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Childhood Cancer - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Childhood Cancer. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

Cancer is uncommon in children. Most cancers (99%) develop in adults, and it is most common in older adults. About one out of every six adults will develop cancer during his or her lifetime, while one in 300 boys and one in 333 girls will develop cancer before the age of 20.

At the same time, there is a lot of research going on to discover new treatments for childhood cancer. This ongoing research has greatly improved the overall survival rate for children with cancer, which is now more than 80%.

What is childhood cancer?

Cancer begins when normal cells change and grow uncontrollably. In most types of cancer, these cells form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread. In leukemia, a cancer of the blood that starts in the bone marrow, these abnormal cells very rarely form a solid tumor. Instead these cells crowd out other types of cells in the bone marrow. This prevents the production of normal red blood cells (cells that carry oxygen to tissues), otherotherwhite blood cells (cells that fight infection), and platelets (the part of the blood needed for clotting).

Cancer in children can occur anywhere in the body, including the blood and lymph node system, brain and central nervous system (CNS), and kidneys. Most of the time, there is no known cause for childhood cancers. Childhood cancers may behave very differently from adult cancers, even when they start in the same part of the body.

Types of childhood cancer

Childhood cancer is a general term used to describe a range of cancer types and noncancerous tumors found in children. Childhood cancer may also be called pediatric cancer. Below are the most common types of cancer in children under 15 years old. For more information on each type, select a name below.

Cancer in teenagers and young adults

There is an increasing amount of research regarding cancer in children diagnosed after the age of 14. As these children are starting to enter young adulthood, they may have unique medical, social, and emotional needs that are different from younger children with cancer. They are part of a group often called adolescents and young adults (AYA).

Most often, teenagers and young adults with cancer should be treated at a pediatric oncology center or at a center where medical oncologists, which are doctors who treat cancer, and pediatric oncologists, which are doctors who treat children with cancer, work together to plan treatment. This will ensure that they receive the newest treatments and are cared for by a team of doctors who are familiar with these diseases. This is especially important for teenagers who have lymphoma, leukemia, or bone tumors, since treatment by specialists familiar with these diseases has been shown to improve survival.

Within the AYA group, there are also patients who have cancers most commonly found in adults, such as melanoma, testicular cancer, or ovarian cancer. Teenagers with these cancers may receive treatments that are similar to adults, but they also need to receive age-appropriate support for their social and emotional needs. In either the pediatric or adult care centers, age-appropriate information and support is very important for children and teens.

Below are the most common types of cancer in teenagers, ages 15 to 19. For more information on each type, select a name below.

Looking for More of an Overview?

If you would like additional introductory information, explore the following item on Cancer.Net:

  • ASCO Answers Fact Sheet: Read a one-page fact sheet (available as a PDF) that offers an easy-to-print introduction for several types of childhood cancer listed above.
  • Cancer.Net Patient Education Videos: View short videos led by an ASCO expert in childhood cancer and AYAs with cancer that provide basic information about treatment, areas of research, and survivorship. In addition, the Moving Forward series, in collaboration with The LIVESTRONG Foundation, provides perspectives from both doctors and survivors on topics that are often faced by young adults living with cancer.

Statistics adapted from the American Cancer Society's publication, Cancer Facts and Figures 2014.

To continue reading this guide, use the menu on the side of your screen to select another section.  

Childhood Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find information about how many children are diagnosed with cancer each year and some general survival information. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

In general, cancer in children and teenagers is uncommon, accounting for less than 1% of all cancer cases in the United States. This year, an estimated 10,450 children (younger than 15) and 5,330 adolescents aged 15 to 19 will be diagnosed with cancer in the United States.

Most children and teenagers diagnosed with cancer can be treated successfully. From 1975 to 2010, the number of deaths from childhood cancer has decreased steadily by more than 50%. However, cancer remains the second leading cause of death in this age group after accidents. It is estimated that 1,350 deaths from cancer will occur this year in children younger than 15 and 610 deaths from cancer in teens aged 15 to 19.

As explained in the Overview, there are several types of childhood cancer, and survival rates are different for each. The overall five-year survival rate is the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases. In general, the overall five-year survival rate for children and adolescents with cancer is 83%.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of children with cancer, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with a particular childhood cancer. Because the survival statistics are often measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's publication, Cancer Facts and Figures 2014.

To continue reading this guide, use the menu on the side of your screen to select another section.  

Childhood Cancer - Risk Factors and Prevention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do.

Doctors and researchers don’t know what causes most childhood cancers. A small percentage of cancers can be linked to the genetic disorder Down syndrome, other inherited genetic abnormalities, and previous radiation treatment. Environmental causes, such as exposure to infectious and toxic substances, are unlikely to cause childhood cancer.

To help doctors learn more about risk factors, the Childhood Cancer Research Network, coordinated by the Children's Oncology Group, is a North American childhood cancer registry. Once registered with the network, patients and families may be asked if doctors and researchers can contact them in the future to collect information for studies on genetic and environmental factors that may be connected to the development of childhood cancers.

