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New clinic links pediatric sarcoma treatment services

Apr. 11, 2013, 8:23 AM

Scott Borinstein, M.D., left, and Jennifer Halpern, M.D., right, celebrate the debut of the Multidisciplinary Pediatric Sarcoma Clinic with patients, from left, Jennifer Simpson, J. Carlton Smith and Adrianna Crawford. (photo by John Russell)

J. Carlton Smith noticed severe pain in his knee five years ago during a lacrosse tournament. Smith, then 13 years old, never imagined hearing the diagnosis doctors would give him: osteosarcoma, a cancer of the bone.

He would get chemotherapy at the Monroe Carell Jr. Children’s Hospital at Vanderbilt, and also see an orthopaedic oncology surgeon at the Orthopaedic Institute on another part of campus, plus blood work and X-rays in other locations. With a sports-career ending knee replacement, Smith and his parents were already overwhelmed.

To lessen some of the stress on patients and families, Children’s Hospital launched the Multidisciplinary Pediatric Sarcoma Clinic April 4 as a one-stop location for patients with sarcoma to receive expedited therapy and more unified, convenient care. The clinic is located within the Hematology and Oncology Clinic on the sixth floor of the Doctors’ Office Tower at Children’s Hospital.

Jennifer Halpern, M.D., assistant professor of Orthopaedics and Rehabilitation, and Scott Borinstein, M.D., Ph.D., director of the Pediatric Sarcoma Program, joined forces to offer the joint clinic hours once a month — for now — from 1-4 p.m. As the program gets under way, they hope to expand days and hours available to patients being treated for sarcomas, including osteosarcoma, Ewing sarcoma, rhabdomyosarcoma and synovial sarcoma.

“The new clinic makes everything a lot easier. We’re very fortunate to live in Nashville and have access to Vanderbilt. It definitely consolidates our time and makes it easier to get all our treatments and doctors’ visits done in one location,” said Smith, now an 18-year-old senior at Montgomery Bell Academy. He is in remission from his cancer.

His mother, Rebecca Smith, echoed his sentiments: “I couldn’t imagine having a better experience or greater care, but the new clinic does make it easier having it all under one roof.”

Until now, Halpern and Borinstein collaborated on and coordinated patient cases from their separate clinic locations – Halpern at the Orthopaedic Institute in Medical Center East and Borinstein at Children’s Hospital. In addition to visiting both physicians, patients also might have scans and X-rays in different locations.

Borinstein treats the patients with sarcomas with chemotherapy, while Halpern’s job is to perform surgery to resect and reconstruct the bone or soft tissues.

“Because we are a large referral center, we often have patients come from several hours away. Being able to create a clinic in which we work together is going to make it a whole lot easier for patients to get everything they need at one time,” said Borinstein, assistant professor of Pediatrics in the Division of Hematology-Oncology.

“We can coordinate all their surveillance scans and their follow-up with Orthopaedic Surgery and Oncology. We can look at the X-rays in real time together and we can make a unified decision.”

Fewer than 1,000 children and young adults (age 20 and younger) are diagnosed each year in the United States with sarcomas. Currently, Children’s Hospital serves as a large referral center for the region, seeing about 40 active patients. Treatment lasts about six months to one year, with follow-up care for 10 years.

Jennifer Simpson, 24, an osteosarcoma survivor, was diagnosed at 19, and similar to Smith, went to multiple locations for her care. Now as a survivor for follow-up surveillance, she will be able to be seen at the new joint clinic.

“It’s a lot easier, especially now that I have a job, I would have to schedule a whole day off to go to different places and have to wait hours in between. It’s a lot easier, a lot faster,” Simpson said.

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