John M. Maris, MD: There have been dramatic improvements in our understanding of what makes a cancer cell tick, and what gives me the most hope is that we're going to see a lot of the recent discoveries that we made pay off in terms of benefiting children with cancer, and that's going to be very exciting to see.

Rochelle Bagatell, MD: A patient can expect to be, sort of, wrapped in our arms in some ways, because the nurses and physicians and child life people – everybody is there specifically because they want to take care of children with cancer.

John M. Maris, MD: So the way that we've approached forming our care teams is by asking the question, "What would a family want in a care-team model as they enter into our center at any stage?"

At the center of it all is the child, and we are very much tuned in to the fact that these children have very different past histories, different amounts of side effects that they've had, different social situations. And so there's not a one-size-fits-all approach to this here. So balancing innovative treatment with quality of life is something that is central to every recommendation we make.

Stephan A. Grupp, MD: A really important part of what I need to do is to help the family take care of their child. And to understand the treatment options that are available for their child and that interaction is one of the things that I enjoy most about my work.

Anne Reilly, MD: There are lots of different kinds of research that go on here at CHOP. Not only do we have research in new drugs just coming out of the lab that reach a child, but we also do a lot of research in the best ways to deliver care, the best ways to give standard care, the best ways to support families and children psychosocially as they're going through their cancer therapy.

Ellen Tracy, RN: More kids that come here survive. So part of our responsibility as caregivers is to help families think about how to put cancer in its place in your life. And it's a part of the child. So we really help and guide families to say, "Yes, my child has cancer, and they're a seventh grader. And they're doing their homework. And it's just part of who they are."

Frank M. Balis, MD: I think being here at this hospital makes me hopeful because you see hope here every day.

Ellen Tracy, RN: These children and parents, their resilience, their energy, it enlightened me. I've learned so much more from kids and families than I've ever taught. It's just really, you know, an honor and the privilege to be here.

Erin Chance, Parent: It's not just about finding a different doctor or a different approach. It's also about the body of research. And when you combine that with how easy it is to coordinate with CHOP and have a relationship here, I think that it's something that every cancer family should look into.

Katherine Barkman, Sister of Lauren: I remember the loudspeaker came on, and they called me down to the office at my school. And my dad took me to Children's Hospital of Philadelphia, and he told me that things weren't really going well. I knew that Lauren had been going for blood tests and other things had been happening. She had been complaining of her back hurting, but this is the first time everything really just exploded right in front of me.

Lauren Barkman: I got leukemia when I was around 6 years old in kindergarten. You just feel helpless because you can't really do anything except just sit there in the bed and wait until your counts come up. As you get through, at the end you're like – you feel like a hero.

Peter Barkman, Father: When Lauren was first diagnosed, CHOP really helped us in many different ways. When we first got to CHOP, they took us right in through the ER and got us into a room almost immediately, which was very comforting. Communication was probably the biggest way. You always felt like you knew what was around the corner, and that was very helpful.

Lauren Barkman: They really help you throughout your treatment. It's like they just guide you as you go along and help you a lot.

Darlene Barkman, Mother: One piece of advice that I would give to families who are coming to CHOP for the first time is to trust the care team that you're working with because they are going to have your hand through every encounter that you will have here. They will treat you as a true partner on your child's care team and stand and fight side by side with you through this ordeal.

Katherine Barkman, Sister of Lauren: My first time at the hospital, when I first walked in, I realized how cool it was. Everybody seemed really calm. I was expecting mayhem when it was really organized.

Peter Barkman, Father: I feel great about the care that she's received here at CHOP. As a dad, that's all you want – is to make sure that you're doing everything you can to get your child the right care.

Darlene Barkman, Mother: One of the most amazing things about The Children's Hospital of Philadelphia is their ability to take every child and work with each family and support each family in the way that works for them.

Peter Barkman, Father: The difference is when something happens, you want to know that you've got other departments that are going to collaborate to solve the problem. And I think that's the CHOP difference – is having those other departments. Having some of the greatest minds that there are in the world working together to figure out what's going on with your child.

Lauren Barkman: You just got to believe in yourself. It's like soccer. Let's say you're trying to get to the goal, trying to get to the goal. And then once you reach that goal, you shoot, and you score, and that's the--that's how you believe in yourself. You gotta try.

Erin Chance, Parent: We were confused about what treatment path that we could also try because we'd gotten two very different recommendations on what we should do with Patrick. And we came to CHOP looking for a third opinion. And I have to tell you, it was one of the best experiences we could have asked for. Because we sat down with Dr. Maris, and he laid out everything that CHOP had to offer. And it gave us a renewed sense of hope, and that's exactly what you need in the relapsed setting.

