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Find an NCCN Member Institution
Stanford Comprehensive Cancer Center
Home Page Find a Clinical Trial |
For information on clinical trials at this NCCN Member Institution click here. Stanford University is an international leader in cancer research and patient care. The mission of the Stanford Clinical Cancer Program is to provide comprehensive care through multidisciplinary collaboration and integrated services, to advance cancer therapies through clinical research, and to train future leaders in the treatment of patients with cancer. The collaborative approach to cancer research and treatment is a hallmark of this program. Surgeons, medical oncologists, radiation oncologists, pediatric oncologists, radiologists, and pathologists participate in sixteen weekly combined modality clinics. The Clinical Cancer Program at Stanford is comprehensive. Highlights include:
One hundred and sixty faculty members participate in cancer care and clinical research with over 500 active clinical trials. Research on the fundamentals of cancer is conducted in the Center for Molecular and Genetic Medicine and the Center for Clinical Sciences Research. Stanford University Medical Center
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General Information - Lucile Packard Children’s Hospital at Stanford
Pediatric Referrals |
650.497.8953 |
Location |
Palo Alto, California |
Facility Description |
Lucile Packard Children's Hospital at Stanford is a 264-bed hospital with 2,074 employees, 704 staff physicians, and more than 2,300 volunteers and auxiliary members who strive every day to make this center a safe haven for sick children. Built in a circular design around a central courtyard, the hospital has numerous gardens and outdoor play areas, including a spacious roof garden. The hospital also includes a Day Hospital serving children requiring specialized medical treatment such as intravenous infusions and chemotherapy that does not necessitate an overnight stay. |
Travel Assistance |
Lucile Packard Children’s Hospital offers travel assistance and coordinates transportation. For more information, please contact the Housing Program at 650.498.2569. |
Lodging |
Social workers assist in lodging arrangements for families. Ronald McDonald House at Stanford provides a "home-away-from-home" and support for families of children receiving treatment at Lucile Packard Children's Hospital or Stanford Medical Center. As medical treatments evolve, an increasing number of children stay at the House as outpatients while receiving treatment. All requests for housing families can be made directly to Ronald McDonald House by calling The Homes With a Heart Program was established to provide temporary housing—when the Ronald McDonald House is full—to family members of children receiving treatment at Lucile Packard Children’s Hospital. The program brings out-of-town patient families together with volunteer hosts who live near the hospital.The Hotels with a Heart program places parents whose children are suffering from life-threatening illnesses in hotels on a complimentary basis. Families are selected for placement based upon financial need and distance traveled. For more information, please contact the Housing Program at 650.498.2569. |
Social Support |
Extensive psychological and social support is offered to pediatric cancer patients and their families. Every family of a pediatric cancer patient is assigned to a social worker. There is a school within Lucile Packard Children’s Hospital and teachers also offer bedside teaching for students unable to attend classroom sessions. Apple and Hewlett Packard computers are available for student use in the classrooms and at the bedside. Activities include word processing, educational programs, and some recreational programs. There is also an active Child Life program and a summer camp for Bay Area children with cancer. A chaplain is available to provide spiritual and emotional support to LPCH inpatients and their families 24 hours a day, seven days a week. International Medical Services (IMS) offers special services for patients and their families who come from outside of the United States for care and assures that international patients receive personalized services during and after their visits. Lucile Packard Children’s Hospital offers timely medical interpretation and translation services for all non-English speaking patients and families. Services for Spanish and other languages are provided in person and/or by phone, 24 hours a day, seven days a week. Sign language and third language interpretation services are offered by the LPCH Language Bank. |
Financial Assistance |
Financial counselors assist patients and families with financial matters related to medical care. |
Home Health Care |
Social workers offer crisis intervention, information, and referral to community agencies and other services. |
Ages Treated |
Children and young adults of all ages are treated. |
Clinical and Research Information
Director, Hematology/ Oncology Stem Cell Transplantation |
Michael P. Link, MD |
Multidisciplinary Teams |
All members of the Lucile Packard Children's Hospital staff are specially trained to meet the needs of children and families. Every team member is dedicated to the philosophy of caring for the whole child, including his or her physical, emotional, developmental, and social needs. Each patient has an assigned attending physician, social worker, and nurse practitioner who work with the child and family from diagnosis through long-term follow-up. Surgeons and radiotherapists are an integral part of this care. |
