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TreatmentMultidisciplinary Teams Clinicians in all oncologic and supporting specialties work together to plan and implement multimodality therapies. Most patients meet with their treatment team members and receive their ambulatory care in one location. The multidisciplinary care center concept was a driving force in the architectural design of the M. D. Anderson complex. M. D. Anderson has 26 multidisciplinary care centers that provide integrated cancer care.
Alternative/Complementary MedicineThe goals of M. D. Anderson’s Complementary and Alternative Medicine service are:
to promote ongoing professional growth through networking in a setting where complementary medicine and conventional cancer treatments can be examined together Place...of wellness More than 75 complementary therapy programs work in concert with mainstream care to manage cancer-related symptoms, relieve stress, and enhance quality of life. Most programs are free of charge, except acupuncture and full body massage, which are provided for a nominal fee. Place...of wellness is open to anyone touched by cancer, their family members, and caregivers, whether or not they were treated at M. D. Anderson. No physician referral is required. For more information about Place…of wellness, call 713.794.4700. Education
Expressive Arts
Meditation & Prayer
Movement
Relaxation & Stress Management
Acupuncture & Massage Place…of wellness. For details or for an appointment, call 713.794.4700.
Late Effects and Survivorship
Cancer Prevention and ScreeningExpanded research efforts in epidemiology and behavioral sciences complement achievements made in the clinical cancer prevention arena. Laboratory activities support developmental and practical applications of cancer prevention. A new research program is focusing attention on health disparities in prevention and care among ethnic minorities and medically underserved populations. The Cancer Prevention Center provides comprehensive cancer screening services, including cancer risk assessment, screening exams based on cancer risk, age and gender, personalized risk-reduction strategies, genetic testing, chemoprevention, tobacco cessation, and nutrition counseling. Cancer Prevention Center
Tobacco Cessation For smokers who are not receiving cancer care at M. D. Anderson, there are numerous tobacco-cessation studies available that provide free treatment. Call the Tobacco Research and Treatment Program at 713.792.2265. Free Prostate Cancer Screenings Support Services
Supportive Care
Department of Clinical Nutrition Services include education, assessment, and counseling in cancer prevention; therapeutic diets; nutrition build-up prior to and during therapy; management of treatment side effects; management of specialized feeding regimens like tube feedings and IV parenteral support; nutrition education for patients, families, caregivers, and the general public; and presentations on nutrition and cancer for other healthcare professionals at M. D. Anderson, professional organizations, universities, and in the community. Cancer Prevention Center Nutrition Counseling A dietary evaluation with personalized counseling for cancer risk reduction is available for the general public. Call 713.745.8040. Cooperative Group Membership
Clinical and Research Efforts
The University of Texas M. D. Anderson Cancer Center
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General Information |
877.MDA.6789 888.543.2435 – Patient Access Center |
Referring Physician Line |
713.792.5410 |
Location |
Houston, Texas |
Travel Assistance |
M. D. Anderson offers travel assistance. |
Lodging |
Social workers provide counseling to parents from diagnosis through end of treatment as well as practical information to make the logistics of cancer treatment go more smoothly. The Jesse H. Jones Rotary House International is a full service hotel exclusively dedicated to serving the needs of M. D. Anderson patients and their families and is connected to the hospital and clinics by an overhead walkway. Call 800.847.5783. The Ronald McDonald House is close by to the facility. |
Social Support |
The Children’s Cancer Hospital Behavioral Pediatrics Section emphasizes normal development of children while they are in treatment for cancer. Social workers see all parents, and psychologists provide support groups, counseling services, and psychological support. Child Life Specialists are available to all pediatric patients and also staff the inpatient and outpatient playrooms and engage in medical play. An education program is designed to prevent academic declines during treatment and offers daily classes. Translation services are available to assist patients and their families during medical meetings. |
