
Chapter 01: Cancer in Pediatric Patients
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Description
In this chapter, Dr. Jaffe provides sketches the problem of treating cancer in children, a disease with dramatic effects on all family members. He concludes this brief (seven-minute) section with the statement that cancer in children is tragic because “children are our most precious commodity.”
Identifier
JaffeN_01_20120420_C01
Publication Date
4-20-2012
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - Overview; The Clinician; Overview; Definitions, Explanations, Translations; Human Stories; Patients; The Professional at Work; Offering Care, Compassion, Help; The Life and Dedication of Clinicians and Researchers
Transcript
Tacey Ann Rosolowski, PhD:
This is Tacey Ann Rosolowski interviewing Dr. Norman Jaffe whose specialty is pediatric—I should say this a little different—who is a pediatric hematologist oncologist and a specialist in pediatric cancer. Dr. Jaffe is Professor Emeritus of Children’s Cancer Hospital at the University of Texas MD Anderson Cancer Center in Houston, Texas. He was a professor of pediatrics in the Department of Pediatrics from 1978 until his retirement in 2006. Prior to his retirement, he was [served as chief of the solid tumor service and] also the chief of the long-term surveillance clinic for pediatric patients cured of [the] cancer. This interview is being conducted for the “Making Cancer History Voices” Oral History Project run by the Historical Resources Center at MD Anderson, and the interview is taking place in the Reading Room of the Research Medical Library in the Pickens Academic Tower on the main campus of MD Anderson. This is the first of our planned sessions together. Today is the 20th of April, 2012, and the time is 10:40. Thank you, Dr. Jaffe, for devoting your time to this interview and to the oral history project. We really appreciate it.
Norman Jaffe, MD :
My pleasure.
Tacey Ann Rosolowski, PhD:
As I mentioned before I turned on the recorder, because you’re the first pediatric specialist that we’ve been interviewing for this—we will be interviewing for this project—I wanted to start with some general issues about cancer in children. I wanted to ask the most general question. What is the percentage of children who develop cancer today, and how does that compare with the rates when your career began?
Norman Jaffe, MD :
Let me put it to you this way. Cancer is the second most common cause of deaths in children. The first most common cause is accidents, but it is the most common disease cause of death in children, and the incidence is probably of the order of about four or five per 100,000 a year. When I started the outlook for most children with cancer—and I’m talking about approximately fifty years ago—the outlook was extremely grave. Very few children survived. It was only children with so-called localized disease in the solid tumor section that had a possibility of good survival, and very few children with leukemia and lymphoma survived the disease. Possibly some children with Hodgkin’s disease had a better chance of survival, but otherwise the outlook for most children with cancer was extremely grave.
Tacey Ann Rosolowski, PhD:
And today, the outlooks?
Norman Jaffe, MD :
Today it is a complete reversal of the situation. Approximately eighty percent of children with leukemia can now be cured of disease, and a similar figure, probably of the order of sixty to eighty percent, in the solid tumor section. There is a complete reversal of the outlook in the modern era.
Tacey Ann Rosolowski, PhD:
How do the survivorship rates among children compare to those of adults?
Norman Jaffe, MD :
They [the statistics for children] are much improved as compared to the adults. In fact, I will put it to you this way: [] we are the pioneers and the guiding light for the treatment and strategies of cancer, and many of the treatments that have been adopted by the adult service were in fact originally devised by the pediatric oncologists.
Tacey Ann Rosolowski, PhD:
Really? For some reason I had assumed that the reverse would be true.
Norman Jaffe, MD :
No, it certainly was not so.
Tacey Ann Rosolowski, PhD:
Interesting. What are some of the special issues and challenges that you face in working with childhood cancer?
Norman Jaffe, MD :
Well, cancer is an enigmatic disease. It affects not only the child, but the entire family is affected, and by the entire family, I mean not only the mother and father and siblings but the grandparents, the aunts, the uncles and so on and so forth. It is a dishonest disease and at the same time has many ramifications. It’s a devastating disease, and in fact, can destroy families if it is not handled appropriately and with hope and courage.
Tacey Ann Rosolowski, PhD:
Why do you call it a dishonest disease?
Norman Jaffe, MD :
It is a dishonest disease, because when it first rear[s] [] its ugly head, you may think you have in fact eradicated the disease only for it to occur later in a very, very subtle way and then to become devastating to the individual like a wildfire.
Tacey Ann Rosolowski, PhD:
What are some of the—? How does cancer destroy a family? How can it happen?
Norman Jaffe, MD :
Well, it can destroy the family simply by the child being affected, and this can affect the child in many, many ways[:] pain, discomfort, irritability, anemia, loss of general ability to play and interact with his siblings, surroundings, and things of that nature, which in turn affects the parents. They become concerned and in fact even devastated at times when they see the child suffering to such an extent.
Tacey Ann Rosolowski, PhD:
What are some of the physical dimensions? How is cancer physically different in children than in adults? I was just thinking that—
Norman Jaffe, MD :
It’s not really different in children compared to adults. It still presents in children in the form of lumps and bumps, in the form of general illness and [the like] []. The signs that we are aware of in adults are also applicable to children, but a child may complain of pain and not be able to express the discomfort as well as an adult, so it’s a more challenging disease for a doctor [to diagnose] in a child as compared to an adult.
Tacey Ann Rosolowski, PhD:
Is there anything about the processes of the child’s growing body that changes the way you deal with cancer? Norman Jaffe, MD Not that we know [of], except that I’ll put it to you this way. It is ludicrous and disastrous to treat an adult like a child, but it is in fact, I think, even inconceivable to treat a child like an adult. Children require specific treatment. We adopt our strategies and tactics in such a way that we tailor our treatment specifically for the disease and for the age of the child.
Tacey Ann Rosolowski, PhD:
Would now be the time to ask you for an example, or would you like to wait until we’re talking more about your research?
Norman Jaffe, MD :
No, I think this will come out in the course of the interview.
Tacey Ann Rosolowski, PhD:
Okay. I wasn’t even quite sure how to ask this question, but I’ll give it a shot. Cancer seems to be more poignant or more tragic when it occurs in a child, and I was wondering what your view is about that.
Norman Jaffe, MD :
Oh, I completely concur. Our most precious commodity in this world is our children, and we need to fix any child. It is devastating. It is devastating from every aspect you’d wish to consider, and those people, those parents who have lost children, remember it for the rest of their lives. I think that it is correct to say that to me it is one of the most devastating causes of destruction in family life [that] [] one could consider in the entire world.
Tacey Ann Rosolowski, PhD:
Thank you for that overview, and I’m sure we’ll be revisiting many of these points over the course of the interview.
Norman Jaffe, MD :
Sure, we’ll bring them up as we come along with the different diseases and things of that nature.
Recommended Citation
Jaffe, Norman and Rosolowski, Tacey A. PhD, "Chapter 01: Cancer in Pediatric Patients" (2012). Interview Chapters. 1139.
https://openworks.mdanderson.org/mchv_interviewchapters/1139
Conditions Governing Access
Open
