Pediatric Oncology Referral Guidelines
Oncology services at Valley Children’s are offered through our Craycroft Cancer Center, one of the leading pediatric cancer centers in the country.
As a prominent member of the Valley Children’s Oncology Group (COG) – the world’s largest organization devoted exclusively to childhood and adolescent cancer research – we make the majority of the nearly 100 active clinical trials open at any time in COG available to our patients. Our oncology research extends to cutting-edge therapies, cancer biology and supportive care such as pain medications.
Our well-trained team of pediatric specialists has the unique expertise and vast experience of treating all forms of childhood cancers through dedicated programs such as neuro-oncology and long-term survivorship.
Craycroft Cancer Center Outpatient Center
To reduce the stress and discomfort associated with a cancer diagnosis, every effort is made to treat patients on an outpatient basis. The outpatient oncology unit has multiple exam and treatment rooms, and an infusion center. A play area in the infusion center and a dedicated child life specialist provide play therapy to help children become more comfortable with tests and procedures.
Starship Craycroft Inpatient Oncology Unit
Sometimes an inpatient stay is necessary. With 36 beds in private rooms and starship-themed décor, Starship Craycroft is a welcoming environment for patients undergoing difficult medical treatments.
Each room has its own high-efficiency filter system to protect children with weakened immune systems from chemotherapy treatments. All rooms have televisions, with in-room movies and video games on-demand. Each room has its own bathroom facilities and accommodations for overnight family stays.
In addition to providing the same outpatient procedures and treatments, we provide inpatient care to children who:
- Have an acute illness in addition to their form of cancer or because of their weakened immune systems from chemotherapy
- Need more intensive chemotherapy
- Need numerous transfusions
- Are just starting their cancer treatment
We offer nurse navigators in the general oncology and neuro-oncology programs. These highly skilled nurses specialize in helping the transition between inpatient admissions and outpatient visits, and in coordinating the patient’s appointments with multiple other divisions within the Hospital and at offsite locations.
Our pediatric oncology specialists are available 24 hours a day, 7 days a week for consultations and urgent patient appointments.
Refer to Oncology
Refer to the Cancer and Blood Disorders Center at Valley Children's online through CareLink or our referral portal, or refer via fax.
Refer a patientOncology Office Numbers
Contact Pediatric Oncology via phone (559-353-5480) or fax (559-353-5490).
Contact a Physician Liaison
Physicians can reach a physician liaison for help with referrals or other questions by calling 559-353-7229.
Please contact our oncology department directly with any immediate questions or concerns about a patient referral or potential diagnosis, or to speak to an attending with STAT referrals to help immediate scheduling of patient. Our phone number is 559-353-5480 or fax 559-353-5490.
Download the pediatric oncology referral guidelines as a PDF
| Disease State | Suggested Work-up and Initial Management | When to Refer |
|---|---|---|
| When referring a patient: Always please include a complete history and physical, any previous labs or X-rays (plain films/ CT scans/ MRI/ ultrasounds on disk if possible). If biopsy has been done we will need the original biopsy tissue for confirmation and a copy of the OR report. | In addition to the guidelines below, referral is appropriate anytime based on the patient’s clinical condition, family’s level of concern and primary care provider’s comfort level. Lab testing can be done prior to the visit here or the day of the patient’s visit. | |
|
Leukemia
May present with progressive bone pain, fevers, pallor, fatigue, bruises, petechiae, hepatosplenomegaly, lymphadenopathy, abnormal blasts on CBC, all or none of the symptoms |
Work-up: CBC, chemistry, phosphorus, uric acid, LDH, PT, PTT, chest X-ray (r/o mediastinal mass) | If concerns or abnormal findings -- please call so that we can assist with the evaluation and accommodate the family as quickly as possible |
|
Brain Tumors
May present with progressive headaches, vomiting especially in the morning not due to other causes, weakness, neck tilt, enlarging head circumference, balance / ataxia problems, vision |
If symptoms warrant, vision or other tests should be done. MRI is most helpful to make the diagnosis, but often a CT scan can be obtained faster to assess a patient’s need for neurosurgical intervention. If the patient is experiencing symptoms of increased intracranial pressure we may wish to refer the patient to Valley Children's Hospital Emergency Department to get an emergent CT scan and contact neurosurgery for rapid intervention. | If concerns or abnormal findings -- please call so that we can assist with the evaluation and accommodate the family as quickly as possible |
|
Abdominal Tumors
May present with progressive abdominal swelling or mass, vomiting, constipation, unexplained fevers, hematuria, generalized symptoms, all or none of the symptoms |
Work-up: CBC, chemistry, phosphorus, uric acid LDH, alpha fetal protein (AFP), PT, PTT, urine analysis, urine for HVA/VMA, abdominal X-ray, and/or ultrasound of the abd/pelvis. These tumors may grow rapidly so early intervention is the key. | If concerns or abnormal findings -- please call so that we can assist with the evaluation and accommodate the family as quickly as possible |
|
Other Soft Tissue Masses
May present with progressive pain, firm or |
Work-up: CBC, chemistry, phosphorus, uric acid, LDH, plain view X-ray to the area involved | If concerns or abnormal findings -- please call so that we can assist with the evaluation and accommodate the family as quickly as possible |
|
Lymphadenopathy
Symptoms worrisome for lymphoma include but are not limited to: mobile, rubbery, nontender lymph nodes, that progressively enlarge over time, persist despite |
Work-up: CBC, chemistry, phosphorus, uric acid, LDH, PT, PTT, EBV, CMV, other viral titers as indicated, bartonella/toxoplasmosis titers as indicated, PPD for suspected atypical TB, chest X-ray (r/o mediastinal mass). One course of oral antibiotics may be helpful for suspected local bacterial adenitis. |
Lymph node > 4 cm in diameter
If concerns or abnormal findings -- please call so that we can assist with the evaluation and accommodate the family as quickly as possible |