The treatment of a child's cancer may involve surgery, chemotherapy , radiation therapy , immunotherapy and various supportive measures.
    The special problems seen with childhood cancers mean that a child should not be treated only by a single physician. A team approach is required, with physicians assisted by many specialists including psychologists and experts in nursing, social services, nutrition, physical therapy, occupational therapy, pharmacy, child life, and other fields. They should all be involved in designing the appropriate treatment and support program for the child and his or her family.
    This kind of multidisciplinary approach can be accomplished only in a "center of excellence," an approved pediatric cancer specialty unit. In the United States and Canada there are two cooperative groups known as The Children's Cancer Group and The Pediatric Oncology Group. Over 90 percent of children younger than 15 with cancer are treated at an institution that is a member of one of these two groups. Families of adolescents and young adults between 16 and 21 are encouraged to seek a referral to one of these centers.
    When a child is diagnosed with cancer in most of these centers, his or her case is presented to a Tumor Board, a meeting of physician specialists, subspecialists and other members of the treatment team who evaluate the child, discuss the options and agree to a proposed treatment plan.

Clinical Trials  Cancer in children is rare. Each year in the United States, slightly over 3,000 children develop leukemia, and 2,000 develop various kinds of brain and nervous system tumors. Approximately 500 children