Pediatric chemotherapy

What is pediatric chemotherapy?

Chemotherapy is a systemic treatment, which means it enters the bloodstream and circulates throughout your child’s entire body. Chemotherapy is used to destroy cancer cells, ease cancer symptoms like bone pain and to prepare your child for stem cell transplants.

Doctors also use chemotherapy to treat certain non-cancerous (benign) conditions like langerhans cell histiocytosis (LCH) and transient myeloproliferative disorder (TMD). These disorders cause blood cells to grow far more rapidly than normal.

Chemotherapy comes in many forms: pills, shots, intravenous (IV) lines into a vein and intrathecal lines into the spine. Depending on the delivery method, your child may get chemotherapy at Children’s Health or at home.

What are the side effects of pediatric chemotherapy?

Chemotherapy drugs must be powerful enough to kill diseased cells. Unfortunately, the drugs can’t tell the difference between unhealthy and healthy cells – they wipe out all of them.

This can lead to many side effects, including:

• Nausea
• Diarrhea
• Constipation
• Fatigue
• Telogen effluvium (temporary hair loss) in children (temporary hair loss)
• Headaches
• Loss of appetite and weight loss
• Mouth or throat sores

What are the risks of pediatric chemotherapy?

Most children who receive chemotherapy enjoy long, healthy lives. Still, chemotherapy does carry risks. It can damage the heart, kidneys, lungs or other organs. Chemotherapy can also cause nerve damage and affect fertility. While those risks are serious, it’s also good to remember that life-threatening risks of cancer far outweigh the risks of treatment.

What to expect with pediatric chemotherapy

Chemotherapy treatment can last anywhere from several months to several years, depending on what type of cancer your child has and whether it has spread.

What can I expect before pediatric chemotherapy?

Most children receive chemotherapy through an IV that goes into a vein. To make infusions easier and more comfortable for your child, we perform a minor surgical procedure to place a central line (soft, flexible catheter or tube) into a large vein under the skin of the collarbone.

This line remains in place between treatments. Your child’s care team uses this central line to give fluids, chemotherapy and anti-nausea medications, and to take blood samples.

Our team will teach you how to care for the central line at home to prevent infections and blockages. The line won’t stop your child from being active.

What can I expect during pediatric chemotherapy?

During chemotherapy, your child may need daily or weekly infusions. First, we’ll use the central line to take blood samples and give fluids and anti-nausea medicine. Then we’ll start the chemotherapy infusion. The infusion takes place in a private room reserved for your family.

IV chemotherapy can take up to one hour, sometimes longer. To help pass the time, our infusion rooms have movies, games, books and toys. Your family can have snacks or meals delivered from the cafeteria. A Child Life specialist will meet with your family during treatment to address worries and ease your child’s concerns.

What can I expect after pediatric chemotherapy?

Every child responds differently to chemotherapy. Most children go home after receiving an infusion. Side effects may appear shortly after treatment or days later. Some children have mild, barely noticeable issues, while others have more severe side effects.

Be sure to talk to your doctor about any side effects you notice so they can provide tips on managing them. For instance, if your child feels nauseous, they may try a different anti-nausea medication next time, or add aromatherapy or other therapies that can help prevent nausea.

After your child completes treatment, we continue to monitor them for side effects and signs of cancer coming back. Your family receives ongoing support through our The After Cancer Experience Program, the largest in North Texas.

How do I prepare my child for pediatric chemotherapy?

Chemotherapy can be scary and it’s important to talk to your child about what they will experience. Our Child Life specialists are here to help. They will meet with your family before and during treatment to answer questions and help explain things in terms that make sense to your child.

Your child might want to bring a beloved stuffed animal or blanket to treatment.

What is my child allowed to eat and drink before pediatric chemotherapy?

Unless your child’s care team says otherwise, your child should eat and drink normally before treatment. You might be tempted to have your child skip food to avoid nausea, but a light meal or snack before treatment may actually prevent it.

How do I prepare my child for chemotherapy-induced hair loss?

Hair loss is a common side effect of chemotherapy. Your child may start losing hair two to three weeks after the initial treatment. Our psychologists and Child Life specialists can help your child understand what’s happening and why.

We also have many books and videos that can help you guide your child on what to expect. And our Child Life specialists visit schools to educate classmates about your child’s condition. If your child wants a wig, we can connect you with organizations that can help. Most children embrace their new look and don’t opt for a wig.

What questions should I ask my provider about pediatric chemotherapy?

• How long will my child need chemotherapy?
• Will my child need other treatments in addition to chemotherapy?
• What medications should my child stop taking before chemotherapy?
• What should I know about giving chemotherapy to my child at home?
• What side effects or signs of complications should I look out for?