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Numerous medical advances have helped health care professionals manage, lessen, and prevent certain side effects of cancer treatments. But parents whose kids need chemotherapy — one of the most common treatments for childhood cancer — often have many questions and concerns about it.

About Chemotherapy
Chemotherapy (often just called "chemo") refers to medications that kill actively dividing cells. Unlike healthy cells, cancer cells reproduce continuously because they don't respond to the normal signals that control cell growth. Chemotherapy works by disrupting cell division and killing these actively dividing cancer cells. In contrast to radiation therapy, which destroys the cancerous cells of a tumor in a specific area of the body, chemotherapy works to treat cancer throughout the body.

If your child has been diagnosed with cancer, doctors will likely develop a customized treatment plan that takes into account your child's age, the type of cancer, and where it's located. A pediatric oncologist (a doctor who specializes in the treatment of childhood cancer) will work with other health care professionals to determine the chemotherapy regimen that's best for your child.

How Chemotherapy Is Given
Just as other medicines can be taken in various forms, there are several ways to get chemotherapy. In most cases, it's given intravenously into a vein, also referred to as an IV. An IV is a tiny tube inserted into a vein through the skin, usually in the arm. The IV is attached to a bag that holds the medicine. The chemo medicine flows from the bag into the vein, which puts the medicine into the bloodstream. Once the medicine is in the blood, it can travel through the body and attack cancer cells.

Sometimes, a permanent IV called a catheter is placed under the skin into a larger blood vessel of the upper chest. That way, a child can get chemotherapy and other medicines through the catheter without having to always use a vein in the arm. The catheter remains under the skin until all the cancer treatment is completed. It can also be used to obtain blood samples and for other treatments, such as blood transfusions, without repeated needle sticks.

Chemo also can be:

•taken as a pill, capsule, or liquid that is swallowed
•given by injection into a muscle or the skin
•injected into spinal fluid through a needle inserted into a fluid-filled space in the lower spine (below the spinal cord)
Chemotherapy is sometimes used along with other cancer treatments, such as radiation therapy, surgery, or biological therapy (the use of substances to boost the body's immune system while fighting cancer).

Lots of kids and teens receive combination therapy, which is the use of two or more cancer-fighting drugs. In many cases, combination therapy lessens the chance that a child will become resistant to one type of drug — and improves the chances that the cancer will be cured.

ContinueWhen and Where Chemotherapy Is GivenDepending on the method used to administer chemotherapy, it may be given at a hospital, cancer treatment center, doctor's office, or at home. Many kids receive chemotherapy on an outpatient basis at a clinic or hospital. Others may need to be hospitalized to monitor or treat side effects.

Kids may receive chemotherapy every day, every week, or every month. Doctors sometimes use the term "cycles" to describe a child's chemotherapy because the treatment periods are interspersed with periods of rest so the child can recover and regain strength.

Side EffectsAlthough chemo often effectively damages or eliminates cancer cells, it also can damage normal, healthy cells. And this can lead to some uncomfortable side effects.

Chemotherapy side effects are different for each child. The type of anticancer drug used, the dosage, and a child's general health affect the risk of developing unpleasant side effects. The good news is that most side effects are temporary — as the body's normal cells recover, the side effects gradually go away.
Cancer treatment is multifaceted — that is, patients receive a lot of care (i.e., fluid and nutrition support, transfusion support, physical therapy, and medicines) to help them tolerate the treatments and treat or prevent side effects such as nausea and vomiting.

It's difficult to pinpoint which side effects a child might experience, how long they'll last, and when they'll end. Talk to your doctor if your child has side effects about how to cope with them.

FatigueFatigue is the most common side effect of chemotherapy. Kids may need to reduce or eliminate all but the most essential activities during chemo, and may feel very tired even after sleeping and resting. Fatigue may last for days, weeks, or months, but it does go away once treatment is over.

Encourage your child to rest and sleep as often as possible — even if it doesn't immediately result in more energy — because rest helps the body recover from chemo. Short naps or breaks from activity may be more beneficial than longer ones.

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Discomfort and PainThere may be some initial discomfort when a chemotherapy catheter or IV needle is placed in the vein. Certain anticancer drugs also cause mouth pain, headaches, muscle pains, and stomach pains. Chemo medicine may cause temporary nerve damage, which can result in burning, numbness, tingling, or shooting pain in the fingers and toes.

Kids taking pain medication should not skip doses — waiting until pain is felt can make it harder to control. If your child's pain persists or worsens at any time, talk to your doctor. Also, be sure to discuss the use of alternative or over-the-counter medicines. There may be drug interactions you'd want to avoid.

Skin Damage or ChangesSkin may be red, sensitive, or easily irritated in the days, weeks, and months during and after treatment. If your child had radiation therapy prior to chemotherapy, the treated skin may turn red, blister, and peel once chemo begins. This condition is known as "radiation recall."

A child who has sensitive or irritated skin should wear loose, soft clothes and avoid using lotions or other commercial products on the affected are
a. Your doctor may recommend an ointment or cream to reduce irritation.

Hair Loss and Scalp SensitivityBecause chemotherapy often kills the healthy cells responsible for hair growth, it's common for kids undergoing chemo to lose their hair or have a sensitive scalp.

Hair thinning and hair loss may occur all over the body during treatment, including the head, face, arms and legs, underarms, and pubic area. Your child's hair may become thinner and then fall out completely or in clumps.

Losing hair can be scary for kids and make them feel bad about standing out. Getting a shorter haircut may make it less traumatic once hair loss starts. Your child may also feel more comfortable wearing hats, bandannas, baseball caps, scarves, or wigs until the hair grows back. And it will grow back. Most kids' hair regrows before treatment ends or within 3 months following its end, though it may be a slightly different color or texture than it was before.

To protect the head from sun exposure, have your child wear a hat and sunscreen while outside. If your child doesn't experience hair loss, mild shampoos and hair products are still recommended to avoid scalp irritation.

