Find below the comprehensive diagnostic and treatment
services that are available at The Tomorrows Children's Institute, part of The Joseph M. Sanzari Children's Hospital at Hackensack
University Medical Center:
Since its inception in 1987, the Tomorrows
Childrens Institute has been a leading participant in the Pediatric Oncology Group
(POG) and its successor, the Children's Oncology Group (COG). COG is
the major collaborative group in North America for the
treatment of childhood cancer.
Tomorrows Children's Institute physicians have taken a
leadership role in the COG and participate in numerous committees,
including acute myelocytic leukemia,
bone tumors, Hodgkin's disease, late effects of cancer, psychology issues,
cancer control and cancer in young adults. For further information on
|Participation in COG enables our patients to receive
cutting-edge treatment protocols.
protocols are available for all types of pediatric cancer, including leukemia, lymphoma,
brain tumors, and solid tumors such as neuroblastoma, Wilms tumor, bone tumors,
soft tissue sarcomas and
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The Pediatric Hematology Program
The Pediatric Hematology Program is one of the most
comprehensive programs in New Jersey to evaluate, diagnose, and treat a wide variety of
The multidisciplinary team consists of physicians, advanced practice
nurses, psychologists, social workers, and creative arts therapists.
|Consultations are available for the following conditions:
- Hemoglobinopathies, such as sickle cell disease and
- Bleeding disorders, such as hemophilia
and von Willebrand's disease
- Qualitative and quantitative disorders of platelets
including immune thrombocytopenia (ITP)
- Abnormal pre-surgical coagulation
- White blood cell abnormalities
- Thrombotic disorders (thrombophilia)
is the site of a Comprehensive Sickle Cell Treatment Center
The Center's services address the medical and
psycho-emotional needs of children with sickle cell syndromes and their families.
- Comprehensive inpatient care
- Outpatient transfusions as necessary
- Outpatient evaluation and treatment of painful crisis and
- Transcranial doppler (TCD) screening to predict the risk of
- Dedicated support groups
for patients, siblings, and parents
- Full evaluation of infants with abnormal hemoglobin detected
by newborn screening
- Stem cell transplantation for sickle cell anemia and thalassemia in selected patients
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Marrow Failure Program
|This program offers comprehensive medical and
supportive care to pediatric patients with inherited, congenital or acquired bone marrow
failure disorders, such as aplastic anemia, myelodysplastic syndromes, Fanconi anemia,
Diamond-Blackfan anemia, and Shwachman-Diamond syndrome.
The programs multidisciplinary team is comprised of doctors, nurses, social
workers, child life specialists, and a genetic counselor. Physicians participate
actively in the Fanconi Anemia Research Fund and hold annual meetings with patients and
their families to discuss new scientific data and treatment options.
State-of-the-art therapeutic modalities
are available, including cytokine therapy, matched-related and unrelated cord blood or
bone marrow transplantation, and supportive care.
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Pediatric Neuro-Oncology Program
The Pediatric Neuro-Oncology Program at Hackensack University
Medical Center is a joint effort of Tomorrows Children's Institute and the
Pediatric Neuroscience Institute. The Program has been developed to address the
unique needs of children with cancer affecting the nervous system. Patients
cared for by our team include those with tumors of the brain, spine, and
peripheral nerves, as well as children whose cancer, or its treatment, may have
resulted in neurologic problems.
We believe that children with cancer affecting the nervous system represent a unique patient population, whose medical, psychological, social, and educational needs set them apart from other childhood cancer patients. It is therefore a major priority for us to ensure that our patients have access to expert care in a patient-friendly setting. Attention is given to all aspects of the child's illness, treatment, and recovery. We strive to achieve a cure for every child, while focusing on maximizing quality of life and minimizing complications.
Pediatric Neuro-Oncology Medical Staff:
Our team is comprised of staff with specialized training and expertise,
allowing us to provide a comprehensive approach to care:
- Stephen J. Thompson, MD
Chief, Pediatric Neuro-Oncology Program
Pediatric Neuro-Oncology and Neurology
- Arno H. Fried, MD
Chairman of The Department of Neurosurgery
Director of Pediatric Neurosurgery
- Steven L. Halpern, MD
- Ann Marie Stiefbold, RN, APNC
Advanced Practice Nurse
Scope of Services Provided:
The Pediatric Neuro-Oncology Program provides care from the moment of diagnosis, throughout treatment, and into survivorship. Working together with other
departments, such as Diagnostic Imaging and Pathology, we determine the exact diagnosis for each patient. This information is then used to guide treatment specific to the type of tumor, while taking into consideration the patient's age and potential complications of therapy. All members of the team are involved when treatment decisions are discussed, and options are then presented to the family. In this way, we can provide our patients with the information and guidance required when faced with a potentially life-threatening illness.
Treatment for most patients involves neurosurgery, often combined with radiation therapy and chemotherapy. Due to the risk of injury to developing nervous system when radiation is administered at a young age (often defined as age less than or equal to 3 years), we often use chemotherapy as a means of delaying or perhaps eliminating radiation. Our skilled
pediatric oncology nurses deliver chemotherapy in the outpatient clinic, in a dedicated Infusion Room. If required, children are admitted to a dedicated Inpatient Oncology Unit. When necessary, radiation is administered by the highly trained physicians and staff in our Department of Radiation Oncology.
