control using robotic-assisted techniques have been shown to be comparable to open surgical techniques.

Radiofrequency-assisted Liver Resection
Surgeons at Dana-Farber/Brigham and Women’s Cancer Center were the first in the world to report laparoscopic radiofrequency-assisted liver resection (hepatectomy). Used in the treatment of liver tumors, hepatectomy with radiofrequency resection is designed to minimize bleeding – the most serious risk during liver surgery. During this procedure, a device that generates radiofrequency energy – or heat – is used to close blood vessels and minimize bleeding along the line that the surgeon cuts to remove the diseased portion of the liver.

Total Mesorectal Excision (TME)
Surgeons in the Center use specialized nerve- and sphincter-sparing techniques during this procedure to avoid permanent colostomy for patients with rectal cancer. Patients treated with this technique generally experience lower cancer recurrence, lower levels of incontinence and impotence, and better overall survival rates.

Extrapleural Pneumonectomy with Chemotherapy Lavage for Mesothelioma

Surgeons at Dana-Farber/Brigham and Women’s Cancer Center have developed revolutionary surgical techniques for the treatment of patients with mesothelioma. During this innovative technique, Extrapleural pneumonectomy, used to remove disease portions of the lung, is combined with a heated chemotherapy lavage or wash to destroy remaining cancer cells. This treatment has added years onto the lives of patients with malignant pleural mesothelioma – a disease with a traditionally poor prognosis.

Photodynamic Therapy for Lung and Esophageal Cancers
Surgeons at Dana-Farber Brigham and Women’s Cancer Center have developed a novel Photodynamic Therapy Program to treat and improve the quality-of-life for patients with lung, esophageal, and airway cancers. The technique uses laser light to activate a photosensitive drug retained in cancer cells to destroy these cells.

Image-guided Neurosurgery
Neurosurgeons at Dana-Farber/Brigham and Women’s Cancer Center use advanced, image-guided techniques to provide minimally invasive treatment and improved quality-of-life for patients. Preoperative planning and intraoperative imaging techniques also enable specialists at the Center to identify and preserve eloquent areas of the brain responsible for key motor, language, and other functions. Specialists at Brigham and Women’s Hospital pioneered in the design and production of the intraoperative magnetic resonance imaging (MRI) scanner for image-guided surgery, and, in 1994, neurosurgeons at Brigham and Women’s Hospital were the first in the world to use this technology to perform a brain tumor craniotomy.

Radio-Guided Surgery for Thyroid Tumors

Endocrine specialists at Dana-Farber/Brigham and Women’s Cancer Center have compiled most of the early experience with radio-guided surgery. This consists of injection of patients with a radioactive tracer that accumulates in the tumor to be removed. The tumor is then located in the body with a hand-held radiation counter called a gamma probe. This has been highly useful for islet cell and carcinoid tumors and can also be used in re-operative surgeries of the thyroid for locating recurrent cancer.

Surgical Care at Massachusetts General Hospital Cancer Center
Surgeons at Massachusetts General Hospital Cancer Center offer the highest degree of specialization and expertise. Published data has demonstrated that hospitals and surgeons with the highest volume and experience with specific operations, especially complex operations, have the best outcomes, including the lowest complication and death rates. Recognizing the relationship between frequency of performing an operation and the quality of outcomes, each surgeon focuses his or her clinical practice on the management of one or two diseases.

Patients with newly diagnosed cancers are evaluated by surgeons working in the context of a comprehensive multidisciplinary team. This provides patients with well-coordinated, state-of-the-art cancer staging and treatment planning.
Specialty surgical techniques at Massachusetts General Hospital Cancer Center include:

• Esophagectomy – Massachusetts General Hospital Cancer Center is a high-volume center, performing over 60 esophagectomies each year
• Minimally invasive video-assisted thorascopic surgery – Video-assisted lobectomy, pneumonectomy and esophagectomy can now be performed, offering an alternative treatment option to patients who cannot otherwise tolerate open surgery
• Chest and airway reconstruction – Our physicians have developed many of the techniques now utilized worldwide in performing airway operations
• Mediastinal tumors – Our physicians are very experienced in the surgical treatment and the multidisciplinary treatment of advanced thymic malignancies
• Fertility-sparing cervical surgery
• Prophylactic surgeries for high-risk patients
• Whipple procedure – Massachusetts General Hospital Cancer Center is the largest referral center in the Northeast for this complex procedure, which offers the best outcomes for pancreatic cancer when performed by experienced surgeons
• Radiofrequency liver tumor ablation
• Hyperthermic isolated liver perfusion for advanced liver tumors
• Hyperthermic isolated limb perfusion for melanoma
• Laparoscopic prostatectomy for prostate cancer
• Intraoperative radiotherapy for advanced tumors
• Laryngeal nerve monitoring during thyroid surgery to minimize the risk of nerve injury
• Liver transplant for both end stage liver diseases and liver cancer
• Endoscopic cranial-base surgery for minimally invasive resection of skull-based nasal-sinus tumors.
• Stereotactic-guided biopsy and tumor resection, including frameless stereotaxy