Because specific causes have not been found for each individual type of childhood cancer, the way to prevent childhood cancer is still unknown.

To continue reading this guide, use the menu on the side of your screen to select another section.  

Childhood Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

Cancer can be hard to detect in children. Children with cancer may experience the following symptoms or signs. Sometimes, children with cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.

Many of the symptoms can be described using an acronym provided by The Pediatric Oncology Resource Center.

Continued, unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in the bones, joints, back, or legs
Lump or mass, especially in the abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash

Constant, frequent, or persistent infections
A whitish color behind the pupil
Nausea that persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes that occur suddenly and persist
Recurring or persistent fevers of unknown origin

If you are concerned about one or more of the symptoms or signs on this list, please talk with your child’s doctor. Your doctor will ask how long and how often your child has been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your child’s health care team about symptoms your child experiences, including any new symptoms or a change in symptoms.

The next section helps explain what tests and scans may be needed to learn more about the cause of the symptoms. Use the menu on the side of your screen to select Diagnosis, or you can select another section, to continue reading this guide.  

Childhood Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose cancer and find out if it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy or surgery to remove as much of the tumor as possible is the only way to make a definitive diagnosis. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread. This list describes options for diagnosing this type of cancer, and not all tests listed will be used for every person. Your child’s doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition
  • Type of cancer suspected
  • Signs and symptoms
  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose childhood cancer:

Blood tests. Routine blood tests measure the number of different types of cells in a person’s blood. Levels of certain cells that are too high or too low can indicate the presence of certain types of cancer.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but except for certain types of brain tumors, only a biopsy can make a definite diagnosis. The type of biopsy performed depends on the location of the cancer. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

Bone marrow aspiration and biopsy. These two procedures are similar and often done at the same time to examine the bone marrow. Bone marrow has both a solid and a liquid part. A bone marrow aspiration removes a sample of the fluid with a needle. A bone marrow biopsy is the removal of a small amount of solid tissue using a needle. The sample(s) are then analyzed by a pathologist. A common site for a bone marrow aspiration and biopsy is the pelvic bone, which is located in the lower back by the hip. The skin in that area is usually numbed with medication beforehand, and other types of anesthesia, which is medication to block the awareness of pain, may be used.

Lumbar puncture (spinal tap). A lumbar puncture is a procedure in which a doctor uses a needle to take a sample of cerebrospinal fluid (CSF) to look for cancer cells, blood, or tumor markers. Tumor markers are substances found in higher than normal amounts in the blood, urine, or body tissues of people with certain kinds of cancer. CSF is the fluid that flows around the brain and the spinal cord. Doctors generally give the child an anesthetic to numb the lower back before the procedure.

Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow. It is important to have this test done in a pediatric specialty center where they can be supervised by pediatric radiologists. These centers are aware of the potential risks of radiation exposure from a CT scan.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

Scans or radioisotope studies. In these procedures, a material (called a tracer) is injected into the body and then followed with a special camera or x-ray to see where the material goes. These studies can find abnormalities in the liver, brain, bones, kidneys, and other organs.

Many of these tests may be repeated during and after treatment to determine the effectiveness of the treatment.

In addition, review tips and guidance on how to prepare your child for medical procedures.

After diagnostic tests are done, your child’s doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor categorize or describe the cancer; this is called staging.

The next section helps explain the treatment options for this type of cancer. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.  

Childhood Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will learn about the different ways doctors use to treat children with cancer. To see other pages, use the menu on the side of your screen.

In general, cancer in children is uncommon, so it can be hard for doctors to determine the best treatment unless they know what has been most effective in other children. That’s why more than 60% of children younger than 15 years old with cancer are treated as part of a clinical trial. Clinical trials are research studies that compare standard treatments (the best proven treatments available) with newer approaches to treatments that may be more effective or test new treatments. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Studying new treatments involves careful monitoring using scientific methods, and all participants are followed closely to track their health and progress.

To take advantage of these newer treatments, all children with cancer should be treated at a specialized cancer center. Doctors at these centers have extensive experience in treating children with cancer and have access to the latest research. In many cases, a team of doctors works with a child and the family to provide care; this is called a multidisciplinary team.

Pediatric cancer centers often have extra support services for children and their families, such as child life specialists, nutritionists, physical and occupational therapists, social workers, counselors. Special activities and programs to help your child and family cope may also be available. As explained in the Overview, however, there are times when a teenager with cancer may need to be treated at an adult cancer center.

Descriptions of the most common treatment options for childhood cancer are listed below. The treatment of childhood cancer depends on several factors, including the type and stage of cancer, possible side effects, the family’s preferences, and the child’s overall health. Your child’s care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your child’s treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what to expect while receiving the treatment. The following are general descriptions of treatments that may be used as part of a child’s treatment plan. Learn more about treatments used for specific types of cancer and making treatment decisions.