Home Health Care |
Home health care is arranged. |
Ages Treated |
Children, adolescents and young adults up to age 25 are treated in the Children’s Cancer Hospital. Patients 16 to 18 years of age have the option of being treated on the adult units. |
Pediatric Oncology Chairman | Eugenie S. Kleinerman, M.D. |
Operate Multidisciplinary Teams | M. D. Anderson uses a multidisciplinary approach to cancer treatment. The diverse health care team includes physicians, nurses, social workers, physical and occupational therapists, radiation therapy specialists, nutritionists, psychologists, and others. |
Cooperative Group Membership | Children’s Oncology Group (COG)—Joann Ater, M.D., COG CCH PI Note: COG now also includes CCG, POG, PBMTC, Intergroup Rhabdo and Wilms’ Tumor Study groups. |
Activities in Cooperative Group | Participation in COG committees includes:
Oncologists are principal investigators on numerous studies. |
Average Number of Pediatric Clinical Trials | 55 |
Pediatric Clinical Trial Coordinator | Jean Johnston |
Cell Therapy (Bone Marrow Transplant)
M. D. Anderson is the largest BMT center in the United States, which includes the Children’s Cancer Hospital’s BMT Program. M. D. Anderson is FACT-accredited and designated by COG and the National Marrow Donor Program as a transplant center qualified to perform matched and unrelated donor transplants as well as autologous transplants. The unrelated transplantation program at the Children’s Cancer Hospital uses umbilical cord transplant and is one of the few places in Texas that performs cord blood pediatric transplants. The program includes expertise in graft manipulation including T-depletion and investigational therapies based on selection of CD133. Active transplant protocols are underway for several types of malignancies: acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), chronic myeloid leukemia (CML), myelodysplasia, lymphoma, neuroblastoma, brain tumors, and other solid tumors of childhood. In addition to undertaking transplants, the program has an active translational research program developing new therapies based on infusion of T cells and NK cells.
Solid Tumors – including DSRCT, Sarcomas and Bone Tumor Cancers (Osteosarcoma, Ewing’s Sarcoma)
The M. D. Anderson Children’s Cancer Hospital is an active treatment center for the many varieties of childhood solid tumors such as Wilms tumor, hepatoblastoma, desmoplastic small round cell tumor, melanoma, tumors of the head and neck, and sarcomas – especially rhabdomyosarcoma, osteosarcoma, and Ewing’s sarcoma. Patient evaluation results in an individualized approach that may or may not result in protocol therapy, depending on the specific circumstances of the patient and family. M. D. Anderson uses diagnostic imaging resources including PET-CT fusion imaging consultation to sort out important issues for not only best survival outcome, but also quality of life issues. Since most solid tumors require at least two and sometimes all three major modalities (e.g. surgery, chemotherapy, radiation), the coordination of care between experienced specialists for treatment of rare and/or difficult situations (e.g. metastatic or recurrent disease) is expected and routine. This group has pioneered and now routinely uses a number of innovative approaches in treatment of these cancers, including outpatient chemotherapy (e.g. high-dose methotrexate, ifosfamide, cisplatin, doxorubicin liposomes, dexrazoxane then doxorubicin, gemcitabine + docetaxel), radiation with concurrent outpatient chemotherapy, use of bone-seeking radiopharmaceuticals (samarium) for osteosarcoma, aerosol chemotherapy (L9NC, gemcitabine), and novel use of immune modulators (e.g. L-MTP-PE, MTher, aerosol cytokines including IL-2 and GM-CSF) in the treatment of bone tumors. For regional disease such as peritoneal spread of desmoplastic small round cell tumor (DSRCT), pleural lesions and disease in the mediastinum, coordinated care between surgical specialties, innovative chemotherapy, radiation oncology, and other services such as interventional radiology plastic surgery is common. Examples include improved enteral nutrition, surgery followed by continuous hyperthermic peritoneal perfusion of chemotherapy (CHPP) for DSRCT, intrapleural chemotherapy and/or chemotherapy for radio sensitization. Many treatment paradigms involve reduced likelihood of hospitalization.
