Pediatric Oncologists Guide Families Through Long-term Cancer Treatment

"Kids need me to be strong to not cave into their wishes when they are concerned about the side effects of therapy. I know that the biggest side effect is not curing the cancer." — Ronnie Neuberg, M.D.

Whenever Dr. Neuberg meets a new patient, he promptly introduces himself to that patient, whether he’s greeting a ten-year-old boy or a five-year-old girl. “The first thing I do is talk to the child, and parents really like that,” he said. “We don’t wear white coats and rarely wear neckties,” he added, describing the relaxed demeanor of himself and Dr. Kevin McRemond, the other oncologist in the Department of Pediatrics.

Dr. Neuberg is well versed with the unique terrain that accompanies the niche he has chosen in medicine. “With a child you are treating the family and many times the whole community as well. A physician wouldn’t have contact with the co-workers of an adult who’s sick, yet we hear from classmates and teachers and siblings and grandparents of sick children,” he said. In fact, it was that extended involvement that helped him combine his initial interest in working with families with a subspecialty in pediatrics. “Pediatric oncology provided the best of both worlds for me: I could have the opportunity to take care of the whole family, yet it wasn’t such a broad field of medicine. It was something I could get my arms around,” he said.

The Chapmans were one of many families that Dr. Neuberg has embraced over the years. What started as a pain in 11-year-old Melissa’s chest suddenly turned the sixth grader’s life upside down.  Initial medical exams suggested a pulled muscle, and then pneumonia was diagnosed. Yet the pain wasn’t going away. When her parents found out that there was a malignant tumor growing in her chest wall, it came as a complete surprise. “I was thinking that maybe Melissa had some type of oddball bug that just didn’t respond to antibiotics. It came completely out of left field,” Chapman’s mother, Elizabeth, said of the diagnosis. “Your heart kind of sinks,” said her dad, Kenneth, of the unexpected news.

The Chapmans soon learned that Melissa had a rare type of tumor and that surgery was on the immediate agenda. Though sobered by a 75 percent cure rate that still left room for fears, the Chapmans were immediately put at ease by the two pediatric oncologists at the School of Medicine. “We knew right away that they had good rapport with kids when they introduced themselves as Dr. Ron and Dr. Kevin,” said Elizabeth. The Chapmans also appreciated the accessibility of the physicians to address the seemingly endless questions that parents can have about their child’s disease. “Parents want availability and consistency, and they need their concerns to be heard. They also want to be armed with information about the disease and the treatment and what’s going on with their child,” Dr. Neuberg said.

With today’s Internet savvy parents, many conduct their own research after their child is diagnosed with cancer. Dr. Neuberg cautions that the glut of available information can become confusing to navigate. Because the Children’s Center for Cancer and Blood Disorders at Palmetto Health Richland is a member of the Children’s Oncology Group, a cooperative clinical trials group, he routinely refers family members to utilize the website’s resources at www.childrensoncologygroup.org. He reassures anxious moms and dads that the care their child receives follows the same sophisticated treatment protocols as over 200 member institutions of the Children’s Oncology Group around the world.

As Melissa and her family endured three surgeries and 18 months of chemotherapy, they found the two oncologists to be a comfortable constant throughout the ordeal. “They were upbeat and joked around a lot, yet were always assuring us that they were going to help us through this,” said Ken. “Kids need a light environment,” added Dr. Neuberg. “It doesn’t have to be all gloom and doom,” he said.

Despite the humor, Dr. Neuberg is well aware that his patients understand the seriousness of their struggle. “Yet when they have faced and beaten cancer, they know that they have done the hardest thing they will ever have to do in their lives. They have this confidence that they can move on,” said Dr. Neuberg. Three and one-half years after Melissa completed treatment, the junior at Chapin High looks back at her own fight with cancer. “In some ways it’s kind of sad that I had to grow up so fast,” she acknowledged, her maturity obvious in the poised way she conducts herself. “I just wish people would open their eyes and spend more time with the people they love. You never know what may happen the next day,” she said.

 “Melissa is a great young woman with a terrific attitude,” Dr. Neuberg said of the teen, who is an energetic volunteer with the American Cancer Society along with other typical high school activities. She’s also found her direction in life: pediatric oncology. “That’s where I want to be. It’s how I feel I can give something back,” she said. Dr. Neuberg revels in seeing patients like Melissa who are excited about pursuing their goals. “That’s what we’re here for – to see these kids go on,” he said.

 Unfortunately all of his patients do not survive their cancer, and Dr. Neuberg concedes that, “There is no easy way to deal with a child dying.” When one of his patients dies, he turns to his faith to sustain him. “I believe that the children are fine; it’s the rest of us who are left behind to handle the grief,” he said. He’s also bolstered by the fact that a growing majority (about 78 percent) can be cured.

As he works with very sick children day after day, Dr. Neuberg remains in awe of how they handle the difficult tests and treatments they have to endure. “A four-year-old can get a spinal tap and then jump off the table, give you a hug, and run off to play,” he said. And as much as he educates about cancer, he learns even more from the youngsters in his care. “They give me a lot of strength and courage and perspective on life,” he said.

Reprinted from Connections newsletter, March 2004

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