Cooperative Group Membership |
All oncologists are members of the Children’s Oncology Group (COG); all patients are eligible for treatment protocols used by this national cooperative group. |
Cooperative Group Activities |
Investigators hold leadership positions in COG. |
Average Number of Pediatric Clinical Trials |
75 |
Pediatric Clinical Trials Coordinator |
Debon Cochrane, CCRA |
Research Efforts
Examples of studies in progress are:
- to determine whether new drugs will improve survival in children with osteosarcoma
- to find novel ways to treat children with brain tumors
- to optimize outcomes for children requiring bone marrow transplantation
- to investigate possible environmental causes of childhood cancer
- to learn more about the psychosocial impact of childhood cancer on the family and the best way to provide support for cancer survivors
- to investigate mechanisms that allow cancer cells to escape killing by chemotherapy drugs and mechanisms of cancer cell growth to find new approaches to interrupting this cycle
Special Expertise
Brain Tumors
A multidisciplinary team of experts in Neuro-Oncology, Neurosurgery, Radiotherapy, and Neuroradiology have established a nationally recognized program for children with brain tumors. These physician scientists are key investigators for innovative therapeutic studies from the Children’s Oncology Group, Pediatric Brain Tumor Consortium, and other regional groups. At Lucile Packard Children’s Hospital, this physician team meets weekly for the region’s only pediatric-dedicated Neuro-Oncology Tumor Board. The service’s Neuro-Oncology clinic provides comprehensive care to address physical, educational, social, and emotional needs of children affected by brain tumors and their therapies.
Hodgkin’s Disease
Investigators at Stanford are recognized internationally as experts in the treatment of Hodgkin’s disease. Management of children with low-dose radiation combined with chemotherapy was pioneered at Stanford and has become the standard around the world. Innovative new therapies designed to minimize toxicity for children with favorable prognosis and intensifying therapy for those with less favorable clinical features are the focus of current studies.
Late Effects/Long-Term Survivorship
The pediatric group at Stanford/LPCH is part of a national study of 25,000 survivors of childhood cancer and places special emphasis on the assessment of cardiac, pulmonary, and neurocognitive late effects.
Leukemia
Investigators at Stanford are leaders in dissecting the immunology of acute lymphoblastic leukemia and in discerning the molecular events that underlie leukemogenesis. Researchers are nationally recognized for studies directed at reversing multi-drug resistance in leukemia and applying these findings to the treatment of children with refractory leukemia and those with newly diagnosed acute non-lymphocytic leukemia.
Non-Hodgkin’s Lymphoma (NHL)
Investigators from Stanford are internationally recognized experts in the management of non-Hodgkin’s lymphomas in children. Stanford faculty have played a key role in the development of cooperative group protocols for children with NHL and have coordinated efforts in early stage NHL for the past 15 years.
Resistant Cancers and New Agents
Stanford has an NIH-funded pediatric clinical research center that is dedicated, in part, to testing new therapies for children with advanced refractory cancer. Novel anti-cancer agents including monoclonal antibodies or immunotoxins specifically directed against leukemias, differentiating agents to induce tumor growth arrest, targeted radiotherapy, and other new cancer chemotherapeutic drugs are administered to children with refractory cancer. In addition, important laboratory/clinical efforts directed at elucidating and overcoming mechanisms of drug resistance is an important part of the Pediatric Oncology program.
Sarcomas of Bone and Soft Tissue
Physicians at Stanford have established multidisciplinary programs in sarcomas of bone and soft tissue led by international experts in Pediatric Oncology, Radiation Oncology, Orthopedic Oncology, and Pathology. There is a strong commitment for optimal individualized tumor management with preservation of maximum function. Investigators from Stanford have had major leadership roles in important trials in malignant bone tumors, demonstrating the role of adjuvant chemotherapy in the treatment of osteosarcoma, the safety of reducing the volume of radiotherapy in treating Ewing’s sarcoma, and the efficacy of intensified regimens for the treatment of Ewing’s sarcoma and osteosarcoma.
Investigators from Stanford have played leading roles in the Intergroup Rhabdomyosarcoma Study Group (IRSG) and have major input in the design of biologic and therapeutic studies for children with Rhabdomyosarcoma. Studies of the IRSG enroll almost all children with Rhabdomyosarcoma in the United States and Canada.
Stem Cell Transplantation
Stanford has a very active pediatric stem cell transplantation program specializing in transplants for hematologic malignancies, solid tumors, and genetic disorders. The program provides transplants using a variety of stem cell sources including autologous, purged autologous with tumor cell removal, unpurged peripheral blood stem cells, autologous transplants including both bone marrow and peripheral blood stem cells from related and unrelated donors, partial mismatches with stem cell manipulation, and cord blood transplants.
