Pediatric Nursing Demystified

Lumbar puncture may be used for head and neck tumors with examina-

tion of cerebrospinal fluid for malignant cells.

Staging

Metastasis has usually occurred by the time of diagnosis.

Five-year survival rate is near 65%, as high as 80%; tumor will not recur

if totally removed by surgery.

Children disease free for 2 years are likely cured; prognosis is poor with

relapse.

Treatment

Multimodal therapy is the treatment of choice.

Complete removal of primary tumor done when possible, however sur-

gical removal of tumors is used less frequently.

High-dose irradiation for tumors stages II through IV.

Intrathecal chemotherapy may be included in the regimen.

Chemotherapy as part of multimodal treatment with metastasis.

• Preferred chemotherapeutic agents:
  Vincristine
  Cisplatin
  VP-16
  Actinomycin D
  Cyclophosphamide
  Carboplatin
  Topotecan
  Melphalan
  Doxorubicin
  Ifosfamide
  Etoposide
  Adriamycin

Nursing Interventions

Same as with solid tumors with additions as follows:

• Assess for signs of tumor:
  Inspect nasopharynx and oropharynx for visible mass.


• Prepare child and family for extensive diagnostic testing.


• Support child and family during diagnosis, procedures, and treatments.

Retinoblastoma

What Went Wrong?

Retinoblastomais a rare malignant tumor of the retina of the eye accounting

for <3% of childhood cancers. It usually occurs in children <5 years of age

3

CHAPTER 8/ Oncology Conditions^169