An Outstanding Pediatric Cancer and Blood Disorders Program
The Tomorrows Children's Institute for Cancer and Blood Disorders, part of The Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center, is an outstanding pediatric cancer and blood disorders program that combines all the elements of world-class medicine, cutting-edge research, an expert and comforting staff, and compassionate care for children and adolescents.
Since its establishment in 1987, the Tomorrows Children's Institute (TCI) for Cancer and Blood Disorders at Hackensack University Medical Center has grown to be New Jersey's premier pediatric center for the diagnosis and treatment of cancer and blood disorders, as well as providing for the psychosocial needs of our patients and their families.
We're There for Children
The Tomorrows Children's Institute provides comprehensive inpatient and outpatient oncology and hematology services for children up to the 22nd birthday.
Because we know a diagnosis of cancer or a serious blood disorder can be devastating to the entire family, we pay special attention to the psychosocial needs of our patients, their family members, friends, and classmates.
We're also there for you, not only to give your child the best opportunity to continue a full life, but to support you and attend to your concerns throughout all stages of your child’s treatment and beyond.
A University-based Cancer and Blood Disorders Program
As a major teaching and research affiliate of the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, physicians, nurses, and staff at the Tomorrows Children's Institute work hand in hand with researchers, physicians, and academic leaders whose expertise spans all areas of medicine.
At the Forefront of Medical Breakthroughs
The Tomorrows Children's Institute is a national leader in clinical research into childhood cancer and blood disorders.
The Comprehensive Diagnostic and Treatment Center for Pediatric Oncology at the Tomorrows Children's Institute has been at the forefront of the fight against childhood cancer.
Treatment is available for all pediatric cancers, including leukemias, lymphomas (Hodgkin’s and non-Hodgkin’s), brain tumors, and solid tumors such as neuroblastoma, Wilms tumor, bone tumors, and soft tissue sarcoma.
In addition, our participation in the Children’s Oncology Group (COG), the foremost national research group dedicated to developing new treatment for children with cancer, further enables us to offer cutting-edge treatment to our patients.
State-of-the-art diagnosis and treatment are available for children with serious blood disorders such as sickle cell anemia, thalassemia, and hemophilia through our Comprehensive Pediatric Hematology Program. A Comprehensive Sickle Cell Treatment Center is located at the Tomorrows Children's Institute. Our program for patients with bone marrow failure states, such as Fanconi anemia and aplastic anemia, attracts patients from across the United States and beyond for innovative treatment and comprehensive care.
The Experience of Your TCI Team
Our team of physicians, nurses, and professional support staff bring years of experience and expertise to your child's individual needs, giving him or her the best possible chance for recovery.
Our staff includes:
Board-certified pediatric hematologists/oncologists
Advanced practice nurses
Creative art therapists/child life specialists
Specialized Nursing Care
Tomorrows Children's Institute's advanced practice nurses are involved in every aspect of caring for patients and in the outpatient setting; the advanced practice nurses coordinate all patient-related services. In conjunction with the physicians, they review the therapeutic protocols and determine the daily investigations and treatments.
These nurses ensure a smooth flow of treatments and serve as a resource for families and staff by providing support, education, and consultation. At the conclusion of each day, they convene a multidisciplinary conference to discuss each patient's status, psychosocial issues, laboratory results, and treatment plan.
For inpatients, the advanced practice nurses provide a link between the patient and the nursing staff on the unit.
Advanced practice nurses also coordinate home care services and hospice care, and they make school visits to ease transition of patients from the hospital to the classroom and community.
In addition to our team of advanced practice nurses, we have a highly experienced and dedicated team of staff nurses on both our inpatient and outpatient units. These nurses are certified in the administration of chemotherapy and biotherapy by the Association of Pediatric Hematology/Oncology Nurses, and many of them hold specialty certifications in either Pediatric Onoclogy and/or Pediatrics. They provide the highest quality patient and family centered care to the patients they serve.
A Spacious, Child-Friendly Facility
The outpatient programs of the Tomorrows Children's Institute are located in the DON IMUS-WFAN Pediatric Center for Tomorrows Children at Hackensack University Medical Center, which provides a comfortable atmosphere for patients and their families.