Diseases treated include malignancies such as acute or chronic leukemia, Hodgkin’s or non-Hodgkin’s lymphoma, and selected pediatric solid tumors such as neuroblastoma and rhabdomyosarcoma.
Lucile Packard Children’s Hospital is a designated CCS Bone Marrow Transplant Center and Center of Excellence. The pediatric BMT service is an approved transplant center for Children's Oncology Group protocols.
Statistics
Percent of children treated in each age range
Age Range |
0–1 |
2–5 |
6–12 |
13+ |
Percent Treated |
12% |
27% |
29% |
33% |
Pediatric Oncology Program, 2002
No. of Inpatient Beds |
No. of Oncologists |
No. of Admissions |
Average Length of Stay(days) |
No. of New Outpatients |
Total Outpatient Visits |
No. of Bone Marrow Transplants |
16 |
10 |
1,028 |
7.3 |
159 |
11,447 |
23 |
Stanford Comprehensive Cancer Center
Genetic Counseling and Testing Service
The Oncology Day Care Center at Stanford University Medical Center operates a Cancer Genetics Clinic offering familial cancer risk assessment and genetic testing. Patients with concerns about an inherited risk for breast, ovarian, colon, or other cancers are encouraged to contact us. The multidisciplinary consultation service provides genetic counseling, risk assessment, and testing to cancer patients, their families, and high-risk individuals. The Cancer Risk Assessment team includes individuals trained in oncology, genetics, and genetic counseling.
Location |
Stanford, California (San Francisco/San Jose Area) |
Director, Cancer Risk Assessment Program |
James Ford, MD |
Breast and Ovarian Surveillance Service |
Allison Kurian, MD |
Colon/GI Cancer Risk Assessment Clinic |
James Ford, MD |
Familial Cancer Service |
Eugene Hoyme, MD / James Ford, MD |
Genetic Counseling Appointments |
Nicolette Chun, MS Kerry Kingham, MS |
The Stanford Cancer Genetics Clinic provides a full range of genetic counseling, testing, screening, and research. The following sets out the components of the comprehensive genetic testing program.
Intake Process
Provider Education |
A high-risk genetics conference focusing on protocols, guidelines, and recommendations for patients with possible genetic predisposition for colorectal cancer is held bimonthly. Significant educational efforts by the staff of the Stanford Cancer Genetics Clinic are directed toward community physicians. Lectures are offered at community hospitals and within the Stanford Medical Center to familiarize physicians with cancer genetic risk indications and issues. Lectures are also provided to medical students, residents, and fellows in related fields, emphasizing the importance of cancer genetics in their practice. |
Patient Education |
Original pamphlets describing indications for cancer genetics referral and the evaluation procedure have been developed and are available for patient education. Copies of these booklets can be obtained at our Web site or by calling 650.724.4363 (Stanford Cancer Genetics-GENE). Additional written educational materials about the genetics of cancer are available at the Stanford Cancer Genetics website, www.stanford.edu/group/cgc/ and the Stanford Medical Center website, www.stanfordhospital.com. |
Referral |
Patients are referred from both physicians within the Stanford University Medical Center system as well as from community physicians in many disciplines, including oncology, surgery, gynecology, internal medicine, and gastroenterology. Physicians or patients can access Cancer Genetic Clinic Services by calling the clinic’s office number above. A genetic counselor is available to assist with medical intake and appointment planning. |
Identifying Eligible Subjects |
Individuals that may benefit from a referral include those with:
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Pre-test Counseling and Risk Assessment: |
The patient's personal and family medical history is obtained by phone at the time of scheduling and may be updated at the scheduled appointment to achieve the most accurate risk assessment. Documentation of relevant tumors and/or genetic test results may also be necessary. A consultation with the Cancer Risk Assessment Service includes:
A letter summarizing the details of our consultation and our recommendations is sent to the patients for their records. A copy of our consultation note will also be sent to the patient's physician only at the patient’s request. |
Informed Consent Procedures |
Patients who elect to proceed with genetic testing for cancer susceptibility will be required to sign a consent form either designed specifically by the laboratory performing the testing or a Stanford Medical Center approved consent form. |
Testing
Confidentiality Standards |
Documentation of the patient's consultation, as well as the patient's family history, is submitted to the hospital's main medical record under high security status. Written consent from the patient is required to access this record and is available only through the Cancer Genetics Clinic office or Medical Records supervisor. If genetic testing is elected, the results of testing will also be documented in the main records under high security status. Reports and test results are not accessible through the routine hospital computer system. Genetic testing results and documentation of a consultation will be disclosed to a third party only with the written consent of the patient. The National Cancer Institute (NCI) has granted a Certificate of Confidentiality, which protects patient information entered in our research database from any level of court ordered disclosure. |