Integrative/Complementary Medicine

Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center offer integrative/complementary therapy services to patients and their families. These therapies can help reduce stress and relieve symptoms and side effects such as pain and chemotherapy-related nausea. Clinicians within both sites of care are committed to advancing the knowledge of the effectiveness and outcomes of these therapies through peer-reviewed, evidence-based clinical research. Our clinicians are dedicated to integrating the practice of complementary therapies into traditional cancer treatments. Acupuncture, yoga, Reiki and massage are a few of the complementary therapies offered.

Late Effects Clinic

At Dana-Farber, the David B. Perini, Jr. Quality of Life Clinic has helped thousands of adult survivors of pediatric cancers to manage the long-term consequences of their disease. Each patient is examined by a clinician with expertise in the long-term care of cancer survivors. The patient may then see specialists in radiation oncology, gynecology, endocrinology, or other areas, depending on the patient’s particular medical history and personal needs. Each patient also meets with a psychologist. At the end of the patient’s visit, the clinic’s healthcare providers have a conference to discuss recommendations for follow-up care. These recommendations are shared with both the patients and their primary care providers. For those who want to meet with other survivors of childhood cancers, a variety of support and educational programs are offered.

Cancer Risk and Prevention

At Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center patients concerned about the risk of virtually any type of malignancy have access to a variety of confidential, individualized services. These services include personal cancer-risk assessment; genetic counseling and evaluation of family history; screening examinations and tests; design of an individualized program of monitoring; and strategies, including lifestyle modifications and cancer-prevention agents, to reduce cancer risk.

A genetic counselor and physician, as appropriate, provides the initial, in-depth evaluation, drawing on the expertise of other oncology and medical specialists. The clinics also conduct active programs of clinical research, providing patients with the opportunity to participate in a variety of investigational studies.

Support Services

Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center offer a broad range of e

Educational/support groups and programs to patients and families.
Offerings include:

• post bone marrow transplant support group
• lung cancer support group
• brain tumor support group
• newly diagnosed breast cancer support group
• lymphoma group
• gastrointestinal cancers support group
• prostate group for patients and partners, and
• gynecological cancers education/support seminar series
• caregivers support group

Other educational seminars and programs are offered with focus on creative arts, complementary therapies, nutrition, pain and symptom management, spirituality, body image, and other wellness topics.
A patient-to-patient matching program connects new patients with other patients who are trained to offer guidance and support. Specialized boutiques provide products and services to help patients address changes in appearance.

Social workers at both sites of care provide emotional support and counseling to patients, couples, and family members. They are available to help patients and families cope with concerns and anxieties that may arise during illness and treatment. Social workers also lead many of the support groups listed above which give patients and families a chance to gain support and learn how others cope with illness. Resource specialists can also help patients identify community-based resources to meet various needs, including transportation, housing, and support groups.

Supportive Care

The Pain and Palliative Care Programs specialize in the management of pain and other physical, emotional, social, and spiritual concerns that patients and their families face as they cope with a life-threatening illness. The teams are made up of specially trained physicians, nurses, social workers, pharmacists, chaplains, and administrative personnel who work collaboratively with the patient’s oncology team to develop a suitable care plan.

The following medical and support services are available to help patients and their families:

• State-of-the-art techniques to help with pain and other symptoms such as fatigue, depression, anxiety, nausea, and shortness of breath
• Emotional and spiritual support for patients and their family members, including children
• Therapies such as relaxation, meditation, guided imagery, therapeutic touch, Reiki, and yoga
• Advance-care planning to help make wishes, beliefs, and values about treatment and life-sustaining measures known to family members and health care providers. This includes help with health care proxies or living wills, decisions about disease treatment in advanced disease, and end-of-life care
• Bereavement support
• Referral for additional services and providers, such as pain specialists, psychiatrists, physical therapists, or community agencies

Hospice Service
Hospice care is available to provide comprehensive medical, social, and spiritual care for patients with terminal illnesses. When aggressive treatment is no longer appropriate, hospice care focuses on keeping the patient comfortable and free of pain.