Our facility includes:
An infusion room for outpatient chemotherapy and transfusion therapy
Six examination rooms
A procedure room for anesthesia and conscious sedation
A recovery room
A clinical laboratory and blood-drawing room
A playroom for school-age children
An adolescent lounge
A schoolroom and patient library
Age-specific group therapy rooms
Our inpatient unit is located in the Joseph M Sanzari Children's Hospital, a state of the art facility with all private rooms, sleeping accommodations for parents/caretakers, in a child and family friendly environment.
The Research Program
In May 2001 the David Joseph Jurist Research Center for Tomorrows Children's Institute opened on the campus of Hackensack University Medical Center.
This building houses the basic research of the Hackensack University Medical Center and the Tomorrows Children's Institute.
In September 2001 the Pediatric Genetic and Cancer Research Laboratory was inaugurated to study the molecular biological aspects of pediatric cancer. The clinical research programs continue to expand through our participation of the COG as well as the pediatric stem cell transplant program. Click here for details on our research program
Tomorrows Children's Fund
Tomorrows Children's Fund is a non-profit organization that was developed by parents of children with cancer and blood disorders.
The Tomorrows Children’s Fund addresses the critical needs of families facing the anguish of this disease by working with the medical staff of the Tomorrows Children’s Institute to provide:
State-of-the-art medical care
A warm, healthy, and loving atmosphere for children during their inpatient and outpatient treatment
A wide range of services to relieve emotional and financial stress
Funding for research on childhood cancer and serious blood disorders
Tomorrows Children's Fund is unique because it is governed by an Executive Board of Directors that is comprised only of parents. They have "been there", and they know from firsthand experience and direct involvement how to help children and families at a difficult time in their lives.
Please visit the Tomorrows Children’s Fund website at www.atcfkid.com to learn more or to make a contribution.
Virtual High School
The Tomorrows Children’s Institute at Hackensack University Medical Center is a participant in Virtual High School.
Click on the logo to the right for more information
Find below the comprehensive diagnostic and treatment services that are available at The Tomorrows Children's Institute, part of The Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center:
Since its inception in 1987, the Tomorrows Children’s Institute has been a leading participant in the Pediatric Oncology Group (POG) and its successor, the Children's Oncology Group (COG). COG is the major collaborative group in North America for the treatment of childhood cancer.
Participation in COG enables our patients to receive cutting-edge treatment protocols
Treatment protocols are available for all types of pediatric cancer, including leukemia, lymphoma, brain tumors, and solid tumors such as neuroblastoma, Wilms tumor, bone tumors, soft tissue sarcomas and others
Tomorrows Children's Institute physicians have taken a leadership role in the COG and participate in numerous committees, including acute myelocytic leukemia, bone tumors, Hodgkin's disease, late effects of cancer, psychology issues, cancer control and cancer in young adults. For further information on COG, please visit http://www.childrensoncologygroup.org/
The Pediatric Hematology Program
The Pediatric Hematology Program is one of the most comprehensive programs in New Jersey to evaluate, diagnose, and treat a wide variety of hematologic disorders.
The multidisciplinary team consists of physicians, advanced practice nurses, psychologists, social workers, and creative arts therapists.
Consultations are available for the following conditions:
Hemoglobinopathies, such as sickle cell disease and thalassemia
Bleeding disorders, such as hemophilia
and von Willebrand's disease
Qualitative and quantitative disorders of platelets including immune thrombocytopenia (ITP)
Abnormal pre-surgical coagulation
White blood cell abnormalities
Thrombotic disorders (thrombophilia)
The Tomorrows Children's Institute is the site of a Comprehensive Sickle Cell Treatment Center
The Center's services address the medical and psycho-emotional needs of children with sickle cell syndromes and their families.
Comprehensive inpatient care
Outpatient transfusions as necessary
Outpatient evaluation and treatment of painful crisis and fevers
Transcranial doppler (TCD) screening to predict the risk of stroke
Dedicated support groups for patients, siblings, and parents
Full evaluation of infants with abnormal hemoglobin detected by newborn screening
transplantation for sickle cell anemia and thalassemia in selected patients
Bone Marrow Failure Program
This program offers comprehensive medical and supportive care to pediatric patients with inherited, congenital or acquired bone marrow failure disorders, such as aplastic anemia, myelodysplastic syndromes, Fanconi anemia, Diamond-Blackfan anemia, and Shwachman-Diamond syndrome.