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Mouth, Gum, and Throat SoresChemotherapy may cause sores in the mouth, gums, and throat or cause gum tissues to become irritated and bleed. The doctor may prescribe a mouth rinse or other products to reduce pain, dryness, and irritation. Be sure to take your child for regular dental checkups and follow the dentist's advice on how to brush your child's teeth during chemotherapy. Kids with mouth or throat pain may find soft, cool foods easier to chew and swallow, and acidic foods and juices should be avoided.

Gastrointestinal ProblemsGastrointestinal problems (including loss of appetite, constipation, diarrhea, nausea, and vomiting) can occur, although medications can help prevent or reduce nausea and vomiting. Talk to your doctor about medicines or dietary changes that may alleviate your child's upset stomach, prevent weight loss, or combat constipation.

If your child who doesn't feel like eating, try serving several small meals rather than fewer larger ones. And be sure to offer foods high in nutrients to prevent weight loss. Avoid serving fatty, sweet, spicy, or fried foods. And even though your child may not feel like drinking, clear broth, juices, and sports drinks can replace fluids lost through vomiting and diarrhea. Room-temperature beverages may be easier to drink than hot or cold liquids. The doctor or a registered dietitian may have suggestions for ensuring adequate nutrition and hydration.

Urinary System ProblemsSome chemotherapy drugs can irritate or damage the bladder or kidneys and can cause the urine to change color or take on a strong odor for a day or two. The doctor may ask for a blood or urine sample before beginning chemotherapy to evaluate kidney function.

Giving your child plenty of fluids to drink will ensure good urine flow and help prevent problems in the urinary tract. Be sure to let the doctor know if your child experiences symptoms that may indicate a problem with the urinary system, such as painful or frequent urination, reddish or bloody urine, or an inability to urinate.

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Central Nervous System ProblemsChemotherapy may cause temporary confusion and depression, which should go away once treatment is completed.
Other central nervous system side effects can include:

Anemia
The doctor will monitor your child's blood counts to check for anemia (low levels of red blood cells, which are made in the bone marrow and carry oxygen throughout the body). Red blood cell transfusions may be necessary.Chemotherapy drugs may inhibit the body's ability to produce platelets, which help blood to clot. Your child may bleed or bruise easily because of a reduction in platelets (called thrombocytopenia). Platelet transfusions can be given to treat low counts.Increased Risk of Infection

Chemo may cause a reduction in white blood cells, which are part of the immune system and help the body to fight infection. Therefore, your child is more vulnerable to developing infections during and after chemo.

Infection precautions: Remind kids to wash their hands before eating, after using the bathroom, and after touching animals. Friends or family members with contagious illnesses (such as a cold, the flu, or chickenpox) should refrain from visiting. Try to avoid crowds and children who have received certain vaccines, such as chickenpox or oral polio — these are live-virus vaccines and can spread disease to kids with low blood cell counts. Your child also shouldn't receive immunizations without your doctor's OK. And to prevent food-borne infection, your child shouldn't eat raw fish, seafood, meat, or uncooked eggs.Long-Term Side Effects

Chemotherapy can cause long-term side effects (sometimes called late effects), depending on the type and dose of chemotherapy and whether it was combined with radiation. These effects may involve any organ, including the heart, lungs, brain, kidneys, liver, thyroid gland, and reproductive organs. Some types of chemotherapy drugs may also increase the risk of cancer later in life. Receiving chemo during childhood also may place some kids at risk for delayed growth and cognitive development, depending on the child's age, the type of drug used, the dosage, and whether chemotherapy was used in addition to radiation therapy.Report any side effects to your doctor so that they can be treated and your child made as comfortable as possible.

Seeing such a long list of potential side effects can be frightening. But remember that chemo is designed to not only help kids with cancer stay healthy in the long run, but to save their lives.

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Caring for Your ChildYour child might have many questions about cancer and its treatment. Be honest when talking about it — discuss the disease in age-appropriate terms and encourage your child to share his or her feelings. And remember that you're not alone: Doctors, nurses, psychiatrists, psychologists, social workers, child-life therapists, and other members of the cancer treatment team are there to reassure you and your child before, during, and after chemotherapy.
Kids who are scared about starting chemo might benefit from a tour of the hospital or clinic beforehand or joining a support group for families coping with childhood cancer. Besides making treatment seem less frightening, meeting other cancer patients and survivors might help your family develop a network of friends and supporters dealing with the same issues.

Once chemo is done, it's still important for the doctor to monitor your child's health and progress in follow-up appointments. During these checkups, the doctor will ask if there are continuing side effects or any signs of the cancer recurring.

It can be difficult to cope with a cancer diagnosis, let alone to take in facts about chemotherapy. Remember that despite the side effects of this cancer treatment, most kids are cured of their cancer and can enjoy happy, productive lives.

Everyone has brief pauses in their breathing pattern called apnea. Usually these brief stops are completely normal.

Sometimes, though, apnea can cause a prolonged pause in breathing, making the breathing pattern irregular. Someone with apnea might actually stop breathing for short amounts of time, decreasing oxygen levels in the body and disrupting sleep.

Types of Apnea
The word apnea comes from the Greek word meaning "without wind." Although it's perfectly normal for everyone to experience occasional pauses in breathing, apnea can be a problem when breathing stops for 20 seconds or longer.

There are three types of apnea:

1.obstructive
2.central
3.mixed

Obstructive Apnea
A common type of apnea in children, obstructive apnea is caused by an obstruction of the airway (such as enlarged tonsils and adenoids). This is most likely to happen during sleep because that's when the soft tissue at back of the throat is most relaxed. As many as 1% to 3% of otherwise healthy preschool-age kids have obstructive apnea.

Symptoms include:

•snoring (the most common) followed by pauses or gasping
•labored breathing while sleeping
•very restless sleep and sleeping in unusual positions
•changes in color
Because obstructive sleep apnea may disturb sleep patterns, these children may also show continued sleepiness after awakening in the morning and tiredness and attention problems throughout the day. Sometimes apnea can affect school performance. One recent study suggests that some kids diagnosed with ADHD actually have attention problems in school because of disrupted sleep patterns caused by obstructive sleep apnea.