Brain and Neural Tumors
The Pediatric Neural Tumor Section provides consultation, evaluation, and treatment for children with central nervous system tumors, neuroblastoma, and neurofibromatosis. For all common types of newly diagnosed brain tumors or neuroblastoma, therapeutic protocols form the basis for treatment with either institutional protocols or collaborative studies through the Children’s Oncology Group. Phase I and II studies provide therapeutic options for children with recurrent tumors. M. D. Anderson pioneered an oral chemotherapy regimen for children with certain types of brain and spinal cord tumors, thus eliminating the need for radiation therapy and decreasing hospital stays. Oral chemotherapy treatments for these cancers have been found to be as effective as radiation.
Leukemias
The Pediatric Leukemia and Lymphoma Section has unique expertise in the care of patients with relapsed or refractory disease. This section works closely with our adult leukemia and lymphoma colleagues, the Children’s Oncology Group (COG) and the POETIC consortium to obtain new or innovative drugs or treatment approaches for patients whose original therapy has failed. The pediatric section was largely responsible for the only new drug, Clofarabine, to obtain FDA approval for childhood leukemia since 1990.
Neuropsychology
The neuropsychology team assesses patients for difficulties in language, memory, intellectual, visual perceptual, and attention skills. All children with brain tumors are evaluated as well as children undergoing bone marrow transplantation and others undergoing chemotherapy or radiation treatments to the brain. The neuropsychology team works closely with the education team to evaluate a child’s strengths and weaknesses to ensure that they can attain their maximum academic potential, in spite of their cancer treatment. Our Cognitive Training research program provides a 20-week course for patients who are at-risk for cognitive difficulties associated with their treatment.
Percent of children treated in each age range
Age Range |
0-4 |
5-9 |
10-14 |
15-20 |
Percent Treated |
13.8% |
20.6% |
28.1% |
37.5% |
Pediatric Oncology Program, 2006
No. of Inpatient Beds |
No. of Admissions |
Average Length of Stay(days) |
No. of New Outpatients |
Total Outpatient Visits |
No. of Bone Marrow Transplants |
No. of Oncologists |
26 + 4 PICU |
1,042 |
5.76 |
506 |
13,703 (does not include lab or nurse visits) |
30 |
27 |
The University of Texas M. D. Anderson Cancer Center offers cancer genetic counseling and testing services through the Clinical Cancer Genetics Program. M. D. Anderson patients are seen in genetic counseling clinics within the Breast, Gynecology, Gastrointestinal, Endocrinology, and Cancer Prevention Centers. These programs all provide comprehensive risk assessment and genetic counseling services to individuals and their family members. Persons affected with cancer as well as those unaffected by cancer are counseled. The services include risk assessment and counseling; discussion of options for risk management, cancer screening, and surveillance; and when appropriate, genetic testing, reproductive risk counseling, coordination of patient care, and opportunities to participate in research protocols. The clinical services are provided by a multidisciplinary team, which includes board-certified and board-eligible genetic counselors as well as physicians with expertise in gynecology, gastroenterology, surgery, oncology, and endocrinology. Individuals found to be at high risk for cancer are offered follow-up in high risk cancer screening clinics at M. D. Anderson.
