More optimistic outcomes
Childhood cancer is scary, but increasingly survivable
Cancer is a leading cause of life-threatening disease in children, with more than 12,000 children and adolescents diagnosed each year, but treatment has improved dramatically during the past four decades. Today, the majority of childhood cancer cases are curable and the current overall pediatric cancer survival rate approaches 80 percent.
Children who develop cancerous tumors are often more responsive to therapy than adults with cancer, and they can tolerate more intense treatment regimens. Additionally, children are frequently treated as part of large national clinical trials that pool results and allow for effective regimens to be identified more rapidly.
While some cancers run in families, the majority of cases are diagnosed in previously healthy children and families. Changes in the genetic material of certain cells make them become cancerous, but the cause remains mostly unknown.
The main methods of cancer treatment for pediatric patients, as with adults, include surgery, chemotherapy, and radiation. Outcomes are least favorable if the tumor has already spread at the time of diagnosis or returns after initial therapy. However, when detected early, most cancers are very treatable and survivable. Some cancers can be successfully treated with surgery alone, but most require chemotherapy for the best chance of a long-term cure.
Radiation is often used to treat brain tumors, and is combined with chemotherapy to treat tumors in other organs. Leukemia comprises up to one-third of all childhood cancers, and is generally treated solely with chemotherapy.
Bone marrow transplantation can increase the intensity of chemotherapy and is reserved for patients with very high-risk leukemia or neuroblastoma.
Because treatments are becoming more successful, and because children are at risk for long-term complications, the challenge in pediatric oncology is to use just enough treatment to be successful, while reducing risks from excessive therapy.
While a pediatric cancer diagnosis is still very serious and scary, the rate of successfully treated patients has also never been greater. Furthermore, about one in every 250 adults and one in every 900 children are now a childhood cancer survivor.
Cure, survival rates way up
More than 12,000 children and adolescents are diagnosed each year with cancer. However, cure rates for acute lymphoblastic leukemia, the most common type of childhood cancer, have increased from less than 20 percent in the 1960s to the current rate of more than 80 percent. Additionally, the overall pediatric cancer survival rate now also approaches 80 percent. Currently, there are about 300,000 childhood cancer survivors living in the U.S.
For more information go online to the American Cancer Society, www.cancer.org, and search for “pediatric cancer” or “choosing a doctor and a hospital.”
Dr. Lars Wagner is the chief of the Division of Pediatric Hematology/Oncology at UK HealthCare.
Dr. Lars Wagner for the February 2015 issue