Treatment for obstructive apnea involves keeping the throat open to aid air flow, such as with adenotonsillectomy (surgical removal of the tonsils and adenoids) or continuous positive airway pressure (CPAP), which is delivered by having the child wear a nose mask while sleeping.

ContinueCentral ApneaCentral apnea occurs when the part of the brain that controls breathing doesn't start or properly maintain the breathing process. In very premature infants, it's seen fairly commonly because the respiratory center in the brain is immature. Other than being seen in premature infants, central apnea is the least common form of apnea and often has a neurological cause.

Mixed ApneaMixed apnea is a combination of central and obstructive apnea and is seen particularly in infants or young children who have abnormal control of breathing. Mixed apnea may occur when a child is awake or asleep.

Conditions Associated With ApneaApnea can be seen in connection with:

Apparent Life-Threatening Events (ALTEs)An ALTE itself is not a sleep disorder — it's a serious event with a combination of apnea and change in color, change in muscle tone, choking, or gagging. Call 911 immediately if your child shows the signs of an ALTE.

ALTEs, especially in young infants, are often associated with medical conditions that require treatment Examples of these medical conditions include gastroesophogeal reflux (GERD), infections, or neurological disorders. ALTEs are scary to observe, but can be uncomplicated and may not happen again. However, any child who has an ALTE should be seen and evaluated immediately.

Apnea of Prematurity (AOP)AOP can occur in infants who are born prematurely (before 34 weeks of pregnancy). Because the brain or respiratory system may be immature or underdeveloped, the baby may not be able to regulate his or her own breathing normally. AOP can be obstructive, central, or mixed.

Treatment for AOP can involve the following:

keeping the infant's head and neck straight (premature babies should always be placed on their backs to sleep to help keep the airways clear)medications to stimulate the respiratory systemcontinuous positive airway pressure (CPAP) — to keep the airway open with the help of forced air through a nose maskoxygenBackContinue

Premature infants with AOP are followed closely in the hospital. If AOP doesn't resolve before discharge from the hospital, an infant may be sent home on an apnea monitor and parents and other caregivers will be taught CPR. The family will work closely with the child's doctor to have a treatment plan in place.
Apnea of Infancy (AOI)Apnea of infancy occurs in children who are younger than 1 year old and who were born after a full-term pregnancy. Following a complete medical evaluation, if a cause of apnea isn't found, it's often called apnea of infancy. AOI usually goes away on its own, but if it doesn't cause any significant problems (such as low blood oxygen), it may be considered part of the child's normal breathing pattern.

Infants with AOI can be observed at home with the help of a special monitor prescribed by a sleep specialist. This monitor records chest movements and heart rate and can relay the readings to a hospital apnea program or save them for future examination by a doctor. Parents and caregivers will be taught CPR before the child is sent home.

If You Think Your Child Has ApneaIf you suspect that your child has apnea, call your doctor. If you suspect that your child is experiencing an ALTE, call 911 immediately.

Although prolonged pauses in breathing can be serious, after a doctor does a complete evaluation and makes a diagnosis, most cases of apnea can be treated or managed with surgery, medications, monitoring devices, or sleep centers. And many cases of apnea go away on their own.

Chances are you know someone who has had cancer, such as an older relative or someone in a friend's family. But sometimes cancer affects teens and when the person affected is you, the word cancer takes on a new meaning — one that can feel personal and frightening.

If you've been diagnosed with cancer, you should know that although it's unusual for people to have cancer during their teenage years, you're certainly not alone. The good news is that most teens who get cancer survive and return to their everyday lives. Read on to learn about how to cope if you or someone you know has cancer.

Learning About Cancer
The word cancer actually refers to many diseases, not one. What these diseases have in common is that the body's cells (tiny units that make up all living things) behave abnormally. In someone who has cancer, cells grow and divide uncontrollably and eventually form tumors.

Many people with cancer (or who know people with cancer) find that learning more about it is a good way to understand and feel more in control of their situations. Knowing more about the disease also allows people to feel knowledgeable enough to ask relevant questions and take charge of their medical options.

Cancer has its own language, and doctors can sometimes forget that non-medical people may not understand its terms and phrases. If there's anything you don't understand, ask for explanations. Most doctors are happy to explain things in a way that makes sense to their patients. People with cancer usually have a specially trained medical team working with them to fight the disease. So if a doctor's not around, an oncology nurse can probably answer any questions.

Another way to make sense of cancer is to read. You can find tons of information and resources in public libraries, bookstores, and on the Internet. Remember, though, that you may come across information (especially on the Internet) that is incorrect or outdated. If you find information in your research that is different from what your doctor is telling you, be sure to ask your doctor about it.

People who are living with cancer and their families often find it helpful and comforting to share their experiences and learn what others have gone through. There are a variety of supportive environments where people can do this - everything from Internet chat areas on cancer sites to local support groups where people meet face to face. Ask your doctor to put you in touch with support resources for people who are dealing with cancer. Although no two patients have the exact same cancer experiences, it can sometimes feel good to know you're not alone.

ContinueTaking Care of Yourself PhysicallySince you were a little kid, you've probably heard again and again that eating right and getting rest are two of the most important things you can do to stay healthy. For people who've been diagnosed with cancer, getting proper nutrition and plenty of sleep are good ways to stay as healthy as possible during treatment.

People who are having chemotherapy or radiation therapy may need help eating right because the side effects of these treatments can include loss of appetite and nausea. It may help to consult with a dietitian, a professional who can create a nutrition plan geared to your specific needs.

Exercise can also help a person stay healthy during recovery. If you're being treated for cancer, a doctor can let you know whether you should exercise, how much, and whether physical therapy might help. Once you are able to exercise, find out which types will help to increase your strength and stamina. Even gentle walking can go a long way to helping people with cancer feel better about themselves.

Taking Care of Yourself EmotionallyIt's natural for people who have learned they have cancer to feel many emotions. Anger, fear, sadness, and anxiety are common reactions to having a serious illness.

Feelings and worries can seem overwhelming if they get bottled up inside. It's important to get help in sorting out your emotions. Some of the professionals you can talk to are social workers, clergy, and psychologists and psychiatrists. You can also share your feelings with trusted adults, such as relatives or members of a cancer support group.

