Office of Cancer Control and Prevention

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Childhood Cancer

 

What is it?

Just as children are not “little adults”, childhood cancer is different in many ways from adult cancer. The most common cancers in adults are breast, cervical, colorectal, lung and prostate; children almost never contract any of these. Acute leukemia, central nervous system tumors, neuroblastoma, Wilm’s tumor, and non-Hodgkin’s lymphomas constitute the top five diagnoses under 14 years of age. This is in contrast to Hodgkin’s disease (HD), germ cell tumors, non-Hodgkin’s lymphomas (NHL), melanoma, and soft tissue sarcomas, which are more frequent in youngsters 15 to 19 years of age (Table 1).

Table 1. Incidence of most common cancers
in 0 to 14 year olds and 15 to 19 year olds, 1990-1997

TOTAL <15 15 - 19
Total
141.3
206.8
Acute Lymphocytic Leukemia (A.L.L.)
29.3
11.5
A.M.L.
6.6
8.8
Hodgkin's Disease
5.7
34.7
Non-Hodgkin's Lymphoma
8.5
17.1
Central Nervous System
31.8
20.3
Malignant Bone Tumors Osteogenic & Ewing's
7.0
15.8
Rhabdomyosarcoma
5.1
3.6
TOTAL
94
111.8

Source: Task Force on Cancer Prevention, Early Detection and Treatment in New Jersey. New Jersey Comprehensive Cancer Control Plan. Report to the Governor, July 2002. Trenton, NJ, New Jersey Department of Health; 59.

Note: Rates are per 100,000

What puts me at risk?

Many adult cancers have identified risk factors; some adult cancers may be preventable. However, there is very little evidence to indicate the causes of childhood cancer other than cancer genetics. There also has been considerable research into the effects of environmental contaminants associated with childhood cancer; however direct causation has not been proven.


Treatment Options

Cancer survival in children under 14 is a great success story of the 20th century. In the 1960s, the five-year survival rate for a child diagnosed with cancer was 28%. By the 1990s this had risen to over 75%. The greatest success was witnessed in acute lymphoblastic leukemia, a virtually incurable disease in the 1960s with a median survival of six months. Today, more than 75% of the children are cured.

For more information on childhood cancer, log onto:

NCI – Childhood Cancers
NCI – Care for Children & Adolescents with Cancer: Questions and Answers
CureSearch

For information on finding a doctor or treatment facility, log onto: http://www.cancer.gov/cancertopics/factsheet/Therapy/doctor-facility

Clinical Trials  

Coping with Cancer

Side Effects of Cancer

Palliative Care-

Palliative care is a coordinated, inter-disciplinary approach to healthcare that enhances the quality of life of patients with cancer and other illnesses. It targets the physical and psychological symptoms and spiritual needs of patients from the time of diagnosis to end-of-life care in all settings.

For more information on Palliative Care, log on to:

Post-Traumatic Stress Disorder (PTSD)
Much of the literature has focused on posttraumatic stress in relation to the family after a childhood cancer diagnosis, with an indication of parental symptoms consistent with Post-Traumatic Stress Disorder (PTSD) (e.g., avoidance, intrusive thoughts, hypervigilance, etc.) Studies have shown significantly higher levels of posttraumatic stress symptoms in parents of children diagnosed with cancer as compared to those parents whose children have not been diagnosed with a chronic illness. Moreover, study findings linked parents’ perceived higher levels of social support to fewer posttraumatic stress symptoms. This confirms the notion that quality of life of survivors, siblings, and parents can be improved by addressing impact at time of treatment and subsequently through psychosocial support at treatment centers.

Late effects of Treatment for survivors of childhood cancer
The available literature has well documented late effects of treatment for survivors of childhood cancer, whether surgical, chemotherapy or radiation induced. Adverse effects have been shown to many organ systems, such as CNS, neuroendocrine, ocular, dental, musculoskeletal, cardiovascular, pulmonary, gastrointestinal, hormonal function, fertility, and risks of secondary malignancies.

Central Nervous System: Neurocognitive deficit (difficulty reading, language, verbal and non-verbal memory, arithmetic, receptive and expressive language, decreased speed of mental processing, attention deficit, decreased IQ, behavior problems, poor school attendance, poor hand-eye coordination); leukoencephalopathy (seizures, neurologic impairment); focal necrosis (headaches, nausea, seizures, papilledema, hemiparesis, speech, learning and memory deficits); stroke; blindness; ototoxicity (abnormal speech development, hearing loss); myelitis (paresis, spasticity, altered sensation, loss of sphincter control); peripheral neuropathy (generalized weakness, localized weakness, lack of coordination, tingling and numbness).

Neuroendocrine: Growth hormone deficiency (poor growth/growth retardation); ACTH deficiency (muscular weakness, anorexia, nausea, weight loss, dehydration, hypotension, abdominal pain, increased pigmentation); TRH deficiency (hoarseness, fatigue, weight gain, dry skin, cold intolerance, dry brittle hair, alopecia, constipation, lethargy, poor linear growth, menstrual irregularities, pubertal delay, bradycardia, hypotension); precocious puberty (early growth spurt, false catch-up, premature sexual maturation); gonadotropin deficiency (delayed or absent pubertal development, testi-cular atrophy, infertility, abnormal menses, estrogen deficiency); hyperprolactinemia (abnor-mal menses, infertility, galactorrhea, osteopenia, loss of libido, hot flashes, impotency).

Ocular system: Dry, red eyes; tearing; ulcerations; tortuous vessels; pain; de-creased visual acuity; cataracts.

Head and neck/dental: Decreased saliva, dental decay, thrush, ulcerations, chronic rhinitis, facial pain, headache, hearing impairment, chronic ear infections, hair loss.

Musculoskeletal: Muscular hypoplasia, spinal abnormalities (scoliosis, kyphosis, etc.), limb length discrepancy, pathological fracture, osteoporosis, osteonecrosis, osteo-cartilaginous exostoses, slipped capito-femoral epiphysis.

Cardiovascular: Cardiomyopathy, valvu-lar damage, pericardial damage, coronary artery disease.

Pulmonary: Pulmonary fibrosis.

Gastrointestinal: Enteritis, adhesions, esophageal strictures, fibrosis of small and large intestines, hepatic fibrosis/liver failure.

Thyroid dysfunction: Hypothyroidism, thyroid nodules, hyperthyroidism.

Infertility: Ovarian failure, premature menopause, decreased or absent sperm production, testicular atrophy (3;32).

For more information on late effects of treatment, log onto:
The Children’s Oncology Group - Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers

Statistics

Comprehensive Cancer Control Plan
New Jersey State Cancer Registry

More Information