Childhood Cancer

Every cell in the body has a system that controls its growth, interaction with other cells, and even its life span. When certain cells lose that control and grow in a way that the body can no longer regulate, it's called cancer.

Different kinds of cancer have different signs, symptoms, treatments, and outcomes, depending on the type of cell involved and how fast the cells grow.

What Is Cancer?

All kinds of cancer progress in the same way — cells grow out of control, develop abnormal sizes and shapes, exceed their typical boundaries inside the body, and destroy neighboring cells. ln time, cancerous cells can spread (metastasize) to other organs and tissues.

As cancer cells grow, they demand more and more of the body's nutrition. Cancer takes a person's strength, destroys organs and bones, and weakens the body's defenses against other illnesses.

Cancer is uncommon in children, but can happen. The most common childhood cancers are leukemia, lymphoma, and brain cancer. As kids enter the teen years, osteosarcoma (bone cancer) is more common.

Most of the time, doctors don't know why kids get cancer. The things that cause cancer in kids are usually not the same ones that cause cancer in adults, such as smoking or exposure to environmental toxins. In children, a genetic condition, such as Down syndrome, can sometimes increase the risk of cancer. Kids who have had chemotherapy or radiation treatment for cancer are more likely to get cancer again.

In most cases, however, childhood cancers come from random mutations (changes) in the genes of growing cells. Because these changes happen randomly and unpredictably, there is no effective way to prevent them.

Sometimes, a doctor might spot early symptoms of cancer at regular checkups. However, some symptoms of cancer (such as fever, swollen glands, frequent infections, anemia, or bruises) can happen with other childhood infections or conditions that are more common than cancer. Because of this, both doctors and parents might suspect other childhood illnesses when cancer symptoms first appear.

Once cancer has been diagnosed, it's important for parents to seek help from a medical center that specializes in pediatric oncology (treatment of childhood cancer).

Cancer Treatment

The treatment of cancer in children can include surgery (to remove cancerous cells or tumors), chemotherapy (the use of medical drugs to kill cancer cells), radiation (the use of radiant energy to kill cancer cells), and bone marrow transplant.

Doctors may use one or more of these treatments for a child who has cancer. The type of treatment needed depends on the child's age, the type of cancer, and how severe the cancer is.

Surgery

For children with leukemia or lymphoma, surgery is not usually the main treatment. This is because leukemia and lymphoma involve the circulatory system and the lymphatic system, two systems that are located throughout the body. This makes it hard to treat these cancers by operating on just one area.

However, in children with solid tumors that haven't spread to other parts of the body, surgery can often effectively remove cancer when used in combination with chemotherapy and/or radiation.

Chemotherapy

Chemotherapy (chemo) is medicine that can eliminate cancer cells in the body. Kids with cancer can take the chemotherapy medications intravenously (through a vein) or orally (by mouth). Some forms of chemotherapy can be given intrathecally, or into the spinal fluid. The drugs enter the bloodstream and work to kill cancer cells throughout the body.

How long chemo lasts and the type and number of different drugs used depends on the type of cancer and how well a child's body responds to the treatment. Every child's treatment is different, so a child may receive daily, weekly, or monthly chemotherapy treatments. The doctor also may recommend cycles of treatment, which allow the body to rest and recover between periods of chemo.

All of the medicines used in chemotherapy carry the risk of both short-term and long-term problems. In the short term after getting chemotherapy, a child might have:

• nausea
• vomiting
• hair loss
• fatigue (tiredness)
• anemia
• abnormal bleeding
• kidney damage
• menstrual problems

Because chemotherapy destroys bone marrow (the spongy tissue inside some bones that helps the immune system by making blood cells), it can increase the risk of infections. Some drugs irritate the bladder and may cause bleeding into the urine, hearing loss, and liver damage. Others may cause heart and skin problems.

Longer-term effects can include infertility, growth problems, organ damage, or increased risk of other cancers. Doctors always take side effects into account before giving chemotherapy and may use medicines to protect patients against as many of the side effects as possible.

Radiation

Radiation is one of the most common treatments for cancer. A child who receives radiation therapy is treated with a stream of high-energy particles or waves that destroy or damage cancer cells. Many types of childhood cancer are treated with radiation along with chemotherapy or surgery. Radiation has many potential side effects (such as increased risk of future cancer and infertility).

Bone Marrow Transplants

Kids with certain types of cancer may receive bone marrow transplants. If a child has a type of cancer that affects the function of blood cells, a bone marrow transplant (along with chemo to kill the defective cells) may allow new, healthy cells to grow. Bone marrow transplants are also sometimes used to treat cancer that does not involve blood cells because they allow doctors to use higher doses of chemotherapy than a child would normally be able to take.

Coping With Cancer

The main goal when treating kids with cancer is to cure them. This takes priority over everything else, even if it means unwanted side effects as a result of treatment. Thankfully, many medicines and therapies can make kids more comfortable while undergoing treatment for cancer.

When possible, kids should be involved with their own cancer treatment. Talk to your child in language he or she will understand and explain the facts about the specific type of cancer and its effects. However, when cancer affects younger children — toddlers and those younger than age 4 — simply telling them that they are "sick" and need "medicine" to get better may be enough of an explanation. For all age groups, the goal is to prevent fear and misunderstanding.

Many kids might feel guilty, as if the cancer is somehow their fault. Psychologists, social workers, and other members of the cancer treatment team can be a great help in reassuring and helping them with their feelings.

If your child is diagnosed with cancer, look to the cancer treatment team to help guide your family through the pain, uncertainty, and disruptions caused by cancer. If necessary, the team can also contact or visit your child's school to explain the diagnosis to teachers and classmates. Replacing fear and misunderstanding with compassion and information is an important part of helping kids with cancer cope with the illness.

The diagnosis and treatment of childhood cancers takes time, and there are both short-term and long-term side effects. But thanks to medical advances, more and more kids with cancer are finishing successful treatment, leaving hospitals, and growing up just like everybody else. Today, more than 80% of all children with cancer live 5 years or more.