It can really help to get to know other teens who have cancer. You can exchange information and ideas and learn how others your own age have managed to cope. There are also many medical organizations devoted to cancer support, and some have websites as well as toll-free telephone numbers to make it easy to contact them.

Above all, remember that although you may have cancer, you are a person first and a patient second. Cancer is not your identity; it is simply an illness you are trying to overcome.

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How Can I Help Someone Who Has Cancer?If a friend or relative has cancer, the most important thing you can do is to be yourself! Many people who have cancer say that the people they love suddenly treat them differently or stay away completely.

It's natural to feel frightened, anxious, or even angry when someone you know has cancer, but don't let that keep you from being there for your friend or loved one. You may need help dealing with your strong emotions, and there are many places you can turn: Many hospitals have counseling groups for families and friends of people with cancer. Or you can talk to an adult whom you trust for support and reassurance. You can also visit websites related to cancer. Another way you might help a person with cancer is to consider volunteering at a hospital or clinic that treats people with cancer. Volunteering is an excellent way to show your support.

If a close friend or family member has cancer, he or she may be on an emotional roller coaster. Being in the hospital or having to stay home a lot to rest can be isolating and cause a person to feel lonely. Most people with cancer like having their friends and family around, even if the visits are short and there may not be much to say. If you're not sure whether to visit, ask. Even if your schedule is very busy, you can keep in touch in other ways, like sending cards, talking on the phone, or using email. It will do a lot to lift the spirits of someone you know who is dealing with cancer.

Keep in mind that the person you care about is simply sick. Despite the cancer, he or she is still the same person you've always known and loved.
Updated and reviewed by: Steven Dowshen, MD

More than half of all people with cancer are treated with radiation therapy, a type of cancer treatment that is used to shrink tumors and stop the growth of cancer cells. Keep reading to get the facts on radiation therapy, including what it is, what to expect, and how to cope with side effects.

What Is Radiation Therapy?
Cancer is a disease that causes cells to grow abnormally and out of control. In radiation therapy, high-energy X-rays are directed at a person's body to kill cancer cells and keep them from growing and multiplying.

Most people have been exposed to radiation in the form of an X-ray - most likely at a dentist's office. And just like the X-rays given in the dentist's office, radiation therapy is painless. But unlike a typical X-ray, the radiation isn't used just to create a picture of a tooth or broken bone. Radiation therapy delivers higher doses of radiation so that the radiation will kill cancer cells and shrink tumors.

While it's killing the cancer, radiation therapy also can damage normal cells. The good news is that normal cells are more likely to recover from the effects of radiation. Doctors take precautions to protect a person's healthy cells when they're giving radiation treatments.

How Is Radiation Given?
Doctors can give people with cancer radiation therapy as the only form of treatment. Or they may use a combination of radiation therapy and chemotherapy (a treatment that uses medications or chemicals to destroy cancer cells) to fight the cancer. Other people with cancer may have surgery to remove tumors or cancer cells first and then have radiation therapy. Each person's situation and treatment is different. A person who has cancer will see an oncologist (pronounced: on-kah-luh-jist), a doctor who specializes in cancer treatment.

A radiation oncologist is a doctor whose specialty is using radiation to treat cancer. The radiation oncologist will work with other health care professionals to decide on the type and dose of radiation therapy that will best treat a person's cancer.

Radiation therapy can be given two ways - externally, through the skin, or internally, through injection or by implanting a radioactive pellet in the body. Internal radiation therapy is very rare in teens - it's usually adults who get this form of treatment.

With external radiation therapy, doctors use a large machine and special equipment that aims specific amounts of radiation directly at the cancer.

What Happens During External Radiation Therapy?
People who are having external radiation treatments usually don't need to stay in the hospital overnight. They usually visit the hospital or treatment center 5 days a week (with weekends off) for 2 to 8 weeks. Getting small daily doses of radiation helps to protect the normal cells from damage. The weekend breaks help the normal cells to recover from radiation.

If you're being treated using external radiation therapy, at each appointment, you'll dress in a hospital gown or robe and enter the radiation treatment room. After the radiation therapist settles you into position on a table or other flat surface, he or she will leave the room (just as an X-ray technician does when you're having an X-ray at the dentist or hospital). Then a large machine called a simulator will deliver the exact amount of radiation necessary to kill the cancer cells in the area, which has usually been outlined with ink or a faint tattoo. It usually takes only a few minutes for a teen to receive the daily dose of radiation. While the simulator is on, you'll have to lie very still so the radiation is directed to the right place on your body.

You don't have to worry that you'll glow in the dark after radiation treatment: People who receive external radiation are not radioactive. You'll be able to have normal contact with family and friends after you leave the treatment room.

What Are the Common Side Effects of Radiation Therapy?
Although radiation therapy is painless, it is powerful, and people who receive it might have some problems during and after treatment. These problems (called side effects) are different from person to person, depending on age, the type of treatment, and where the cancer is located. For example, some people who have radiation therapy may feel more tired than usual, not feel hungry, or lose their hair.

Some of the more common side effects of radiation therapy include:

•Fatigue. Fatigue, or feeling tired, is the most common side effect of radiation treatment, both during treatment and after. You may feel tired for up to 6 weeks after radiation therapy has ended.
•Skin damage or changes. The skin around the treatment area may be red, sensitive, or easily irritated in the days, weeks, and months during and after treatment. The skin may swell or droop or the texture may change. (Most symptoms of skin damage are temporary, although a person may get permanent changes in skin tone or texture.)
•Hair loss. People who receive radiation therapy to the head and neck can lose their hair. Most people grow their hair back within 3 months after radiation treatment has ended.
•Sore mouth and tooth decay. If you received radiation therapy to the head and neck, your mouth may be sore and sensitive and you may get more cavities. Your doctor may prescribe a mouth rinse to reduce pain. To help reduce these side effects, see the dentist during radiation therapy.
•Stomach and digestive problems. If you receive radiation treatment to the pelvis or abdomen, you might feel sick to your stomach, not feel like eating, have diarrhea, or throw up after radiation treatment. Some people who receive radiation therapy to the head and neck may also experience nausea and vomiting.
•Blood changes. Radiation therapy can kill the germ-fighting cells in the blood. This may temporarily make it harder for a person's body to fight off infection and may increase the need for blood transfusions.
Depending on how old a person is when he or she gets radiation therapy, there may be some long-term side effects. Some people may notice they're not growing as fast as their friends. This happens because normal tissues, especially areas that are still growing, may be damaged during radiation treatments. And teens who receive radiation to the pelvic or abdominal region may have problems having children later in life, although doctors do everything they can to prevent this. Some people who have had radiation therapy may also be more likely to develop a second cancer later in life. Anyone who has been successfully treated for cancer should be extra careful to have regular checkups and avoid smoking and sun exposure.