Family-centered care is provided at home, in extended care facilities, and in hospitals in Boston and surrounding communities. The hospice team is made up of the patient's primary care physician, a registered nurse, a medical social worker, a home health aide, a pastoral counselor, and a volunteer. Services are based on identified needs and the wishes of the patient.

Nutrition Service
Registered dietitians at both sites of care help patients and their families make healthful food choices. Working with the other members of the health-care team, the dietitians tailor an eating plan to meet each patient’s individual needs. In addition, the dietitians help patients manage changes in appetite and weight, deal with the side effects of treatment, and advise about foods that will help rebuild strength.

Cooperative Group Membership

Clinical and Research Efforts

Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Massachusetts General Hospital Cancer Center have consolidated the prolific clinical research programs of its three institutions into a single, fully integrated program. Doing so has not only fostered a greater exchange of ideas, which is the lifeblood of research, but has also improved the efficiency and speed with which discoveries can make their way from the laboratory bench to the patient's bedside.

The high volume and diversity of cancer patients served by Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center make it possible for physician-investigators to conduct a wide variety of clinical research designed to answer many critical questions. These include studies evaluating the toxicity and effectiveness of new anticancer drugs, as well as investigations comparing the effectiveness of a new agent to a standard therapy.

Currently, more than 2,100 patients a year are enrolled in clinical research trials within the cancer centers. These patients have access to promising new therapies and, at the same time, contribute to knowledge that may lead to better treatments for all cancer patients, today and in the future.

Although innovative clinical trials are under way in virtually all aspects of cancer care, from studies of patients' quality of life to investigations of novel forms of therapy, areas of particular strength in the clinical research program include the exciting new fields of angiogenesis, clinical genetics, and vaccines.

Support for clinical research programs comes from the National Institutes of Health, national cooperative oncology groups, and private industry. Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Massachusetts General Hospital Cancer Center receive more than $500 million in annual support for cancer research from the National Institutes of Health and private industry.

Dana-Farber Pediatric Oncology Services
www.danafarberchildrens.org

Introduction

Pediatric oncology services are provided through a collaborative program between Dana-Farber Cancer Institute and Children’s Hospital Boston. This 60-year old partnership, known as Dana-Farber/Children’s Hospital Cancer Care, offers the combined strengths of one of the nation’s leading cancer research and treatment institutions and one of the premier pediatric medical centers to provide state-of-the-art care for children, adolescents and young adults with cancer. Outpatient care is provided at Dana-Farber’s Jimmy Fund Clinic, while inpatient care and certain outpatient procedures occur at Children’s. These two neighboring institutions function as one to provide continuity of care for children with cancer.

The pediatric oncologists at Dana-Farber and Children’s have expertise in the management of all childhood cancers and are world-renowned experts in the areas listed below.

General Information

Leadership

Clinical and Research Information

Research Efforts

Major research initiatives are underway in the following areas:

• Anti-angiogenesis in the treatment of pediatric brain tumors
• Medulloblastoma
• Ependymoma
• Brain stem tumors or gliomas
• Brain tumors – recurrent or progressive
• Leukemia – Precursor B Cell
• Low-grade pediatric brain tumors, including astrocytoma
• Hodgkin disease and Non-Hodgkin lymphoma
• Osteosarcoma
• Rhabdomyosarcoma
• Renal tumors
• Solid tumors
• Ewings
• Retinoblastoma
• Neuroblastoma
• Stem cell transplantation: autologous transplant for brain tumors and neuroblastoma, including the use of MIBG, management of post-transplant pulmonary complications, the role of double umbilical cord blood transplant and reduced-intensity transplants for aplastic anemia.
• Immunology
• Cancer Genetics
• Quality of Life Outcomes:

Special Expertise

Acute Lymphoblastic Leukemia

Treatment programs for acute lymphoblastic leukemia cover newly diagnosed and relapsed patients. Dana-Farber Cancer Institute leads a cooperative group in the investigation of newly diagnosed acute lymphoblastic leukemia and is the recipient of a program project grant from the National Cancer Institute for these endeavors. The Acute Lymphoblastic Leukemia program has numerous publications and is considered a model for the world.