Location |
Houston, Texas |
Directors, Clinical Cancer Genetics Program |
Banu Arun , MD Karen Lu, MD |
Schedule Appointments |
713.745.7391 |
M. D. Anderson provides a full range of genetic counseling, testing, screening, and research. The components of our comprehensive genetic counseling and genetic testing program include:
Physician and Community Awarenes |
Members of the M. D. Anderson Clinical Cancer Genetics program provide continuing education for physicians, nurses, and other health care providers on topics related to hereditary cancer identification, risk assessment, and management. Continuing education is provided through grand rounds, in-services, and presentations given throughout Texas through physician and nurse oncology education programs. Presentations on hereditary cancer are also given to cancer support groups and other community organizations. |
Patient Education |
M. D. Anderson operates The Learning Center, a free consumer health information center that offers high-tech computer databases and traditional information sources to help patrons learn about reducing cancer risks. |
Referral |
Individuals interested in genetic counseling and testing services may self-refer by calling Clinical Cancer Genetics at 713.745..7391. In addition, referrals are made via healthcare professionals within the institution and from those outside of the institution. All inquiries to the M. D. Anderson system for genetic counseling services are reviewed by Clinical Cancer Genetics and triaged to the appropriate team. |
Identify Eligible Subjects |
Multidisciplinary teams with expertise in inherited breast and ovarian cancer syndromes, hereditary colorectal cancer syndromes, multiple endocrine neoplasia syndromes, and other cancer syndromes are available to provide comprehensive services. Each team obtains initial intake information and a comprehensive medical/social and family history. The family history is often obtained prior to the first appointment via telephone or using a family history questionnaire. Clients may be requested to bring medical records or pathology reports prior to initial visit. |
Pre-test Counseling and Risk Assessment |
Comprehensive risk assessment and cancer genetic counseling services are provided by physicians and master’s-level trained genetic counselors who are experts in hereditary cancer. Individuals and families are educated about the risk of developing cancer based on their personal and family history. Discussion includes a review of the benefits and risks of genetic testing when appropriate, surveillance measures, and available options for prevention. When the option of genetic testing is pursued, a thorough informed consent process is followed (see below). |
Informed Consent Procedures |
The informed consent process is incorporated into the counseling session. Discussions include:
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Confidentiality Standards |
Genetic consultation reports and genetic test results are documented in patients’ M. D. Anderson medical record. All medical records at M. D. Anderson are confidential, and the institution strictly adheres to all relevant federal and state laws regarding the confidentiality of medical records. |
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Testing |
Genetic tests for mutations in cancer susceptibility genes, which are ordered for M. D. Anderson patients, are generally performed by either licensed commercial labs or institutional labs with CAP/CLIA accreditation. Relevant tumor studies (microsatellite instability and immunohistochemistry) are done in-house by the Department of Pathology. Occasionally, testing is done in research laboratories. Should such research laboratory testing identify a mutation, clinical confirmation through a CLIA-certified lab is recommended. |
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Available Testing at or Through MDACC |
Other relevant hereditary cancer predisposition genetic tests may be ordered as appropriate and when clinically available. |
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Laboratory Quality Assurance |
M. D. Anderson clinical laboratories are CAP/CLIA accredited. |
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Test Result Interpretation |
The multidisciplinary genetics team interprets the laboratory test results in the context of the client's personal and family history. Current literature and specific mutation databases are used in estimating the individual's risk for developing cancer. |
Post-test Counseling |
Test results are generally disclosed in a face-to-face follow-up counseling visit. The client's risk for developing cancer and options for managing the risk are reviewed and discussed. The counseling team assists the client in coping with test results; discusses decisions and approaches to communication of test results to other health care providers, family members, and others; and helps the client develop a plan for follow-up. |
Cancer Screening |
The genetic counseling team offers recommendations to the client regarding appropriate screening and surveillance approaches based on his or her specific risk. Discussions include the recommended frequency for the given procedure/test and the data available to show efficacy and potential risks of the screening modality. Clients are offered follow-up, as appropriate, in the M. D. Anderson high-risk breast, ovarian, and/or GI screening clinics. |
Medical and Surgical Management |
Medical and surgical options such as chemoprevention studies or prophylactic surgery for management of increased risk for developing cancer are reviewed at length with clients. These services are readily available within the institution and there are also mechanisms to refer clients to other NCCN institutions as appropriate. |
Psychological and Supportive Services |
Mechanisms for referrals for psychological and supportive counseling as well as specialized medical services are in place. For some individuals, referral to a support or peer group is beneficial. |
M. D. Anderson also offers ongoing clinical trials to answer important questions related to genetic testing, prevention, and early detection of cancer. Please visit www.mdanderson.org for more detailed information on all of these studies.