Psychosocial, Educational, and Other Issues:
We are aware of the special needs of our patients, and address these issues by involving members of our Child Life, Social Work, Psychology, and School Liaison Programs. By paying attention to such issues, it is hoped that we can avoid or rapidly identify problems, and begin interventions in a timely manner. We include the entire family in the process, thus allowing siblings and parents to participate in the child's care.
School and education are extremely important, and we aim to keep children active in these activities during treatment. Our
educational liaisons will even visit the child's school if necessary. The concern continues after the child completes their treatment, as we know that many patients will develop difficulties with hearing, learning, attention, memory, and endocrine function. These problems are addressed by working closely with Dr. Anne Farrar-Anton, Psychology Supervisor and Pediatric Neuropsychologist, and Dr. Michael B. Harris, Director of Cure and Beyond-A Childhood Cancer Survivorship Program. When appropriate, referrals are made to Physical, Occupational, and Speech Therapy, as well as to Endocrinology and other medical services.
Our team is actively involved with the Children's Oncology Group, thus allowing our patients to be enrolled
in appropriate Clinical Research Trials. In addition, we are developing our own
clinical research programs in areas related to neuro-oncology and the
neurologic and cognitive problems encountered by survivors of childhood cancer. The recently opened David Joseph Jurist Research Center for Tomorrows Children will provide the infrastructure required as we pursue our research interests.
Members of our team are involved in the education of medical students and
residents from UMDNJ-New Jersey Medical School. In addition, we are active in educating health care providers in the region, giving lectures and participating in symposia and other programs.
Please feel free to contact Dr. Thompson at (201) 996-5437 for questions, consults, and patient referrals.
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Pediatric Blood and Marrow Transplant Program
Click here for an
in-depth discussion of this program with a complete listing of respective personnel,
transplantation types offered, and current transplantation protocols.
The Pediatric Blood and Marrow Transplant Program at Hackensack University Medical Center,
established in 1990, is a national leader in the field of allogeneic and autologous stem
cell transplantation. It is one of the largest programs
in the New York metropolitan region and the only pediatric transplant program in New
|In 1997, HUMCs Pediatric Blood and Marrow Transplant Program
received certification by the Foundation for Accreditation of Hematopoietic Cell
Therapy (FAHCT), and was recertified in 2001.
Dr. Alfred Gillio, has been exclusively involved in the clinical and
laboratory aspects of pediatric stem cell transplantation for nearly 20 years and is a
recognized authority in the field.
Since the program is recognized by the
Children's Oncology Group; patients from
any COG-affiliated institutions may be referred here for a stem cell
transplant according to cooperative group protocols.
In addition, the program participates in selected
national trials coordinated by the Pediatric Blood and Marrow Transplant Consortium.
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For Childhood Cancer Survivors
|The Cure and Beyond program offers a comprehensive array of support services for survivors of childhood cancer, who completed their therapy two or more years ago.
The goals of the program are:†
To educate the survivor about his/her previous diagnosis and therapy by preparing a written summary with
recommendations about follow up (based on the current literature).
- To teach and encourage a healthy lifestyle and health maintenance.
- To assist the survivor in obtaining adult medical services when appropriate, and to communicate specific follow up needs.
- To observe and carefully document the late effects the survivor may experience so that future survivors may benefit from this information.
The program offered to survivors consists
- A telephone interview prior to the visit to discuss the concerns the survivor or family may have.
- A treatment summary prepared prior to the visit, and given to the survivor at the visit.
- A history and physical exam.
- The opportunity to meet with a social worker, school abilities specialist, child psychologist, and/ or child life specialist depending on the survivor's needs and requests.
- At the conclusion of the visit, a roundtable discussion of the summary, potential (if any) late effects of therapy and follow up recommendations.
- Discussion time to address any questions, concerns or issues the survivor, family and/or significant others may have.
The CAB team includes:
Michael B. Harris, M.D., pediatric oncologist and program director.
Dr. Harris has a special interest and expertise in the long-term results of childhood cancer therapy. Other TCI physicians see their survivors in CAB also.
- Carol Friedman, Ph.D, pediatric psychologist.
Dr. Friedman provides insight into emotional issues, counsels and makes referrals as indicated. She also coordinates psychological and neuropsychological testing.
- Hope Castoria, RN, BSN, CPON, case manager/coordinator.
Ms. Castoria assesses, plans, and provides care for the survivor and coordinates the multidisciplinary team needed to address the survivorís issues.
- Sherri Mayans, R.N., APN, C.,
pediatric nurse practitioner.
Ms. Mayans provides comprehensive care including teaching and follow-up for health maintenance.
- Libby Klein, LCSW, licensed clinical social worker.
Ms. Klein works with survivors to evaluate and enhance their quality of life through counseling, advocacy and referral to community resources.
- Jill Brooks, clerical coordinator.
Ms. Brooks coordinates the scheduling of tests and appointments, insurance issues and the general operation of our offsite office.
As needed, we have the services of child life specialists and creative arts therapists at Tomorrows Childrenís Institute.
Under the direction of Libby Klein, LCSW and Carol Friedman, PhD, CAB offers a monthly activities group for young adult survivors interested in socializing with other survivors. In addition, several members of the CAB team serve on the Pediatric Committee of the New Jersey Office of Cancer Control and Prevention (NJOCCP). The CAB team collaborates with the NJOCCP and other organizations to provide educational conferences for professionals, survivors, and their families about the medical and psychosocial late effects of childhood cancer treatment.
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