Every cell in our bodies is tightly regulated with respect to
growth, interaction with other cells, and even its life span.
Cancer occurs when a type of cell has lost these normal control
mechanisms and grows in a way that the body can no longer regulate.
Different kinds of cancer have different signs, symptoms,
treatments, and outcomes, depending on the type of cell involved
and the degree of uncontrolled cell growth.
What Is Cancer?
All kinds of cancer, including childhood cancer, have a common
disease process - cells grow out of control, develop abnormal sizes
and shapes, ignore their typical boundaries inside the body,
destroy their neighbor cells, and can ultimately spread (or
metastasize) to other organs and tissues. As cancer cells grow,
they demand more and more of the body's nutrition. Cancer takes
a child's strength, destroys organs and bones, and weakens the
body's defenses against other illnesses.
Cancer affects only about 14 of every 100,000 children in the
United States each year. Among all age groups, the most common
childhood cancers are
leukemia
,
lymphoma
, and brain cancer. As children enter their teen years, there is
also an increase in the incidence of
osteosarcoma
(bone cancer). The sites of cancer are different for each type, as
are treatment and cure rates.
Typically, the factors that trigger cancer in children are
usually not the same factors that may cause cancer in adults, such
as smoking or exposure to environmental toxins. Rarely, there may
be an increased risk of childhood cancer in kids who have a genetic
condition, such as Down syndrome. Those who have had chemotherapy
or radiation treatment for a prior cancer episode may also have an
increased risk of cancer. In almost all cases, however, childhood
cancers arise from noninherited mutations (or changes) in the genes
of growing cells. Because these errors occur randomly and
unpredictably, currently there is no effective way to prevent
them.
Sometimes, a doctor may be able to spot early symptoms of cancer
at regular checkups. However, some of these symptoms (such as
fever
, swollen glands, frequent infections,
anemia
, or bruises) are also associated with other infections or
conditions that are not cancer. Because of this, it is not uncommon
for both doctors and parents to suspect other childhood illnesses
when cancer symptoms first appear.
Once cancer has been diagnosed, it is important for parents to
seek help for their child at a medical center that specializes in
pediatric oncology (treatment for childhood cancer).
Cancer Treatment
The treatment of cancer in children can include
chemotherapy
(the use of medical drugs to kill cancer cells),
radiation
(the use of radiant energy to kill cancer cells), and surgery (to
remove cancerous cells or tumors). The type of treatment needed
depends on the type and severity of cancer and the child's
age.
Surgery
For children with leukemia or lymphoma, surgery generally plays
a minor role. This is because leukemia and lymphoma involve the
circulatory system and
lymphatics
, two systems that are located all throughout the body, making it
difficult to treat by operating on one specific area. In children
with osteosarcoma and other solid tumors that haven't spread to
other parts of the body, however, surgery can often effectively
remove cancer when used in combination with chemotherapy and/or
radiation.
Children with certain types of cancer may receive bone marrow
transplants. Bone marrow is a spongy tissue inside certain bones of
the body that produces blood cells. If a child has a type of cancer
that affects the function of blood cells, a bone marrow transplant
(in conjunction with chemotherapy to kill the defective cells) may
allow new, healthy cells to grow. Bone marrow transplant is also
sometimes used to treat cancer that does not involve blood cells
because it allows doctors to use higher doses of chemotherapy than
would otherwise be tolerated.
Chemotherapy
Chemotherapy is medication which is used as a complementary tool
to eliminate remaining cancer cells in the body. A child or teen
with cancer is usually given the chemotherapy drugs
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 in parts of the body to which the cancer has
spread.
The duration of chemotherapy treatment and type of drugs that
are used depend on the type of cancer the child has and his or her
response to the drugs. Every child's treatment differs, so a
child may receive daily, weekly, or monthly chemotherapy
treatments. The doctor may also recommend cycles of treatment,
which allow the child's body to rest between periods of
chemotherapy treatment.
Many of the medications used in chemotherapy also carry the risk
of both short-term and long-term problems. Short-term side effects
include nausea, vomiting, hair loss, fatigue, anemia, abnormal
bleeding, and increased risk of infection due to destruction of the
bone marrow, as well as kidney damage and menstrual irregularities.
Some drugs carry a risk of bladder inflammation and 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.
Your doctor will use precautions as well as other medications to
counteract 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 in
conjunction with chemotherapy or surgery.
Radiation has many potential side effects (such as increased
risk of future malignancy and infertility), which you should
discuss with the doctor.
The primary goal when treating kids with cancer is to cure them;
this takes priority over all other aspects of care. However, there
are many medications and therapies that can make children more
comfortable while undergoing treatment for cancer.
Coping With Cancer
When possible, older kids should be involved with their own
cancer treatment. Facts about the specific type of cancer and its
effects should be explained in language that is suitable for the
child's age level. 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 is often enough explanation. For all age groups, the
goal is to prevent fear and misunderstanding.
Older 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. The cancer treatment team can guide
patients and their families through the pain, uncertainty, and
disruptions caused by cancer. If necessary, the cancer treatment
team can also contact or visit the child's school to explain
the child's diagnosis to teachers and classmates. Replacing
fear and misunderstanding with compassion and information is a goal
in 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, up to 70% of all children with cancer can be
cured.
Reviewed by:
Robin E. Miller, MD
Date reviewed: June 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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