The program’s multidisciplinary team is comprised of doctors, nurses, social workers, child life specialists, and a genetic counselor. Physicians participate actively in the Fanconi Anemia Research Fund and hold annual meetings with patients and their families to discuss new scientific data and treatment options
State-of-the-art therapeutic modalities are available, including cytokine therapy, matched-related and unrelated cord blood or bone marrow transplantation, and supportive care.
The Pediatric Neuro-Oncology Program
The Pediatric Neuro-Oncology Program at Hackensack University Medical Center is a joint effort of Tomorrows Children's Institute and the Pediatric Neuroscience Institute. The Program has been developed to address the unique needs of children with cancer affecting the nervous system. Patients cared for by our team include those with tumors of the brain, spine, and peripheral nerves, as well as children whose cancer, or its treatment, may have resulted in neurologic problems.
We believe that children with cancer affecting the nervous system represent a unique patient population, who’s medical, psychological, social, and educational needs set them apart from other childhood cancer patients. It is therefore a major priority for us to ensure that our patients have access to expert care in a patient-friendly setting. Attention is given to all aspects of the child's illness, treatment, and recovery. We strive to achieve a cure for every child, while focusing on maximizing quality of life and minimizing complications
Pediatric Neuro-Oncology Medical Staff
Our team is comprised of staff with specialized training and expertise,
allowing us to provide a comprehensive approach to care:
Stephen J. Thompson, M.D.
Chief, Pediatric Neuro-Oncology Program
Pediatric Neuro-Oncology and Neurology
Arno H. Fried, M.D.
Chairman of The Department of Neurosurgery
Director of Pediatric Neurosurgery
Ann Marie Stiefbold, RN, APNC
Advanced Practice Nurse
Scope of Services Provided
The Pediatric Neuro-Oncology Program provides care from the moment of diagnosis, throughout treatment, and into survivorship. Working together with other departments, such as Diagnostic Imaging and Pathology, we determine the exact diagnosis for each patient. This information is then used to guide treatment specific to the type of tumor, while taking into consideration the patient's age and potential complications of therapy. All members of the team are involved when treatment decisions are discussed, and options are then presented to the family. In this way, we can provide our patients with the information and guidance required when faced with a potentially life-threatening illness.
Treatment for most patients involves neurosurgery, often combined with radiation therapy and chemotherapy. Due to the risk of injury to developing nervous system when radiation is administered at a young age (often defined as age less than or equal to 3 years), we often use chemotherapy as a means of delaying or perhaps eliminating radiation. Our skilled pediatric oncology nurses deliver chemotherapy in the outpatient clinic, in a dedicated Infusion Room. If required, children are admitted to a dedicated Inpatient Oncology Unit. When necessary, radiation is administered by the highly trained physicians and staff in our Department of Radiation Oncology.
Psychosocial, Educational, and Other Issues
We are aware of the special needs of our patients, and address these issues by involving members of our Child Life, Social Work, Psychology, and School Liaison Programs. By paying attention to such issues, it is hoped that we can avoid or rapidly identify problems, and begin interventions in a timely manner. We include the entire family in the process, thus allowing siblings and parents to participate in the child's care.
School and education are extremely important, and we aim to keep children active in these activities during treatment. Our educational liaisons will even visit the child's school if necessary. The concern continues after the child completes their treatment, as we know that many patients will develop difficulties with hearing, learning, attention, memory, and endocrine function. These problems are addressed by working closely with Dr. Anne Farrar-Anton, Psychology Supervisor and Pediatric Neuropsychologist, and Dr. Michael B. Harris, Director of Cure and Beyond-A Childhood Cancer Survivorship Program. When appropriate, referrals are made to Physical, Occupational, and Speech Therapy, as well as to Endocrinology and other medical services.
Our team is actively involved with the Children's Oncology Group, thus allowing our patients to be enrolled in appropriate Clinical Research Trials. In addition, we are developing our own clinical research programs in areas related to neuro-oncology and the neurologic and cognitive problems encountered by survivors of childhood cancer. The recently opened David Joseph Jurist Research Center for Tomorrows Children will provide the infrastructure required as we pursue our research interests.