It's important to tell a nurse or doctor about any side effects so they can help treat the problem. If you're receiving radiation therapy as a cancer treatment, your doctors will work to cure you, but they'll also want you to be as comfortable as possible while you're being treated.

What Can I Expect After Radiation Treatment?
Although radiation therapy itself doesn't hurt, it can be scary to think about. If you want, talk to your doctor about taking a tour of the hospital or radiation treatment center. Meeting the radiation technologists who will be helping you every day and seeing the radiation equipment may help you feel more comfortable during treatment. Many hospitals set up routine treatment planning visits to prepare patients for treatment. These include a tour of the facilities and an opportunity to ask questions.

In a lot of hospitals, you can talk to a parent or the radiation therapist on an intercom during external radiation treatment. Someone will always be watching you during treatment, and the machine can be stopped at any time if there's a problem. Some treatment centers even provide closed-circuit televisions so your parent can watch you during the procedure.

As you go through radiation treatment, you may feel like you're all alone - but you're not. Your parent, friends, doctors, nurses, psychiatrists, psychologists, social workers, and other members of the cancer treatment team are there to reassure you before, during, and after radiation therapy.

Friends make you feel good when you're healthy - so surrounding yourself with your buds when you're sick is sure to be a pick-me-up. If you're too tired to head to the mall after school, plan a video-fest at your place instead. Sometimes people worry that their friends will feel weird or uncomfortable around them. A parent, nurse, or counselor may be able to give you tips on how to help with this situation.

There are also plenty of camps, support groups, and other activities for teens with cancer. Your nurse or hospital social worker can help you find these opportunities. Who knows? Your treatment for cancer might lead you to a lifelong friend.

In addition to coping with the many emotions you'll feel, you have to deal with the physical stuff, too. Try these tips for chilling out more comfortably during treatment:

•Sleep long, sleep often. Your body needs plenty of rest to recover from radiation and to keep up with basic activities. So scale back on strenuous stuff, and make time to get a good night's sleep every night. Opportunities to get your family to wait on you hand and foot don't come along often!

•Focus on good nutrition. Your appetite may be in the toilet from all that nausea, vomiting, and diarrhea, so try to eat foods that are high in nutrients. Also, eat a balanced diet to prevent weight loss. Several small meals may be easier to eat than a fewer larger ones - you may find it helps to eat every few hours so you don't get too hungry. At times when your stomach is upset, try foods like crackers, toast, broth, and juice pops.

•If you're frequently sick to your stomach, ask your doctor about anti-nausea medicine.

•Get your doctor's OK before taking any medications, including herbal medicines or over-the-counter drugs.

•Wear loose-fitting, soft clothes, especially around the treatment area. This can help you feel more comfortable, so dig those sweatpants out of the closet or ask the radiation tech if you can borrow some scrubs!

•Your skin is more sensitive to sunlight during and after radiation treatment. Avoid exposing the treated area to the sun during the weeks you're getting radiation therapy. And when the treatment's over, wear an SPF 30 sunscreen on the treated area.

•If you lose your hair because of radiation therapy, protect your head from sun exposure and irritation by wearing soft hats or scarves.

•Wash sensitive areas of skin gently using only lukewarm water - no soaps or skin products, including creams and lotions, until you get your doctor's OK. Pat your skin dry after bathing. If your skin is itchy and irritated, your doctor may prescribe ointments or cream to speed healing and reduce irritation.

Once you've finished radiation treatment, it's still important to visit the doctor for follow-up appointments. During these checkups, the doctor will want to know how you're feeling, whether you're having any continuing side effects, and whether there are any signs of the cancer coming back.

Undergoing treatment for cancer can be time-consuming, scary, and sometimes painful - both for the kids going through it and their friends and families. The good news is that radiation therapy can be an effective cancer fighter that enables many people to go on to live healthy, full lives.

Hematopoietic stem cells are immature cells that are capable of developing into the three types of blood cells:

1.red blood cells that carry oxygen
2.white blood cells that fight infection
3.platelets that help blood to clot
Hematopoietic stem cells can be found in bone marrow (the spongy tissue inside bones), the bloodstream, or the umbilical cord blood of newborn babies.

A stem cell transplant can replenish a child's supply of healthy hematopoietic stem cells. It's used to treat a wide range of diseases, including cancers like leukemia, lymphoma, neuroblastoma, Wilms tumor, and certain testicular or ovarian cancers; blood disorders; immune system diseases; and bone marrow syndromes.

Transplanted hematopoietic stem cells are introduced (or infused) into the bloodstream through an intravenous (IV) line, much like a blood transfusion. Once in the body, they can produce healthy new blood and immune system cells.

Types of Transplants
The two main types of stem cell transplants are autologous and allogeneic. The type of transplant needed will depend on the child's specific medical condition and the availability of a matching donor.

•Autologous hematopoietic stem cell transplant. With this type of transplant, patients act as their own donor. That is, a child who is about to undergo cancer treatment will have his or her own stem cells removed (harvested) and frozen for later use. After the child receives chemotherapy and/or radiation, the stem cells are thawed and put back into the child's body. This procedure may be done once or many times, depending on the need. Sometimes doctors will use extra-high doses of chemotherapy during treatment (to kill as many cancer cells as possible) if they know a patient will be getting a stem cell transplant soon after.