Identifying New Genes |
Mutation in Childhood Cancer: Implications of a Model—a clinical research study aimed to find out why some people develop cancers and tumors, why some families have more cancers than others, and whether certain genes or regions of DNA affect a person's risk of getting cancer. |
Improving Counseling Methods |
M. D. Anderson is embarking on multiple efforts to extend genetic counseling and genetic testing to both rural and county hospital populations. |
Improving Testing Methods |
Clinical and Predictive Genetic Testing for Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome—The goal of this research study is to confirm a diagnosis of MEN1 in individuals through genetic testing. Researchers also want to find out if there are patterns between specific changes in genes and the severity of the disease. |
Running Chemoprevention Trials |
HNPCC and Endometrial Cancer: Chemoprevention Using the Oral Contraceptive vs. Depo-Provera—The goal of this randomized clinical research study is to study the effects of these agents on the endometrial lining in women with HNPCC after three months of using the oral contraceptive Lo-Ovral or Depo-Provera. A Two-Arm Phase II Chemoprevention Trial in Adenomatous Polyposis Coli Patients—The goal of this clinical research study is to compare the effects of Celebrex (celexocib) alone with celecoxib plus DFMO on the growth of polyps in patients with familial adenomatous polyposis (FAP). The safety of combining the two drugs will also be studied. |
Discovering Clinical Treatments for Genetic Disorders |
A Phase 2 study of SU011248 in von Hippel-Lindau Syndrome. The goal of this clinical research study is to learn if sunitinib malate (SU011248) can help to control VHL. The safety of this drug will also be studied. |
Tracking Long-Term Results of Prophylactic Surgeries, Medical Surveillance Choices, and Preventative Interventions |
Prospective Follow-Up of Women Who are at Increased Risk for Developing Breast Cancer—A follow-up research study that monitors women who have developed breast cancer or who are at increased risk to develop breast cancer and checks for any changes in their breast-related health. The aim of this study is to identify certain factors that may play a role in breast cancer development in high-risk women. Prospective Study of Risk-Reducing Salpingo-Oophorectomy and Longitudinal CA-125 Screening Among Women at Increased Genetic Risk of Ovarian Cancer—The goal of this clinical research study is to learn more about how to care for women who are at increased risk of ovarian cancer. BRCA1 and BRCA2 are the two genes that cause most of the genetic forms of ovarian cancer, and women with changes (mutations) in these genes are more likely to get ovarian cancer than women without changed BRCA1 or BRCA2 genes. |
Familial and National Registries |
Prospective Follow-up of Women Who are at Increased Risk for Developing Breast Cancer—A follow-up research study that monitors women who have developed breast cancer or who are at increased risk to develop breast cancer and checks for any changes in their breast-related health. The aim of this study is to identify certain factors that may play a role in breast cancer development in high-risk women. |
Quality Assurance |
Hereditary cancer services are provided through established M. D. Anderson clinical centers, and adhere to all relevant quality control procedures. Multidisciplinary case conferences are held weekly to allow for input from all members of the multidisciplinary team. |
Training |
M. D. Anderson has been in existence for over 65 years. It offers opportunities for advanced training and collaborative research including molecular genetics, genetic epidemiology, behavioral and psychosocial issues related to cancer, cytogenetics, clinical genetics, and cancer pain management. Graduate training in genetic counseling is provided at M. D. Anderson through its collaboration with The University of Texas Graduate School for Biomedical Sciences. |
Last updated: 2/20/2008
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NCCN 1st Annual Forum: Innovative Diagnostics & Therapeutics in Cancer Care™ |
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