pediatric cancer
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By Bernadette Starzee

Sayville resident Brooke Dubay, now 16, was a healthy teenager playing on three varsity sports teams when she developed a bump inside her mouth. At first, she dismissed it as a cold sore, but when it got bigger, her dentist referred her to an oral surgeon, who removed it. 

“The oral surgeon said it didn’t look like anything to worry about, but when the biopsy results came back, we found out it was rhabdomyosarcoma,” said Kim Dubay, Brooke’s mother.

Rhabdomyosarcoma is a rare type of cancer that develops in muscle tissue and most commonly affects children and adolescents. 

Brooke, who was diagnosed in April 2020, had surgery at Memorial Sloan Kettering Cancer Center (MSK) to remove the surrounding tissue. Although her cancer was Stage 1, Dubay had to undergo radiation and chemotherapy treatments. The first couple of treatments were done at MSK’s main campus in Manhattan.

“For one type of treatment she had to spend the whole day there, and we didn’t get home till about 8 p.m. and we had to go back at 7 a.m. the next day,” Kim Dubay said. “Brooke sometimes felt sick on the long drive and we would have to pull over.”

Many of the treatments were shorter in duration, but trekking into Manhattan meant that Brooke would have to miss full days of school, as would Kim, who is a teacher. Further, it would take Kim away from her three other children. At Kim’s request, approval was given for Brooke to have most of her treatments, scans, and visits at MSK’s Commack facility. 

“It has been so much less disruptive to not have to go to Manhattan,” Kim Dubay said, adding that she can sometimes schedule a 4:30 p.m. appointment and she and Brooke can go after school. 

In recent years, MSK has developed regional centers in the New York suburbs, including locations in Commack and Uniondale, and begun shifting many services, including radiology, chemotherapy and lab tests, to these suburban centers. The pandemic accelerated this trend, according to Dr. Andrew Kung, a pediatric oncologist and chair of MSK’s Department of Pediatrics (MSK Kids), which treats all common and rare forms of cancer affecting children and adolescents. Many patients were nervous about going to Manhattan in the early months of the Covid-19 crisis. This contributed to the shift toward the regional centers as well as the introduction of telemedicine for certain types of visits, such as psychosocial care. 

“Since the pandemic, about 30 percent of all MSK Kids care is either at our regional sites or via telemedicine,” Dr. Kung said. 

Causing minimal disruption to the lives of children and their families is one of the goals of MSK Kids. 

“About 80 percent of children’s cancers are curable, which is a real testament to the advances that have been made over the last 40 to 50 years,” Dr. Kung said. “With that success, we have to pay equal attention to making sure the therapies are not only effective in treating disease, but that we cause as little toxicity as possible, both in terms of the medicine itself and the disruption to kids’ lives.”

Not all services can be done on Long Island. 

“What we do for each patient is make sure that for each therapeutic modality they need, they are treated at the most appropriate site,” Dr. Kung said. “Our capabilities span from very routine to very high-tech therapies, and some therapies are not appropriate for an outpatient setting and should be treated in our main facility in Manhattan.”

But where possible, MSK Kids is continuing to expand the services it provides close to home.   

“Bringing services to the child’s community allows kids and their families to try to get back to a more normal life,” Dr. Kung said. “Instead of hauling into Manhattan and losing whole days, kids can stay engaged in school and sports.”

Brooke Dubay attended online classes for most of the school year and began in-person classes in April. Sports were disrupted because of the pandemic, but the teenager, whose recent three-month follow-up scans were clear, is looking forward to returning to a full sports schedule in the fall.

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