•Allogeneic hematopoietic stem cell transplant. With an allogeneic transplant, the stem cells come from a donor — often a sibling but sometimes another volunteer — whose cells are considered a "match" for the patient. The process of finding a match is called tissue typing (or HLA [human leukocyte antigen] typing). HLA is a protein on the surface of blood cells. Basically, the more "HLA markers" a child and the potential donor have in common, the greater the chance that the transplant will be successful.

Unlike with an autologous transplant, there is a risk of rejection. Sometimes, despite the donor being a good match, the transplant simply may not take. Other times, the donor cells can begin to make immune cells that attack the recipient's body. This condition is called graft-versus-host disease, and can be quite serious. Fortunately, most cases are successfully treated with steroids and other medications.

Sometimes, an upside of graft-versus-host disease is that the newly transplanted cells recognize the body's cancer cells as different or foreign, and actually work to fight them.

ContinueTransplantationStem cell transplantation is a very complex process than may span several months. A team of doctors is usually involved in determining if a child is a candidate and, if so, whether the transplant will be autologous or allogeneic.

For an allogeneic transplant, a compatible donor will be sought among family members or through a national registry of volunteers. Once a match is found, the donor's stem cells will be harvested. Three different types of hematopoietic stem cells can be collected or harvested:

Peripheral blood stem cells are harvested from donated blood. The stem cells are separated and collected and the rest of the blood is returned to the donor. Bone marrow stem cells are collected from the patient's hip bone through a surgical procedure. Cord blood stem cells are collected from a mother's placenta immediately after a child is born. While all three types can replenish a patient's blood and bone marrow cells, there are advantages and disadvantages to each. The doctor will suggest the best type of stem cell for your child's illness.

The next step in the transplantation process is conditioning therapy, which is when very high doses of chemotherapy and/or radiation are given to the child to kill cancer cells. These treatments have side effects: They'll destroy the child's bone marrow and weaken the immune system. But from a transplant standpoint, these consequences are potentially useful. They not only help to make room in the bone marrow for the new cells to take hold, but they also suppress the immune system, thus lessening the chance of rejection.

Soon after the conditioning phase, the transplant itself will be done through infusion and healthy stem cells will be introduced to the child's body. After the infusion, the child will be watched very closely to make sure the new stem cells are settling into the marrow and beginning to manufacture new blood cells (called engrafting). Doctors will watch for any signs of rejection as well as graft-verses-host disease in kids with allogeneic transplants.

Engrafting takes an average of 2 weeks, but can be as quick as 1 week or as long as 6 weeks. Your child will receive medicines to promote engrafting and prevent rejection and graft-verses-host disease.

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RecoveryKids who receive stem cell transplants have a high risk of infection because during conditioning therapy and while the transplant is grafting, their immune systems are compromised and unable to fight bacteria and other germs that enter the body. Children who receive an allogeneic transplant have an even greater risk of infection because they require medications to further suppress their immune systems to reduce the chance of rejection.

Because of these risks, a child who's had a stem cell transplant will not be released from the hospital until doctors are sure the transplant has successfully engrafted and the child is otherwise doing well.

Once released, a child needs very close monitoring and follow-up care. School and other public indoor areas may be off limits for 6 months to a year, and other places might be restricted as well. This is because for kids with a compromised immune system, even a simple infection like a common cold can be serious and even life-threatening if untreated.

CopingThe stress of having a child who is being treated for any type of cancer can be overwhelming for a family. That stress can be magnified when treatment requires a long "isolation period," as is necessary with a stem cell transplant.

To find out about support that may be available to you or your child, talk to your doctor, a hospital social worker, or child life specialist. Many resources are available that can help you get through this difficult time.

It's not uncommon to find a tick on a child. While most tick bits are harmless and don't require medical treatment, some ticks do carry harmful germs.

What to Do:

Useing fine - tipped tweezers, grasp the head of the tick close to the skin.
Firmly and steadily pull the tick straight out of the skin. Do not twist the tick or rock it from side to side while removing it.

put the tick in alcohol to kill it. Don't use petroleum jelly or a hot match to kill and remove the tick.

wash your hands and site of the bite with soap and water. then swab the bite with alcohol.

Call the Child's doctor if the tick may have been on the skin for more than 24 hours, part of the tick remains in the skin after attempted removal

the child develops a rash of any kind ( especially a red-ringed bull's - eyed rash )

the area looks infected ( increasing redness, warmth, swelling, pain, or oozing pus )

the child develops symptons like fever, headache, fatigue, chills, stiff neck or back or muscle or joint aches.

The term concussion conjures up the image of a child knocked unconscious while playing sports. But concussions — temporary loss of brain function — can happen with any head injury, often without any loss of consciousness. And many head injuries occur off the playing field, in car and bicycle accidents, in fights, and even routine calamities and falls.

Kids who sustain concussions usually can recover within a week, without lasting health problems, by following certain precautions and taking a breather from sports.

But a child with an undiagnosed concussion can be at risk for brain damage and even disability.

If your child does sustain a head injury, even without a loss of consciousness, it's important to watch for symptoms of a concussion, including:

•a change in mental state
•a bad headache
•confusion
•repeated vomiting
A child with these symptoms should be taken to the emergency room.

About Concussions
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. The brain can move around inside the skull and even bang against it. If the brain does bang against the skull — for example, if a child hits his or her head on the sidewalk — the brain can get bruised, blood vessels can be torn, and the nerves inside the brain can be injured. These injuries can lead to a concussion, which is the temporary loss of brain function.

There are three different types, or grades, of concussions. The severity of a concussion determines the length of time needed before a player can safely return to sports activities:

•Grade 1 concussions involve no loss of consciousness and cause a temporary change in mental state, like confusion, disorientation, and trouble focusing, which resolves within about 15 minutes.
•Grade 2 concussions are similar but the change in mental state lasts longer than 15 minutes.
•Grade 3 concussions include a loss of consciousness, regardless of how long they last.
Head injuries that result in concussions can be caused by car, bike, and motorcycle accidents; falls; assaults; and contact sports (football, ice hockey, volleyball, lacrosse, basketball, wrestling, field hockey, rugby, soccer, softball, baseball, etc.).

