Kids and Cancer

Girl with tongue out

“The pediatric cancer patient is never an individual, but is looked at in the context of the family,” says Dr. Sender, explaining the need for a family-centered treatment approach with young cancer patients. “Kids have siblings. They have parents. We try to understand that patient as a child, or teen, or young adult, but we also understand how they fit into  their family and the family dynamics. In adult medicine, the family’s wishes are often secondary to the patient’s wishes. In pediatrics, they can be equal or overshadowed. A three-year-old can’t define what they want to do but with teens, we try to find the balance between the patient’s and the parent’s wishes.”

Pediatric cancer patients are classified in one of three major groups: young children, tweens/early teens and teens/young adults, says Dr. Sender. Developmental issues and stages of the child’s growth, including in utero before birth, are  considered. “We think of adult cancers as the consequences of living your life. In childhood, it really is more about developmentally what is going on. Sometimes the cause is unknown,” says Dr. Sender.

Children with cancer are not just considered “little adults” in terms of care. “We want them to still be children,” says Dr. Sender. “We make sure that we provide an environment that is nurturing and comforting to the family. This is very stressful for these families. We are always thinking of that. We have a team-centered approach. We have oncologists, social workers, psychologists, child life experts and others all working to provide the young patient with as normal of a life as possible while they are being treated. CHOC is truly committed. It’s our passion. We want to deliver the most advanced treatment we can.”

Adolescents and young adults into their late 30s who are being treated for cancer face a wide range of issues that need to be considered to help them cope. These issues include fertility preservation, the development of body image, career and education considerations, and dealing with an increased dependence on parents at a time when many in this age group strive to be more independent.


  • The incidence of childhood cancers (up to age 15) that are diagnosed as leukemia: 1/3
  • The number of pediatric cancer cases (up to age 15) diagnosed annually in the U.S.: 14,000

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Dr. Leonard Sender
Dr. Leonard S. Sender
CHOC Cancer Specialist


Dr. Sender is the medical director at the Hyundai Cancer Institute at CHOC Children’s and director of clinical  operations and program development at the Chao Family Comprehensive Cancer Center at UC Irvine Medical Center.  He also is a professor of medicine at UC Irvine. Dr. Sender completed his internship and residency in pediatrics  at UC Irvine Medical Center and had a fellowship in pediatric hematology/oncology at Children’s Hospital in  Los Angeles. Dr. Sender has twice been named a “Top Doctor” by U.S. News & World Report. He serves as board chairman of the “Stupid Cancer” Foundation and is a founding member and chairman of, an adolescent cancer advocacy organization.

Dr. Sender’s philosophy of care: “I take a patient-centric approach and treat young patients as people, while understanding the context in which they get cancer. My goals are to cure the cancer and achieve a meaningful survivorship.”

Medical school at the University of the Witwatersrand in Johannesburg, South Africa

Pediatric Hematology/Oncology

More about Dr. Sender | More about The Hyundai Cancer Institute at CHOC Children’s

This article was featured in the Orange County Register on January 28, 2014 and was written by Amy Bentley.

Helping Adolescents and Young Adults Cope with Cancer

girlwithcancerThere’s never a good time for a cancer diagnosis, but the teen and young adult years can be an especially tough time for cancer patients. Adolescents and young adults into their 30s who are being treated for cancer face a wide range of issues special to their age group that need to be considered to help them cope. These issues include fertility preservation, the development of body image, career and education considerations, and dealing with an increased dependence on parents at a time when many in this age group strive to be more independent.

“Teens are starting to enter adulthood and move away from parents. They are starting to become more of an individual. In the normal struggle between the teenager and their parents, you throw cancer into the mix and you create tremendous stress. This is a time when they want to be independent but they are sick,” explains Dr. Leonard Sender, director of the Hyundai Cancer Institute at CHOC Children’s and specializes in the unique issues relating to cancer treatment in adolescents and young adults from the ages of 15 to 39.

For several years, Dr. Sender has served as an advocate for this very special group of patients through the SeventyK that he co-founded in 2008 and currently chairs. Dr. Sender is especially sensitive to the psychosocial impacts of a cancer diagnosis on those just beginning to enter their most productive years. He remains a vocal advocate for this group, working to make sure they receive age-appropriate medical treatment and support, including, psychosocial, community and palliative services. In 2010, Dr. Sender founded two entities critical to the development of the emerging adolescent and young adult oncology subspecialty as president of the Society for Adolescent and Young Adult Oncology (SAYAO) and editor-in-chief of the Journal of Adolescent and Young Adult Oncology (JAYAO).

According to SeventyK, adolescents and young adults with cancer have often been described as a medically underserved population, falling through the gap between pediatric and adult oncology. As they transition from childhood to adulthood, the normal issues people in this age group face are compounded when they are diagnosed with cancer.

These patients may face treatment-related issues such as infertility; the loss of a job or breaks in education due to treatment; increased dependence on parents; and other health concerns, all of which can be exceptionally difficult for this group to cope with. Fertility preservation, in particular, has long been overlooked for adolescents, especially considering the fact that many young men and women haven’t yet started to think about having children. Adolescent and young adult patients may need extra support or psychological help to cope.

“Our goal is to cure these kids,” says Dr. Sender. “We bring in the best science, the best clinical delivery of care that we can. We always take into account the developmental stage of these patients. We never lose sight of the fact that these patients undergo tremendous amounts of interventions that can physically and emotionally scar them. We try to think about them as survivors from day one.”

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