Episode 382: Radiation Oncology Treatment Care for Pediatric Patients

"I think sometimes people don't expect pediatric patients to handle radiation as well as they do. They may have a family member who also had radiation for breast cancer or for prostate cancer and they were an older adult and had really severe side effects. And then they say, 'Oh, no, I've got to put my little baby through this. I don't really want to do this.' We say kids are very different in how they handle this. They're very resilient, so we can provide good education about that," Elizabeth Cummings, MSN, CPNP-AC, CPHON®, radiation oncology nurse practitioner at Children's Hospital of Philadelphia in Pennsylvania, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about radiation treatment care for pediatric patients. Music Credit: " Fireflies and Stardust " by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 26, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learner will report an increase in knowledge related to radiation oncology treatment care for pediatric patients. Episode Notes Complete this evaluation for free NCPD . ONS Podcast ™ episodes: Episode 365: Radiation-Associated Secondary Cancers Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices Episode 298: Radiation Oncology: Nursing's Essential Roles Episode 204: How Radiation Is Used in Palliative Care Episode 50: Difficult Decisions in Childhood Cancer ONS Voice articles: Fertility Preservation Protects Possibilities for Patients With Cancer Have Meaningful Conversations With Pediatric, Adolescent, and Young Adult Patients and Their Families Pediatric Cancer Survivors Require Additional Care and Monitoring Prepare Survivors for the Risk of Secondary Cancers Secondary Cancers in Pediatric Survivors ONS book: Manual for Radiation Oncology Nursing Practice and Education (Fifth Edition) ONS courses: Essentials in Survivorship Care for the Advanced Practice Provider ONS/ONCC® Radiation Therapy Certificate™ Clinical Journal of Oncology Nursing articles: Radiation Therapy Survivorship: Healthcare Providers' Perspectives on Education and Care Radiation Therapy: Understanding the Patient Experience Reducing Pediatric Patient Anxiety: Implementing a Nonpharmacologic Intervention to Aid Patients Undergoing Radiation Therapy Other ONS Resources Inclusive Care Learning Library Late Effects of Cancer Treatment Huddle Card Proton Therapy Huddle Card Radiation Huddle Card Radiation Learning Library Oncolink Jr. Pediatric Radiation Oncology Society To discuss the information in this episode with other oncology nurses, visit the ONS Communities . To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library . To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org . Highlights From This Episode "I think one of the things to think about with kids is sometimes they're not as forthcoming with what's going on, and sometimes it's a little bit harder to understand. Sometimes that's just because developmentally, they're much younger. A 1-year-old can't exactly tell you what's wrong. And so you're really trying to figure it out based on their cues versus a teenager who can tell you, but maybe they're too embarrassed about something in a way that an adult might not be." TS 7:01 "Child life specialists are incredible. ... They provide age-appropriate education and explanations for patients, so talking to a 3-year-old about cancer is very different from an 8-year-old or even a teenager. They really are able to meet each patient exactly where they are and at the level that they are, and then provide the appropriate amount of information, which is so helpful for a patient since they learn to build trust and cope with their treatment and [they feel like they] have somebody who can relay that information in a clear and concise way." TS 11:16 "There's certainly growing concern about the potential effects of anesthesia on brain health, especially in a vulnerable population like very young children, which are the ones who need anesthesia. We really try to mitigate this by optimizing our anesthetic agents, so we'll use propofol, which has a really quick onset and offset. And even when the radiation treatment is done, they'll stop the propofol in the radiation room—even though they are still walking back to recovery, just to minimize the amount of time that it's on—and trying to use the lowest dose possible. We also [explore] a lot of nonanesthetic strategies, [like] child life support, trying to introduce video distraction when we can, and having music and audiobooks." TS 17:47 "[In] pediatrics, the patient, not the parent, is your patient. And that can look really different for a 3-year-old versus a 17-year-old. Somebody who can't officially sign consent, but they certainly have a lot of buy-in about the things that reach their body, versus a 3-year-old, where the parents are really taking ownership of that. I think sometimes it's tricky in the world of pediatrics as we think about the ethics of 'Who are we training here? Is it the patients? Is it the parents?' And we continue to advocate for our patients." TS 23:32 "I think that pediatric patients still want to be normal kids. They still want to do their normal activities. ... Our pediatric patients, a lot of times, have healthier tissues. They haven't seen as much wear and tear. They haven't developed the bad habits of some adults. They don't have the same environmental exposures, they're not smoking, they probably have fewer comorbidities. ... They're a different population. ... They're just amazing. They still want to be a kid, they still want to go to school, they still want to be with their friends. It's really encouraging to see that." TS 36:03