ContinueSigns and Symptoms of a ConcussionA child with a concussion may lose consciousness, but this doesn't occur in every case. Other signs of a concussion include:
feeling confused and dazedtemporary amnesiablurred visionheadacheslurred speech or saying things that don't make sensedifficulty concentrating, thinking, or making decisionsdifficulty with coordination or balance (such as being able to catch a ball or other easy tasks)vomitingtrouble remembering things, such as what happened right before or after the injuryfeeling anxious or irritable for no apparent reasonYoung kids can have the same concussion symptoms as older kids and adults, but changes in mood and behavior may be more subtle.

Call an ambulance or go to the ER right away if, after a head injury, your child:
can't be awakenedhas one pupil — the black part of the eye — that's larger than the otherhas convulsions or seizureshas slurred speechseems to be getting more confused, restless, or agitatedThough most kids recover quickly from concussions, some symptoms — including memory loss, headaches, and problems with concentration — may linger for several weeks or months. It's important watch for these symptoms and contact your doctor if they persist.

DiagnosisIf a concussion is suspected, the doctor will ask about how the head injury happened, when, and its symptoms. The doctor also may ask basic questions to gauge your child's consciousness, memory, and concentration ("Who are you?", "Where are you?", "What day is it?").

The doctor will perform a thorough examination of the nervous system, including testing your child's balance, coordination, nerve function, and reflexes. Sometimes a doctor may order a CT scan of the brain (a brain X-ray) or an MRI (a non-X-ray brain image) to rule out bleeding or other serious injury involving the brain.

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TreatmentIf the concussion is not serious enough to require hospitalization, the doctor will provide instructions on how to take care of your child at home. The doctor may have you wake your child up at least once during the night. If your child cannot be easily awakened, becomes increasingly confused, or has other symptoms (such as continued vomiting), it may mean there is a more serious problem that requires contacting the doctor again.

The doctor will probably recommend that your child take acetaminophen, ibuprofen, or other aspirin-free medications for headaches.

After a concussion, the brain needs time to heal. It's very important for kids to wait until all symptoms of a concussion have cleared up before returning to normal activities. Recovery time will depend on how long the symptoms last. Healthy kids can usually resume their normal activities within a few weeks, but each situation is different. A doctor will monitor your child closely to ensure that recovery is going well.

A child diagnosed with a concussion shouldn't participate in sports or other physical activities until the doctor says that it's safe. Even if your child pleads that he or she feels fine or a competitive coach or school official urges you to go against medical instructions, it's essential to wait until the doctor has given the OK. Even mild concussions require the player to sit out for the remainder of the game. It may take less force to sustain a second or subsequent concussion. And evidence shows that repeated concussions can result in lasting brain damage, even when the injuries occur months or years apart.

If your child was hurt while playing sports, the doctor will advise you when it is OK to return to play. After a Grade 1 concussion, a patient is usually cleared to play once symptoms go away. After a Grade 2 concussion, the individual should not play again that day and should only return after being symptom free for at least a week. After a Grade 3 concussion, a child is typically told to wait for 1 to 2 weeks without symptoms before returning to play.

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Preventing ConcussionsChildproofing your home will go a long way toward keeping an infant or toddler safe from concussions and other injuries. Babies reach, grasp, roll, sit, and eventually crawl, pull up, "cruise" along furniture, and walk. Toddlers may pull themselves up using table legs; they'll use bureaus and dressers as jungle gyms; they'll reach for whatever they can see.

All of these activities can result in a head injury that leads to a concussion. Be sure your child has a safe place to play and explore, and never leave a baby or toddler unattended.

All kids should wear appropriate headgear and safety equipment when biking, blading, skateboarding, snowboarding or skiing, and playing contact sports.
In vehicles, children younger than 1 year should be placed in rear-facing infant-only seats or convertible child safety seats. Kids older than 1 year who weigh more than 20 pounds can be safely restrained in forward-facing child safety seats. Those weighing between 40 and 80 pounds, usually between 4 and 8 years of age, can use belt-positioning booster seats or combination seats that allow the harnesses to be removed. Older kids should always wear a seat belt.

The time you spend taking these safety precautions — and getting your child into the habit of abiding by your safety rules and regulations — will help keep your child safe and sound!

About Lead Poisoning
If you have young kids, it's important to find out whether there's any risk that they might be exposed to lead, especially if you live in an older home.

Long-term exposure to lead, a naturally occurring metal used in everything from construction materials to batteries, can cause serious health problems, particularly in young kids. Lead is toxic to everyone, but unborn babies and young children are at greatest risk for health problems from lead poisoning — their smaller, growing bodies make them more susceptible to absorbing and retaining lead.

Each year in the United States 310,000 1- to 5-year-old kids are found to have unsafe levels of lead in their blood, which can lead to a wide range of symptoms, from headaches and stomach pain to behavioral problems and anemia. Lead can also affect a child's developing brain.

The good news is that you can protect your family from lead poisoning. If you have kids between 6 months and 3 years of age, talk to your doctor about potential lead sources in your house or anywhere they spend long periods of time.

And it's important for kids to get tested for lead exposure at age 1 and again at age 2, as many with lead poisoning don't show any symptoms.

Why Is Lead Harmful?
When the body is exposed to lead — by being inhaled, swallowed, or in a small number of cases, absorbed through the skin — it can act as a poison. Exposure to high levels of lead in a short period of time is called acute toxicity. Exposure to small amounts of lead over a long period of time is called chronic toxicity.

Lead is particularly dangerous because once it gets into a person's system, it is distributed throughout the body just like helpful minerals such as iron, calcium, and zinc. And lead can cause harm wherever it lands in the body. In the bloodstream, for example, it can damage red blood cells and limit their ability to carry oxygen to the organs and tissues that need it.

Most lead ends up in the bone, where it causes even more problems. Lead can interfere with the production of blood cells and the absorption of calcium that bones need to grow healthy and strong. Calcium is essential for strong bones and teeth, muscle contraction, and nerve and blood vessel function.

