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Pediatric proton treatment in the age of COVID

por John R. Fischer, Senior Reporter | March 14, 2022
Rad Oncology Pediatrics Proton Therapy
From the March 2022 issue of HealthCare Business News magazine

Nursing staff are also kept informed and updated daily. All care teams working with the child will have the chance to evaluate them, especially anesthesiologists who must be able to determine if a child who needs anesthesia can be safely sedated and treated. “If they need anesthesia, we will provide it as long as it’s safe to treat them. The anesthesiologist, myself and the oncologist all evaluate the patient,” said Danielle Fohl, a nurse practitioner for Cincinnati Children’s Proton Center.

Should anesthesia not be safe to perform, alternative options are available. Cincinnati Children’s Proton Therapy Center is currently enrolled in an avatar study that allows a patient, who is on the cusp of possibly needing anesthesia for daily treatment, to watch a movie with the use of goggles, while wearing a mask for treatment.

Despite these innovations, the pandemic has made some proton therapy facilities hesitant to take patients from out-of-town. This can be frustrating for pediatric patients, who are already limited in the number of facilities designed to care for their specific needs, according to Dr. Victor Mangona, a radiation oncologist and physician at the Texas Center for Proton Therapy in Irving, Texas. “Different institutions have taken or not taken distant patients from out of town as much. So we’ve actually seen in some instances an increase, because some hospitals weren’t taking patients from out of town during the pandemic.”

Finding the right facilities with the right personnel
In addition to COVID, pediatric patients face obstacles that predate the pandemic, primarily having to travel long distances for treatment, according to Dr. Danny Indelicato, a professor in the department of radiation oncology at the University of Florida. “Many of the existing facilities are not affiliated with large children’s hospitals or academic medical centers. The nature of pediatric cancer dictates specialized, multidisciplinary care that goes beyond the proton therapy facility itself.”

Long treks to facilities and in many cases, relocation, are hard not just on children but on their families as well. Work and school commitments and lodging costs may make such options impossible, and parents may have other children to care for. Relocating also means having to switch care teams and transfer current treatment regimes. The logistics for facilitating these changes can often be complex.

Additionally, children require specifically trained personnel, including pediatric nurses and oncologists, social workers, child life specialists and therapists and very importantly, pediatric anesthesiologists. And whereas the majority of proton therapy centers are single-room facilities, children require multiroom facilities to best handle their needs.

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