Members of our team are involved in the education of medical students and residents from UMDNJ-New Jersey Medical School. In addition, we are active in educating health care providers in the region, giving lectures and participating in symposia and other programs.
Please feel free to contact Dr. Thompson at (551) 996-5437 for questions, consults, and patient referrals.
Pediatric Blood and Marrow Transplant Program
Click here for an in-depth discussion of this program with a complete listing of respective personnel, transplantation types offered, and current transplantation protocols.
The Pediatric Blood and Marrow Transplant Program at Hackensack University Medical Center, established in 1990, is a national leader in the field of allogeneic and autologous stem cell transplantation. It is one of the largest programs in the New York metropolitan region and the only pediatric transplant program in New Jersey.
In 1997, HackensackUMC’s Pediatric Blood and Marrow Transplant Program received certification by the Foundation for Accreditation of Hematopoietic Cell Therapy (FAHCT), and was recertified in 2001.
Dr. Alfred Gillio, has been exclusively involved in the clinical and laboratory aspects of pediatric stem cell transplantation for nearly 20 years and is a recognized authority in the field.
Since the program is recognized by the Children's Oncology Group; patients from any COG-affiliated institutions may be referred here for a stem cell transplant according to cooperative group protocols.
In addition, the program participates in selected national trials coordinated by the Pediatric Blood and Marrow Transplant Consortium.
Cure and Beyond- For Childhood Cancer Survivors
The Cure and Beyond program offers a comprehensive array of support services for survivors of childhood cancer, who completed their therapy two or more years ago.
The goals of the program are:
To educate the survivor about his/her previous diagnosis and therapy by preparing a written summary with recommendations about follow up (based on the current literature).
To teach and encourage a healthy lifestyle and health maintenance.
To assist the survivor in obtaining adult medical services when appropriate and to communicate specific follow up needs.
To observe and carefully document the late effects the survivor may experience so that future survivors may benefit from this information.
The program offered to survivors consists of:
A telephone interview prior to the visit to discuss the concerns the survivor or family may have.
A treatment summary prepared prior to the visit, and given to the survivor at the visit.
A history and physical exam.
The opportunity to meet with a social worker, school abilities specialist, child psychologist, and/ or child life specialist depending on the survivor's needs and requests.
At the conclusion of the visit, a roundtable discussion of the summary, potential (if any) late effects of therapy and follow up recommendations.
Discussion time to address any questions, concerns or issues the survivor, family and/or significant others may have.
The CAB team includes:
Michael B. Harris, M.D., pediatric oncologist and program director.
Hope Castoria, RN, BSN, CPON, case manager/coordinator.
Sherri Mayans, R.N., APN, C., pediatric nurse practitioner.
Jill Brooks, clerical coordinator.
As needed, we have the services of child life specialists and creative arts therapists at Tomorrows Children’s Institute.
CAB offers a monthly activities group for young adult survivors interested in socializing with other survivors. In addition, several members of the CAB team serve on the Pediatric Committee of the New Jersey Office of Cancer Control and Prevention (NJOCCP). The CAB team collaborates with the NJOCCP and other organizations to provide educational conferences for professionals, survivors, and their families about the medical and psychosocial late effects of childhood cancer treatment.
Child Life / Creative Arts Therapy
Child life specialists and creative arts therapists help children and adolescents cope with and adjust to all of the stresses involved with their illnesses
Patients have the opportunity to receive therapy individually and/or in groups, both as outpatients or inpatients. All interventions are conducted with sensitivity to unique individual, family, and cultural features.
Therapeutic modalities include child life, art therapy, music therapy, and dance/movement therapy which help children meet the challenge of coping with chronic, life-threatening medical illness.
The team's focus is on normal development across emotional, social, and psychological areas, highlighting the child's understanding of their illness and its treatments.
A wide variety of services are offered, including:
Outpatient creative arts therapy groups for children and siblings of all ages.
Inpatient individual and group creative arts and child life therapy
Preparation for medical procedures and other treatment-related concerns
Intensive individual therapy to promote positive adjustment throughout treatment
Developmentally-based creative arts therapy evaluation
The team also collaborates on research projects and works closely with the psychosocial staff on clinical and therapeutic treatment goals.
