Children and Cancer
What causes cancer in children?
When a child develops cancer, everyone has the same question: Why? In most cases, there is no obvious explanation. Cells in the body sometimes make mistakes when copying themselves, and some of those mistakes can turn into cancer. A few rare types of childhood cancer -- such as retinoblastoma, a cancer in the retina of the eye -- run in families. In those cases, children may have inherited faulty genes from their parents. There's also some evidence that children are more likely to develop cancer if their mothers were exposed to large amounts of radiation or harmful chemicals such as pesticides during pregnancy. But for the most part, childhood cancers seem to pick their targets at random. There's no way to predict which child might develop cancer or to pinpoint the blame when it happens.
What types of cancer occur in children?
In 2014, the last available statistics, about 15,780 children and teens were diagnosed with cancer. The most common form of cancer in children is leukemia, a type of cancer of the white blood cells; it accounts for about a third of all childhood cancers. Tumors in the brain and elsewhere in the nervous system are a close second. In fact, leukemia, brain tumors, and other nervous system tumors combined account for more than half of all childhood cancers. .
What are the symptoms of childhood cancers?
Symptoms in children depend on the type and location of the cancer. Leukemia can cause pain in bones and joints, weakness, fever, bleeding, and weight loss. Children with brain tumors may have headaches, blurred or double vision, dizziness, nausea, and trouble with walking or basic motor control. Neuroblastomas (cancers of the nerve tissue) can cause swelling in the belly, bone pain, fever, or diarrhea and affect eye or muscle movements; Wilm's tumor (a cancer of the kidney) and tumors in muscles may produce localized pain, swelling, and lumps. If your child has any unusual symptoms, your first stop should be your child's doctor. Because childhood cancers are relatively rare, more likely than not the signs your child exhibits are due to something else. However, persistent unexplained symptoms or the sudden occurrence of new ones warrant a visit to the doctor to check things out.
How are childhood cancers treated?
Just like adults, children with cancer can be treated with chemotherapy, surgery, radiation, or some combination of the three. Newer immunotherapy treatments may be available through clinical trials. Of course, the particular treatment depends on the type of cancer. Chemotherapy is the main treatment for leukemia. If the leukemia comes back or doesn't respond to treatment, blood stem cell or a bone marrow transplant can give the child a chance to make new, healthy blood cells and will sometimes cure the disease when chemotherapy and radiation have failed. Chemotherapy, surgery, and radiation can all be used in the treatment of brain tumors.
If possible, a child should be treated at a center that focuses on childhood cancers. These centers employ specialists who may have more experience with rarer cancers and children's special needs. They afford the most up-to-date-treatment by offering promising new therapies and participation in clinical trials. Specialized centers also provide the kind of atmosphere, encouragement, and support that children and their families need. Social workers, psychologists, and education experts can be vital members of the team.
What are the chances for recovery?
Outcomes are improving. Cancer recovery is measured by five-year survival rates, and these outcomes for childhood cancers have increased dramatically in the last few decades. In 1975, just over 50 percent of children with cancer lived five years or longer; today, the figure is 80 percent, with the prospects of children with Hodgkin and non-Hodgkin lymphoma especially good.The majority of kids with childhood cancers can now expect to recover and live full lives, though they may experience some long-term side effects due to the damage that treatments can cause to healthy cells.
But each case is different, and keep in mind that these are survival rates for children diagnosed and treated more than five years ago. Kids with more recent cases may benefit from improvements in treatment.
Side effects and long-term effects
Cancer treatments are tough on the body. Chemotherapy, radiation, and surgery often create short-term problems in adults and children. Children who go through these treatments are also at risk of additional late-appearing and long-term health problems. Some of the more common late effects of treatment (appearing a few months or years after treatment ends) can include growth problems, learning disabilities, fertility problems, heart problems, hearing and vision loss, and (in rarer cases) additional cancers.
To help doctors better identify and manage these long-term effects, the Children's Oncology Group has published a comprehensive set of guidelines for follow-up care. Remember that each case is unique, and your child's health team can help you understand the challenges you might face. With the right treatments and plenty of support, most kids have a long future ahead.
American Cancer Society. What are the most common types of childhood cancers?
American Cancer Society. How are childhood cancers treated? 2008.
National Cancer Institute. Cancer in Children and Adolescents.https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet
American Cancer Society. What are the risk factors and causes of childhood cancer? August 17, 2010.
Children's Oncology Group: Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers
Adult Survivors of Childhood Cancer Are Prone to Chronic Health Conditions
Mayo Clinic: cancer Survivors: Managing the Late Effects of Cancer Treatment
National Institutes of Health. U.S. National Library of Medicine. Genetics Home Reference. Retinoblastoma.
American Cancer Society. What is neuroblastoma?
Biggs, J.C., Horowitz, M.M., Gale, R.P., et al. Bone marrow transplants may cure patients with acute leukemia never achieving remission with chemotherapy. Blood 80:1090-1093.
Orentas, R. Immunotherapy in pediatric oncology: into the 21st century. Immunology and Allergy Clinics of North America Vol 19, Issue 2, p.309-326.