A college course in the genetics of cancer and a desire to help people
led Susan Spiller, M.D., into the field of pediatric hematology/oncology
a decade ago, while a love for the mountains brought her to East Tennessee
and Children's Hospital this summer. In June, Dr. Spiller joined the
pediatric hematology/oncology practice of Ray Pais, M.D.; Shahid Malik,
M.D.; and John Stephen Corns, D.O.; at Children's Hospital.
Dr. Spiller was drawn to pediatric hematology because she felt there was
a tremendous need in the field to help these very sick young patients.
Unlike adult oncology, however, the majority of children with cancer are
long-term survivors. She also liked the aspect of being able to work with
parents. "Parents are advocates on your side," she said. "Even
if a patient doesn't want to do what you are asking, you have a cheerleader
at home on your side" the parents who want their child to be cured.
Dr. Spiller grew up in the mountains and hills of upstate New York and
loves that area of the country. But much of her family is in the south,
so that drew her to this region. When she met with the hematology/oncology
practice here, she was impressed with how happy everyone seemed. "I
want to raise my children where people are happy, where I can have job
satisfaction, and where we can go to the mountains whenever we want to,"
she said, explaining the main reasons why Children's Hospital was
a perfect fit.
Diagnoses for patients referred to a pediatric hematologist/oncologist
include all types of cancers and blood problems, such as neutropenia,
anemia, thrombocytopenia (low platelets) and sickle cell disease. Some
patients' needs involve making a diagnosis and providing education,
while others require significant care. Children with sickle cell disease,
for example, require ongoing health maintenance to prevent such serious
complications as infections and strokes. Most cancer patients require
treatment and long-term follow up evaluations.
The most common types of cancer in children are leukemias, lymphomas, brain
tumors and other solid tumors, rather than common adult cancers of the
lung, breast, prostate and colon. Treatment for cancer has improved in
recent years due in large part to cooperative groups working together
to share information and ideas for making treatments more effective and
less toxic. Additionally, better imaging techniques using CT, MRI and
PET scans enable more precise staging and earlier detection of recurrence.
New cancer drugs are being developed every day that target cancer cells
and spare normal tissue, yielding better success rates. Better antibiotics
to fight risky infections and improve prevention in individuals with decreased
immunity due to chemotherapy, and safe, available blood for transfusions
are also helping to improve cancer care.
The flip side of improved care is the challenge of telling parents their
child has cancer. "It's always difficult to tell because it's
devastating to the parents, whether the cancer is treatable or not,"
Dr. Spiller said. "I work hard to provide parents with really good
information so they understand their child's diagnosis and know what
to worry about as well as what they don't have to worry about."
Dr. Spiller is particularly interested in brain tumors. "I have done
a lot of research in brain tumors, which has helped me to understand the
unique challenges that face this population of patients," she said.
"I like to think this helps me anticipate potential problems that
can be prevented or prepare families if prevention isn't possible.
Kids with brain tumors are a really special set of people, and I really
love working with them."
The pediatric hematology/oncology group at Children's Hospital is a
member of the Children's Oncology Group (COG). This organization of
more than 200 member institutions worldwide conducts clinical trials and
performs research to identify cancer causes and pioneer treatments and
cures. Because of this affiliation, Children's is able to offer the
same treatment regimens as other Children's Oncology Group institutions
for most types of childhood cancer. Among the more well-known of the COG
member institutions are Memorial Sloan-Kettering Cancer Center in New
York City; Mayo Clinic in Rochester, Minn.; St. Jude Children's Research
Hospital in Memphis; and Monroe Carell Jr. Children's Hospital at
Vanderbilt in Nashville.
Children's Hospital welcomes Dr. Spiller to our pediatric referral
center and looks forward to working with her in providing hematology/oncology
care to this region's children.