Q. You know the statistics, more or less. Since you became a nurse practitioner, the survival rates in general have started to increase for children with cancer.
A. We also have a lot easier treatments because we have central lines (for admitting drugs) that we can put in kids and that stay in kids so you don't have to be having painful pokes every time you need a blood test or have to get chemotherapy.
Yeah, it's kind of fun to see kids that you saw when they were 5 who had leukemia, and now they're 35 and doing OK. That's nice.
Q. How has the public outlook on childhood cancers changed or evolved during that time?
A. We used to tell people that their child had cancer, and it was pretty much a bleak outlook because there weren't good treatments for a lot of the cancers. There are now great treatments for most of them, and most kids do really well.
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Yet, it's still hard for them to see the light at the end of the tunnel because their lives pretty much revolve around when they have to come in and what the parents have to do regarding their sick child. And so it's hard because sometimes the rest of the kids feel neglected, and parents feel guilty because they have to spend so much time on the one child. But it works out really well most of the time.
Q. Imaging equipment improved dramatically in the 1980s. Some other things involving childhood cancers have changed, such as classifications of brain tumors, better procedures for biopsies.
A. You can put the medication on a pump now and give so much per minute or so much per hour. It's much more high-tech than it was before. I just think that everything has really improved.
Q. There's still not a lot known about what causes childhood cancers.
A. You could ask eight different people and get eight different theories.
People have thought that our part of the country has a much higher rate of cancer than other parts of the country. I'm not sure that's true. I just think we know about it more because of the small-town kind of camaraderie we have.
It'd be interesting to see if the (U.S. Centers for Disease Control and Prevention) has ever studied that. I don't know if they have. But different people seem to ask about that all the time.
Q. Do you think there's greater awareness of, and better education about, the symptoms of childhood cancers?
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A. You hear about it much more often, so people are more likely to come in sooner than they did before, I think, which also helps the survival rate.
I think people are pretty in tune and pretty good in this part of the country about bringing their kids in if they have things they're concerned about.
We don't have a lot of people who don't come when we want them to or when they should.
Q. How has your outlook and your approach with children dealing with cancer evolved since 1979, personally and professionally?
A. Like I said, things were not as easy as they are now. They were a lot more painful.
You didn't have central lines. You didn't have other things to help. So, my thought was always "What can I do to make this a better experience for the child?"
I try to give them a choice -- as simple as, "Do you want to have your blood test now or go have lunch and then have your blood test?"
You try to make their life a little more fun. So, we have birthday parties with sports teams. We go to the CanadInns' water park and have a birthday party there.
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They might come in for their treatment, and then they know they get to go to (UND) hockey practice when the treatment is over, so they can look forward to that. I've had great cooperation from coaches and from people over the years who say, "Just bring 'em out. Let's see 'em. Anything we have to do is less important."
So, I just try to make it fun for them, as fun as it can be when the circumstance is not so great.
Q. So, your approach has changed?
A. Yeah, I think the more kids I've seen, the more I've tried to do for them. In the 1970s, you maybe had one or two kids. Now, it seems like we always have six or seven at one time whom we're dealing with.
And I think that's just because more people are aware, too. It used to be that kids would get sent out, and they wouldn't come back to us. And now they do, so that makes a difference, too.
Q. How has your approach with parents or guardians changed over the years?
A. Everybody's a little different with how they deal with it. Some people are very angry. Some are very sad. You try to tune in to what they're feeling and help as best you can, you know. Offer suggestions for other help, if they need counselors, if they need their pastors, if they need other people to help with the kids. All that stuff makes a big difference.
Q. Dealing with younger kids versus older ones -- how different is it?
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A. The really young kids really don't know what it means to them, so it's really more dealing with their families than dealing with them. The kids in the 4, 5, 6 age group, they become very familiar very quick with what's happening to them.
The older kids, you know, they don't want to lose their hair. That sucks. They don't want to wonder what the rest of their friends are thinking of them. They know they have their family support, but they wonder if they're going to have their friends' support.
Q. You saw the news from southern Minnesota about the young teen, Daniel Hauser, who initially refused further conventional chemotherapy treatments for Hodgkin's lymphoma, a cancer with a high rate of treatment success. His parents finally are following court-ordered treatments.
What's your reaction?
A. It's hard because I've had some people who have done similar things. They've gone to different places to have alternative treatments, usually when the standard recommended treatment isn't working.
And I'm not sure I wouldn't do the same thing in their shoes. Everybody's a little bit different. I lost my own father to colon cancer, so I understand the feeling that you want to do everything you can to make it go away, to make it better.
Chemotherapy does have side effects, and they're not always pleasant.
If I'm the person talking to that mom, I would just say, "Here's the X-ray, it looks like things have improved. You tell me why you don't want to continue with this."
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In the end, you have to respect their decision because it's theirs; it's not really yours. All you can do is tell them what you know and give them the best possible facts."
Q. Relay for Life events fundraising events for the American Cancer Society are being held around our region. How do you think those events are perceived by children with cancer?
A. The younger kids, they're into the balloons and the games and the fun things that they do for Relay for Life, and I'm not sure they always understand that it's about them.
But the older kids? They do understand. I think they're impressed by all the people who are supporting them.
I think the littler kids become very sophisticated, though, in their understanding as they get older because of what they've gone through, how it went and all those kinds of things. And they're really wise beyond their years. They know.