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Testing |
For those patients electing genetic testing for cancer susceptibilities, most samples are sent for testing to a licensed commercial laboratory. If a patient participates in a research protocol, the qualifications and procedures employed by the testing lab will be discussed prior to testing. |
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Available Testing at or Through the Stanford Cancer Genetics Clinic |
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Laboratory Quality Assurance |
CAP/CLIA accreditation is current at all reference labs providing clinical tests for the Stanford Cancer Genetics Clinic. |
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Test Result Interpretation |
The test result is interpreted by the physician and genetic counselor involved with the patient's consultation. The result is interpreted based on the findings of the laboratory, published information about the mutation and condition, and the patient's personal and family history. |
Post-Test Counseling and Follow-Up
Post-test Counseling |
The results of genetic testing are shared with the patient in person during a follow-up disclosure session. Information about the implications of the results and recommended screening and follow-up is discussed. |
Cancer Screening |
Recommendations for early detection and prevention of cancer are provided. Recommendations are based on a combination of evidence and empiric data, expert opinion, consensus statements, and take into account the patient's personal and family history. Specific screening protocols have been devised for certain cancer susceptibility syndromes. |
Medical and Surgical Management |
Patients may be referred to the gynecology, breast surgery, radiology, gastroenterology, and general surgery clinics at Stanford where they are offered state-of-the-art treatment options, including the opportunity to enroll in a clinical trial, if eligible. Recommendations can also be made for medical and surgical management outside the Stanford system. |
Psychological and Supportive Services |
Professional and peer support referral is often facilitated through the Cancer Genetics Clinic. |
Other Components of Genetic Services
Research
Identifying New Genes |
Studies are underway to identify genetic factors associated with cancer development among high-risk cancer families enrolled in our clinics. Clinic patients may voluntarily participate in the tissue and DNA banking program that will be used to identify and confirm the existence of new cancer genes and genes that modify cancer risk. |
Implementing Chemoprevention Trials |
Chemoprevention trials are underway for breast and colon cancer syndromes. |
Discovering Clinical Treatments for Genetic Disorders |
MRI and ductal lavage screening procedures are available for women at high risk for breast cancer. The sensitivity and specificity of these screening procedures are being monitored. The biological characteristics of premalignant changes identified by these methods are being studied using advanced genomic and proteomic techniques of gene expression. MSI (microsatellite instability) is a characteristic of tumors associated with the most common form of inherited colon cancer, HNPCC. We are studying HNPCC tumors for any correlation between MSI status, expression of DNA repair gene, and patients’ response to various chemotherapy trials in an effort to define the most effective treatments for HNPCC related cancer. We are collaborating with investigators in Vancouver, B.C. and the International Gastric Cancer Linkage Consortium to explore the role of E-cadherin and DNA repair genes in familial gastric cancer. |
Tracking Long-Term Results of Prophylactic Surgeries, Medical Surveillance Choices, and Preventative Interventions |
The clinic maintains an off-net, secured, encrypted database to track both genetic and environmental cancer risk factors and the efficacy of surveillance and treatment options for patients who voluntarily enroll in this project. |
Participating in Familial Registries or National Registries |
Participation in numerous familial cancer registries is available through our clinic. |
Educational Outreach
Education and Training |
The Stanford Program for Applied Cancer Genetics has a substantial commitment to education and training of primary care physicians. One aspect of this effort involves an education and outreach project to primary care physicians in affiliated health centers that provide services to a substantial number of patients from traditionally under-served groups. Ultimately, the Stanford Program for Applied Cancer Genetics envisions a variety of educational interventions, including print media, Web-based education, and presentations by program personnel, both at community hospitals and within the Stanford Medical Center. |
Quality Assurance |
Our genetic counselors are certified through either the American Board of Genetic Counselors or the American Board of Medical Genetics. Clinic cases are reviewed at weekly conferences to ensure consensus among experts. |
Last updated: 2/20/2008
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NCCN 1st Annual Forum: Innovative Diagnostics & Therapeutics in Cancer Care™ |
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