Bone Marrow/Stem Cell Transplantation

The Stem Cell Transplantation program at Dana-Farber and Children’s is one of the oldest and largest programs in the nation. It remains a pioneer in areas such as the treatment of high-risk solid tumors, infant transplantation, and other specialized protocols. Types of malignancies treated include:

• Leukemias: acute lymphocytic leukemia, acute myelogenous leukemia, chronic myeloid leukemia
• lymphomas
• primary immunodeficiencies, including severe combined immunodeficiency syndrome
• inherited blood disorders, such as sickle cell disease, and
• solid tumors, including neuroblastoma, brain tumors and Wilms’ tumor, among others.

The 13-bed transplant unit combines state-of-the-art filtration and infection control with comfort for patients and parents. In January 2008, the unit will also feature a lead-lined room which will be used in neuroblastoma MIBG treatments. Patients have their own television and computers, with easy access to the hallway area, nurse’s station, and playroom. All patient rooms are equipped with a bed and closet so one parent can always stay with their child. 

Bone Tumors—Ewing’s Sarcoma and Osteosarcoma

An accomplished multidisciplinary team, consisting of an orthopedic surgeon, two pediatric oncologists, and a radiotherapist, provides comprehensive care for patients with bone tumors. Each member of this team also leads efforts with the Children’s Oncology Group.

Brain Tumor /Neuro-Oncology Program

Dana-Farber and Children’s Brain Tumor program is the largest in the region. World-class neurosurgical staff use the latest technologies, including operating with microscopes, the latest MRI techniques, and new focal radiotherapy procedures. Children’s also offers the Intraoperative MRI, which is used to optimize tumor resection. Stereotactic radiotherapy  used to treat small tumors more precisely. After treatment, Dana-Farber’s Stop & Shop Family Pediatric  Neuro-Oncology Outcomes Clinic provides specialized care for patients dealing with long-term effects caused by treatments, including the Back to School program.

Germ Cell Tumors

A multidisciplinary team of oncologists, pediatric surgeons and pediatric gynecologists provides treatment of germ cell tumors. Treatment protocols are generally those used by the Children’s Oncology Group.

Graft-vs.-Host Disease

Research expertise in immunology and the effects of immuno-suppression drugs are applied to bone marrow and stem cell transplant reactions. Patients are seen in a multidisciplinary clinic focused on chronic GVHD and on late effects and follow-up.

Late Effects

Dana-Farber Cancer Institute operates an extensive quality of life/late effects clinic for young cancer survivors called The David P. Perini, Jr. Quality of Life Clinic. This multidisciplinary clinic offers the expertise of pediatric oncologists, radiation oncologists, endocrinologists, cardiologists, dentists, psychologists, advanced practice nurses, and many other experts to evaluate and provide aid for patients who have previously received treatment for childhood cancers. Research efforts include the long-term side effects of many drugs including anthracyclines and cyclophosphamide.

Lymphoma—Hodgkin’s and non-Hodgkin’s Lymphoma

A multidisciplinary team supervises the care of all patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. This team consists of pediatric oncologists, radiation oncologists, and surgeons, all nationally prominent in the care of patients with lymphomas.

Non-Bone Solid Tumors—Rhabdomyosarcoma, Neuroblastoma, and Wilms’ Tumor

A multidisciplinary team is dedicated to the care of patients with non-bone solid tumors. The team consists of a pediatric oncologist, a dedicated oncologic surgeon, and a radiation oncologist.

Radiation Oncology

This program offers state-of-the-art technologies, some available at only a few medical centers in the nation. These include a unique two-headed linear accelerator for total body irradiation given prior to transplantation. a radiation simulator, which allows radiation treatment to be carefully mapped out in advance for optimum treatment with minimum exposure, and a unique two-headed linear accelerator for total body irradiation given prior to transplantation. The team may also prescribe proton beam therapy, when necessary.

Dana-Farber Genetic Counseling and Testing Service

The Cancer Risk and Prevention Program of Dana-Farber Cancer Institute and the Center for Cancer Risk Assessment at Massachusetts General Hospital Cancer Center provide genetic counseling, risk assessment, and medical management recommendations for patients at hereditary risk of cancer. The programs provide genetic testing for all cancer susceptibility genes for which analysis is available and facilitates connection of patients to pertinent research projects nationally and internationally.

Intake Process

Testing

Post-Test Counseling and Follow-Up

Research

Other Components of Genetic Services

Last updated: 2/7/2008