Spread Hope, Go Gold this September for National Childhood Cancer Awareness Month

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello there and welcome to the show. You're listening to Weekly Dose of Wellness. It's brought to you by MemorialCare Health System. I'm Deborah Howell and today's guest is Dr. Jerry Finklestein. Dr. Finklestein completed his pediatric training at the Montreal Children's Hospital and his hematology oncology training at Children's Hospital of Los Angeles. In 1976, he created the Hematology Oncology Service at Miller Children's Hospital, Long Beach, and became the founding medical director of the Jonathan Jaques Children's Cancer Center. He headed the center for more than 17 years, and he's our special guest today. Welcome to you, Dr. Finklestein.

Jerry Finklestein, MD: Thank you very much.

Deborah Howell (Host): Today we're going to be talking about National Childhood Cancer Awareness Month, among other things. In a nutshell, what is childhood cancer and how is it different from adult cancer?

Jerry Finklestein, MD: Well, childhood cancer is first of all cancer, which means it involves the body where there's uncontrolled growth. So this occurs both in children and in adults. However, the difference is as follows. Children have different cancers for the most part than adults. Now, they both may have acute leukemia. On the other hand, adults have cancer of the lungs, such as lung cancer caused by smoking. Children don't have cancer in the lung. They may have cancer in the lung. Children have tumors of the kidney called Wilms tumors. If you're over 16 years of age, you're considered to have elderly Wilms. Adults have a cancer of the kidney. It's called renal cell carcinoma. So the basic uncontrolled growth is the same. The types of cancer and how they respond to treatment is different.

Deborah Howell (Host): Okay. Well, let's get a little perspective on what a child with cancer goes through, and if you could tell us what the average treatment plan might be for a child with acute lymphoblastic leukemia.

Jerry Finklestein, MD: Well, the average treatment in terms of time is approximately two and a half to three years, assuming that everything works out well for the child. But it's more than the child going through it. It's the whole family going through it. Once you have a child with a serious disease in a family, it affects the entire family. So the child will receive usually just chemotherapy, sometimes additional therapy. It may require some surgery, usually minor, to help implant devices that enable them to accept the therapy with ease. But it not only changes the child's lifestyle, it changes the family's lifestyle. The best way to think about this is to climb a mountain. When you climb a mountain, you have curves. There are switchbacks. The switchbacks may involve a change of therapy. The switchbacks may be a change of plan. The switchbacks may be hospitalizations. It may be nausea, vomiting, diarrhea, constipation, secondary to therapy. It may be temporary hair loss. It may be difficulties in school because our therapy sometimes affects intellectual development. However, when you climb a mountain, you can get to the top.

Deborah Howell (Host): That's right.

Jerry Finklestein, MD: Most of our children today reach the top where the sun is shining, the sky is blue, and the child is cured.

Deborah Howell (Host): That's what we all hope for in our most fervent prayers. So what is the most importance of cancer research, Doctor?

Jerry Finklestein, MD: The importance of cancer research is really epitomized with the pediatric oncologist. Decades ago, we recognized in our subspecialty that to do the job, we had to collaborate with people throughout the country or perhaps throughout the world. The pediatric oncologist way back in the 50s, and certainly in the 60s, when I entered the field, started working together in collaborative clinical research. So if you are treated, for example, at Long Beach Memorial Miller Children's Hospital, you will receive the same treatment as if you're treated in a cancer center in Texas or the middle part of the country or the East Coast or in Canada. This collaboration has enabled us to improve the survival of childhood cancer from less than 10% when I entered the field to somewhere between 85% and 95% today in 2013.

Deborah Howell (Host): Yeah. And how many years have you been? So that would be about 30 years?

Jerry Finklestein, MD: No longer than that. It's roughly 40 years. In the 60s, there was a colleague that called around the country to find out how many children with leukemia were living more than three years. The numbers were in the teens. He stopped calling in the 70s.

Deborah Howell (Host): Yes. Remarkable progress. What are some of the accolades that the Jonathan Jaques Children's Cancer Center has received?

Jerry Finklestein, MD: Well, we're recognized as a multidisciplinary approach to childhood cancer. And I referred to that in my earlier comment. When a child has a serious life-threatening disease, it not only involves the child because you want to make sure they receive the most modern therapy that's available, but involves the siblings, the parents, the grandparents. Everything changes. I'll give you an example. Decades ago, one of my patients was doing very well, but the mother approached me and let me know that her other child was really giving her a tough time.

Deborah Howell (Host): Right.

Jerry Finklestein, MD: And the other child was now a teenager. It was about five or six years past the time that the sibling had been diagnosed. And the other child went to the mother and said, where were you when I needed you? Because this could be an overwhelming challenge for a family. We recognize this. We have probably more psychologists and social workers working with us than physicians because we recognize that the psychosocial support that's necessary for this family who are confronting childhood cancer is of paramount importance. So at the very beginning, we concentrated on making sure that this would be a total multidisciplinary approach to a child with serious disease.

Deborah Howell (Host): Well, on behalf of all the families going through this, we thank you. What type of research is Jonathan Jaques Children's Cancer currently involved in?

Jerry Finklestein, MD: Most of our research is clinical, and that means clinical studies of either multiple drugs or single drugs. We work with agencies such as drug companies, we also have done some nutritional research, we've also done a fair amount of psychological research and we're also very interested in what we would call the survivorship challenge namely a child who has done well with cancer what challenges are they left with for the rest of their life. You can look at the late effects of therapy and some of the other aspects that their body is going to confront because of the very intense therapy that it received for its disease.

Deborah Howell (Host): Right. It is a lifetime challenge, but, you know, luckily we've had so much experience now with this that you know exactly what the course of treatment and aftercare is.

Jerry Finklestein, MD: Well, we know up to a point. The point being, it's very nice for me to say, as I said earlier, the survival rates in the 85-90% range, but that doesn't count until it's 100%. That's item one. I did mention that there are children that are left with residual effects because of our therapy. We have to tailor, and we're doing this, our treatment. So our child who's confronting this disease will be cured and not be left with any long-term challenges because of the therapy. So we still have work to do.

Deborah Howell (Host): Maybe you can tell our listeners how they can help raise awareness for childhood cancers and maybe even get involved themselves with the Jonathan Jaques Children's Cancer Center.

Jerry Finklestein, MD: Well, first of all, we're going to pronounce it Jonathan Jaques. I hate to correct you.

Deborah Howell (Host): I'm so sorry. I see Jaques and I think French! I'm so sorry.

Jerry Finklestein, MD: All right, no problem. Secondly, there are a number of ways to be involved. First of all, this program is helping people become aware. We need support. We need financial support. Philanthropy is extremely important. The government is not able to do the job, so we need the philanthropists out there to help us. Children do not vote, so they do not necessarily get the money that the adults do for their challenges. We have fundraisers in our unit that are very exciting. If you cycle in May, you could cycle 5 miles, 31, 62, or 100. And we have thousands of people doing what's called the Tour of Long Beach, which raises money for our research. We have other fundraisers which do receive publicity and do help us in terms of supporting our research and our psychosocial program. And just the other day, a gentleman friend had his children making cookies for childhood cancer.

Deborah Howell (Host): And I'm going to stop you there, unfortunately, because we're out of time. But Dr. Finklestein, it's been magical to have you with us today to talk about childhood cancer awareness. Thank you so much for the good work you do.

Jerry Finklestein, MD: Have a good day.

Deborah Howell (Host): I'm Deborah Howell. Have a fantastic day.