Prevention and Early Detection for Pediatric Hereditary Cancer Syndromes at Texas Children’s Cancer and Hematology Center

Improving childhood cancer outcomes through early intervention or prevention is a goal for all pediatric oncologists, and the Childhood Cancer Prevention and Screening Clinic at Texas Children’s Cancer and Hematology Center was established in 2012 to achieve that goal. The clinic was one of the first in the country to provide centralized cancer screening and prevention services to improve patient outcomes for children or adolescents with known or suspected hereditary cancer predisposition syndromes. When screening evaluations reveal pre-malignant or early-stage tumors, early intervention and treatment can be initiated, which ultimately leads to improved survival, decreased treatment-related chronic health issues or both. 

How it works 

Image

Developed and directed by Surya Rednam, MD, MS, the Childhood Cancer Prevention and Screening Clinic is part of the Cancer Genetics and Genomics Program at Texas Children’s, which is co-directed by Sharon Plon, MD, PhD, FACMG, and Will Parsons, MD, PhD. Providers at the clinic work closely with the patient’s health care team, which includes pediatricians, pediatric oncologists, other pediatric subspecialists and geneticists, to ensure that children with conditions that make them highly susceptible to developing cancer receive the best possible care to reduce this risk. 

The clinic sees children and adolescents from all over the world for personalized recommendations about cancer prevention or screening strategies. This includes three main groups of patients with known hereditary cancer predisposition syndromes: 

1. Those who have had cancers/tumors in the past 
2. Those who are presently being treated for a cancer/tumor 
3. Those who have not had any prior cancers/tumors but have had positive genetic testing 

For each child, the team develops and implements screening recommendations adapted for their specific case based on the latest guidelines, medical literature and personal and family history. Longitudinal assessments include interviews, physical exams, laboratory testing, imaging and other subspecialty evaluations.  

“Our team members and the specialists with whom we collaborate have substantial experience with the genetic syndromes and conditions affecting our patients. In addition, Texas Children’s offers specialized care and imaging that may not be as readily available elsewhere,” said Dr. Rednam. “We also recognize the process of screening for cancer may be stressful for patients and their families, which is why psychology and social work support are essential components of our clinic.” 

Evidence-based approach 

All screening regimens are individualized based on consensus guidelines for specific conditions, the latest medical literature and the patient’s medical and family history.  

“For many years, consensus guidelines weren’t available, and cancer screening and prevention practices were highly variable,” Dr. Rednam said. “Experts from Texas Children’s, including Dr. Plon, Sarah Scollon, MS, CGC, and myself, participated in the American Association of Cancer Research Childhood Cancer Predisposition Workshop, developing an initial comprehensive set of consensus guidelines for high-risk children. We have continued to contribute to ongoing updates of these pediatric cancer screening and prevention recommendations.”  

The frequent updates to these guidelines highlight the need for a dedicated team focused on managing cancer risks in children with hereditary cancer predisposition syndromes. Dr. Plon pointed out: “Patients really need a specialist who is dedicated to keeping up with the changes to the screening and prevention guidelines. It’s our job to keep track of these changes to optimize care for our patients and their families.” 

In collaboration with Baylor College of Medicine, the clinic also serves as a training site for both medical genetics trainees and pediatric hematology-oncology fellows.  

Expert help for referring pediatric specialists 

The clinic team prides itself in partnering closely not only with families, but also with referring physicians throughout the process to ensure they are fully informed about their patient’s care. After the initial visit is completed, referring providers receive summaries of the child’s cancer risks and the clinic’s management plan. For children who receive longitudinal cancer screening services, primary medical providers receive ongoing status updates and recommendations on their patients. 

“We want physicians to know our team is available and excited to care for our shared patients and to support their families in ensuring their needs are addressed — cancer/tumor risks, other needs related to their underlying condition and psychosocial issues,” Dr. Rednam said. “We make a great effort to work collaboratively with all members of a child’s medical team, including the primary care physician and specialists.”  

If you have a patient who might benefit from the Childhood Cancer Prevention and Screening Clinic at Texas Children’s Cancer and Hematology Center, call 1-800-226-2379 to learn more about referring a patient.