Social Work Services
Social workers assess and address the needs of every family. An initial assessment includes, but is not limited to, determining the structure of the family, coping styles, and patterns of communications with other family members, the medical staff, and the community.
Throughout the duration of treatment, a social worker tracks the family and provides a variety of services, including crisis intervention, problem solving, supportive counseling, and insight-oriented psychotherapy. Services are performed on an individual basis and/or in supportive group sessions for patients and parents. Individual and/or group bereavement services are available for parents and caretakers as needed. Social workers also provide referrals to a variety of community resources to help the family meet the financial burden placed upon them.
Contact: Judy Solomon, LCSW, MPH, Supervisor of Professional Support Services, (551) 996-5624
Pediatric psychologists provide a wide range of mental health services for patients and family members. These include evaluation, diagnosis, and treatment of various psychological syndromes related either directly or indirectly to the disease and its treatment. Cognitive, academic, neuropsychological, social and emotional/behavioral functioning are evaluated. Based on these diagnostic assessments, a number of psychotherapeutic strategies are available, including insight-oriented, cognitive-behavioral, social learning, and educational modalities including cognitive remediation. All services are provided by highly skilled, doctoral-level faculty, who are also involved in numerous research studies.
Contact: Anne Farrar-Anton, Ph.D., Psychology Supervisor, (551) 996-5255 or afarrar-anton@HackensackUMC.org
L.E.A.R.N. (Liaison for Effective Academic Resource and Networking) is a program that provides educational guidance to children with cancer and blood disorders. The goal is to share information as well as provide practical assistance to families and school personnel regarding the impact of the disease on a child's educational development. Families no longer have to face school challenges alone.
School may be one of the last things to be considered when a child is diagnosed with cancer or a serious blood disorder. However, it often provides reassurance through every day events such as homework assignments and peer relationships. L.E.A.R.N. is sponsored by the Tomorrows Children's Fund and is available to all families followed by the Tomorrows Children's Institute at Hackensack University Medical Center.
- LIAISON Consultation with families and school personnel regarding children's academic development is an essential component of this program. This may include obtaining school records, securing tutoring services while a child is unable to attend school, attending Child Study Team meetings, or working directly with the child's teacher to design specific classroom modifications that assist in addressing the child's academic needs. Communication between family, healthcare providers, and school staff is essential in order to maintain the flexibility that is necessary to meet the changing needs of the student within the classroom setting.
- ADVOCACY From the time a child is diagnosed with cancer or a blood disorder, special considerations need to be made to address individual educational needs. At times, parents and teachers are unsure of the specific needs of the child because of changes that occur on a daily basis. As advocates the Educational Liaisons assist parents and school staff in determining the child's educational needs and work with them to implement the necessary modifications.
- LONG-TERM EFFECTS OF TREATMENT Advances in childhood cancer therapies have greatly enhanced long-term survival and rates of cure. Despite these breakthroughs, certain cancer therapies can affect a child's academic performance. It is essential that parents and educators become aware of potential learning effects associated with certain cancer treatments that may be subtle and appear slowly over time. The Educational Liaisons assist in the early detection of treatment-related learning problems through regular contact with parents and teachers. If necessary, more thorough psychoeducational testing will be pursued in order to assist in the development of an appropriate educational plan. Further assistance can be provided when students are ready to explore employment opportunities or college programs.
Advocacy on behalf of families within school districts
Consultation on school placement and use of resources
Staff education about disease, treatments, and related effects
Referral for diagnostic educational evaluations
Consultation with patients through the Cure & Beyond Program, stem cell transplant service, Neuro-oncology, and hematology programs
Coordination of tutoring services for children in the outpatient clinic as well as the inpatient oncology service
Use of technology to keep students connected to their classrooms
Contact: Sarah Donnangelo, MS, Coordinator of Educational Services, (551) 996-5672 or email@example.com
Angela Tortora, MA, LDT-C is a Learning Consultant/Educational Liaison at Tomorrows Children’s Institute (TCI) and the Pediatric Cure and Beyond Survivorship Program (CAB).