ContinueEffects of Long-Term Lead PoisoningLead poisoning may lead to a variety of health problems in kids, including:

decreased bone and muscle growthpoor muscle coordinationdamage to the nervous system, kidneys, and/or hearingspeech and language problemsdevelopmental delayseizures and unconsciousness (in cases of extremely high lead levels)How Lead Poisoning OccursMost commonly, kids get lead poisoning from lead-based paint, which was used in many U.S. homes until the late 1970s, when the government banned the manufacture of paint containing lead.

That's why kids who live in older homes are at a greater risk for lead poisoning. Also at risk are those who immigrate to the United States or are adopted from a foreign country that doesn't regulate the use of lead.

Lead is also found in other environmental areas, including:

Contaminated soil, which is found near busy streets, in part because lead was an ingredient in gasoline until the late 1970s. The soil that surrounds homes that were painted with lead-based paint may be contaminated too. Contaminated soil is a particular concern because it can also introduce lead dust into the home.Water that flows through old lead pipes or faucets, if the pipes begin to break downFood stored in bowls glazed or painted with lead, or imported from countries that use lead to seal canned foodSome toys, jewelry, hobby, and sports objects (like stained glass, ink, paint, and plaster)Some folk or home remedies, such as greta and azarcon (used to treat an upset stomach)BackContinue
Signs of Lead PoisoningMany kids with lead poisoning don't show any signs of being sick, so it's important to eliminate lead risks at home and to have your young child tested for lead exposure.

When kids do develop symptoms of lead poisoning, they usually appear as:

irritability or behavioral problemspica (eating of nonnutritious things such as dirt and paint chips)difficulty concentratingheadachesloss of appetiteweight losssluggishness or fatigueabdominal painvomiting or nauseaconstipationpallor (pale skin) from anemia (lower than normal red blood cells)metallic taste in mouthmuscle and joint weakness or painseizuresThese symptoms may also indicate a wide variety of other illnesses, so if your child has any of them, talk to your doctor. A blood test may be necessary to look for lead poisoning or other health problems.

TreatmentTreatment for lead poisoning varies depending on how much lead is in the blood. Small amounts can often be treated rather easily; the most important part of therapy is reduction of lead exposure. Gradually, as the body naturally eliminates the lead, the level of lead in the blood will fall.

Kids with severe cases and extremely high lead levels in their blood will be hospitalized to receive a medication called a chelating agent, which chemically binds with lead, through an IV to make the lead weaker so the body can get rid of it naturally.

All siblings of a child found to have lead poisoning also should be tested. Doctors will report cases of lead poisoning to the public health department.

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Protecting Your FamilyYou can protect your kids from lead poisoning by ensuring that your home is lead-free — ask your local health department about having your home evaluated for lead sources. And have your kids tested for lead exposure, particularly if when they're between 6 months and 3 years old. Kids this age spend a lot of time on the floor and trying to put things in their mouths.

These tips can help you reduce the risk of lead exposure:

Be wary of old plumbing. Old plumbing might be lined with lead. If you have an old plumbing system (in homes built before 1970), let cold water run from the faucet for a minute before drinking it. If possible, drink bottled water instead. And because hot water absorbs more lead than cold water, don't use hot tap water for meals.Keep your home and your family clean. Wash your child's hands and toys frequently, and keep dusty surfaces clean with a wet cloth.Ensure that iron and calcium are in your diets. If kids are exposed to lead, good nutrition can reduce the amount that will actually be absorbed inside the body. Eating regular meals is helpful because lead is absorbed more during fasting.Know where your kids play. Keep them away from busy roads and the underside of bridges.If you suspect that you might have lead-based paint on your walls, use a wet cloth to wipe windowsills and walls. Watch out for water damage that can make paint peel. Sanding or heating lead-based paint is a bad idea because these increase the risk that lead will be inhaled. If the paint doesn't have many chips, a new layer of paint, paneling, or drywall will probably reduce the risk. It's best to consult a professional, especially because other precautions may need to be taken to contain the lead in the paint.

Most small cuts don't present any danger to your child. But bleeding from large cuts may require immediate medical treatment. Depending on the type of wound and its location, there can be damage to tendons and nerves.

What to Do:
For Minor Bleeding From a Small Cut or Abrasion (Scrape):

•Rinse the wound thoroughly with water to clean out dirt and debris.

•Then wash the wound with a mild soap and rinse thoroughly. (For minor wounds, it isn't necessary to use an antiseptic solution to prevent infection, and some can cause allergic skin reactions.)

•Cover the wound with a sterile adhesive bandage or sterile gauze and adhesive tape.

•Examine the wound daily. If the bandage gets wet, remove it and apply a new one. After the wound forms a scab, a bandage is no longer necessary.

•Call your child's doctor if the wound is red, swollen, tender, warm, or draining pus.

For Bleeding From a Large Cut or Laceration:

•Wash the wound thoroughly with water. This will allow you to see the wound clearly and assess its size.

•Place a piece of sterile gauze or a clean cloth over the entire wound. If available, use clean latex or rubber gloves to protect yourself from exposure to possible infection from the blood of a child who isn't your own. If you can, raise the bleeding body part above the level of your child's heart. Do not apply a tourniquet.
•Using the palm of your hand on the gauze or cloth, apply steady, direct pressure to the wound for 5 minutes. (During the 5 minutes, do not stop to check the wound or remove blood clots that may form on the gauze.)

•If blood soaks through the gauze, do not remove it. Apply another gauze pad on top and continue applying pressure.

•Call your child's doctor or seek immediate medical attention for all large cuts or lacerations, or if:

◦you're unable to stop the bleeding after 5 minutes of pressure, or if the wound begins bleeding again (continue applying pressure until help arrives)

◦you're unable to clean out dirt and debris thoroughly, or there' s something else stuck in the wound

◦the wound is on your child's face or neck

◦the injury was caused by an animal or human bite, burn, electrical injury, or puncture wound (e.g., a nail)

◦the cut is more than half an inch long or appears to be deep - large or deep wounds can result in nerve or tendon damage

If you have any doubt about whether stitches are needed, call your child's doctor.