So we kind of came to CHOP confused and needing hope, and that's exactly what we got was hope and a little bit of clarity. And to me, that's one of the most outstanding moments of this whole journey.

Stephan A. Grupp, MD: We're one of the busiest Children's Oncology Group institutions in North America. We are very focused on offering specific therapies that are earlier in clinical development, brand-new, targeted therapies, brand-new therapies that are just being developed for cancer patients and for pediatric cancer patients. So there is a wide variety of these earlier-phase treatment options that are available to patients whose cancers have recurred.

Frank M. Balis, MD: When a patient comes here to be treated on a clinical trial, it makes all the difference in the world that the physician who developed that study is here who understands the trial the best, who understands the treatments that are being administered and the potential complications and can explain those to the patients. Oftentimes, we are called from other institutions around the country regarding those clinical studies to provide answers to those questions for the patients that they care for.

Anne Reilly, MD: Here at CHOP we're one of the first places that a proton program was conceived and built with children in mind and built side by side with our oncology program there to support it. So that a child that comes here to get proton therapy has the advantage of the CHOP oncology program there to support the child in their chemotherapy and all their other medical needs while they're getting their proton therapy.

John M. Maris, MD: Proton therapy, boiled down, is a different type of radiation therapy that has the very strong potential to provide curative radiation therapy in a much more precise manner. It was designed to be able to get the bad stuff and spare the surrounding tissue. We view it as a way to expand the reach of what radiation therapy can do by reducing both the short-term and long-term side effects of the treatment.

Rochelle Bagatell, MD: We have surgeons with tremendous depth, and they have experience with both the most common pediatric cancers and some of the more rare form of cancers.

Erin Chance, Parent: I would say the best part of our experience here has been the quality of life that it has given Patrick because some of our other options when Patrick relapsed were to throw the most toxic, sickening chemotherapies at his body. But here we have new medicines he's never seen. We have medicines that are working that don't make him sick. He's going to school, he feels great, he's sledding, he's playing with his sisters. He's having a great life. And you really can't ask for more than that.

Stephan A. Grupp, MD: Often, the second opinion just confirms the fact that the patient is being treated appropriately. And I think that's very valuable to families, and it gives the parents a sense that they have more control over what's actually happening with their child. And they've actually actively participated in the treatment decisions, especially at the beginning, which is the most critical time for pediatric cancer patients.

Thomas W. McLean, MD: It is very easy, when you're in a desperate situation, to want to go out and get as many opinions as you can. So that complicates things, obviously. When you have different opinions, then it makes it even harder to decide, "Well, what's the right thing to do?" To me the thing that drives a patient referral is really what the family wants to do. But I really want the parents to feel good about their child's care.

Peter C. Adamson, MD: When a cancer returns or recurs, it's obviously a very difficult time for a family and their physicians as well. What's most important for a family to know is, "What's the best option for my child?" And that's where The Children's Hospital of Philadelphia can often lend a hand in both providing reassurance, as well as providing a range of options for difficult to treat situations.

Rochelle Bagatell, MD: When a child is initially diagnosed, CHOP has a great deal to offer. We can appreciate the diagnosis and draw up an appropriate treatment plan in a very short time period. We have a very active developmental therapeutics team and often will have access to the newest therapies that other practitioners may have thought of and considered but might just not have the access to.

Anne Reilly, MD: We have specialists in each area of disease, and we'd like our children who come for second opinions to see one of our experts in the disease that that child has so that the opinion they get the thoughtful and rapid and of the best quality possible. We can partner with the primary oncologist in helping the family make sure that the therapy that the child's getting is in fact the best thing for them and, if there are any options for the future, what those might be.

Frank M. Balis, MD: Those with more complex diseases or more rare cancers, I think, are well served by referral here because of the large experience here. Even for the most rare pediatric cancers, there tends to be at least somebody here who's seen a number of cases that is able to make some informed and experienced treatment recommendations for those patients.

John M. Maris, MD: It's an important point to make that the referring physician remains the center of the treatment team. We are a consultative service. We respect the long history that the referring physicians often have with their patients and their families. And that's made clear to the families when they arrive here at CHOP, that we're here to help, not to supplant.

Erin Chance, Parent: It's not about egos. It's not about who's higher on the totem pole. It's about working together as a team. That's the emphasis. And the kids are always the emphasis. This is how it's supposed to work.