Surgery

Surgery is the removal of the tumor, either cancerous or noncancerous, and surrounding tissue during an operation. Many children with a tumor will need surgery at some point during their treatment. A surgical oncologist is a doctor who specializes in treating a tumor using surgery. The goal of surgery is to remove the entire tumor and the margin (tissue around the tumor), leaving a negative margin (no cancer in the healthy tissue). For most childhood tumors, there is microscopic tumor left after surgery, and then doctors will recommend chemotherapy, radiation therapy, or other treatments.

Side effects of surgery depend on the location and type of the tumor and whether it has metastasized. Learn more about cancer surgery.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a pediatric oncologist, a doctor who specializes in treating children with cancer.

Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein, muscle, spinal fluid or under the skin using a needle, or in a pill or capsule that is swallowed (orally). A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, increased risk of infection, increased risk of bleeding, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your child’s doctor is often the best way to learn about the medications prescribed for your child, their purpose, and their potential side effects or interactions with other medications. Learn more about your child’s prescriptions by using searchable drug databases.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles such as photons to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen usually consists of a specific number of treatments given over a set period of time.

Side effects from radiation therapy may include fatigue, mild skin reactions, nausea, and loose bowel movements, depending on the part of the body that is receiving radiation. Most side effects go away soon after treatment is finished. Learn more about radiation therapy.

Immunotherapy

Immunotherapy, also called biologic therapy, is designed to boost the body’s natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Examples of immunotherapy include cancer vaccines, monoclonal antibodies, and interferons. Learn more about immunotherapy.

Stem cell transplantation/bone marrow transplantation

A stem cell transplant is a medical procedure in which bone marrow that contains cancer is replaced by highly specialized cells, called hematopoietic stem cells, that develop into healthy bone marrow. Hematopoietic stem cells are blood-forming cells found both in the bloodstream and in the bone marrow. Today, this procedure is more commonly called a stem cell transplant, rather than bone marrow transplant, because it is the stem cells in the blood that are typically being transplanted, not the actual bone marrow tissue.

Before recommending transplantation, doctors will talk with the patient and family about the risks of this treatment and consider several other factors, such as the type of cancer, results of any previous treatment, and patient’s age and general health.

There are two types of stem cell transplantation depending on the source of the replacement blood stem cells: allogeneic (ALLO) and autologous (AUTO). ALLO uses donated stem cells, while AUTO uses the patient’s own stem cells. In both types, the goal is to destroy all of the cancer cells in the marrow, blood, and other parts of the body using high doses of chemotherapy and/or radiation therapy and then allow replacement blood stem cells to create healthy bone marrow.

Learn more about stem cell and bone marrow transplantation.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care can help a person at any stage of illness. People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, and other therapies. Your child may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, and radiation therapy. Talk with your child’s doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your child’s health care team about the possible side effects of the specific treatment plan and supportive care options. And during and after treatment, be sure to tell your child’s doctor or another health care team member if your child is experiencing a problem so it is addressed as quickly as possible. Learn more about palliative care.   

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called “no evidence of disease” or NED. 

A remission can be temporary or permanent. This uncertainty makes many patients and families worried or anxious that the cancer will come back. While many remissions are permanent, it’s important to talk with your child’s doctor about the possibility of the cancer returning. Understanding the risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence

If the cancer does return after the original treatment, it is called recurrent disease. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place in the body (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence, including whether the cancer’s stage has changed. After testing is done, your child’s doctor will talk with you about treatment options. Often the treatment plan will include the therapies described above such as surgery, chemotherapy, and radiation therapy but they may be used in a different combination or given on a different schedule. Your child’s doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer.

When cancer recurs, patients and their families often experience emotions such as disbelief or fear. Families are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Although treatment is successful for most children with cancer, sometimes it is not. If a child’s cancer cannot be cured or controlled, this is called advanced, terminal, or refractory cancer. This diagnosis is stressful, and it may be difficult to discuss. However, it is important to have open and honest conversations with your child’s doctor and health care team to express your family’s feelings, preferences, and concerns. The health care team is there to help, and many treatment centers have a palliative care service, with nurses and doctors who have special skills, experience, and knowledge to support patients and their families during this time.

Parents or guardians are encouraged to think about where the child would be most comfortable: at home, in a home-like setting elsewhere, in the hospital, or in a hospice environment. Hospice care is a type of palliative care for people who are expected to live less than six months. It is designed to provide the best possible quality of life for people who are near the end of life. Nursing care and special equipment can make staying at home a workable alternative for many families. Some children may be happier if they can attend school part-time or keep up other activities and social connections for as long as possible. The child’s health care team can help parents or guardians decide on an appropriate level of activity. Making sure a child is physically comfortable and free from pain is an extremely important part of end-of-life care. Learn more about caring for a terminally ill child and advanced cancer care planning.

The death of a child is an enormous tragedy, and families may need support to help them cope with the loss. Pediatric cancer centers often have professional staff and support groups to help with the process of grieving. Learn more on grieving the loss of a child.

The next section helps explain clinical trials, which are research studies. Use the menu on the side of your screen to select About Clinical Trials, or you can select another section, to continue reading this guide.  

Childhood Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

Doctors and scientists are always looking for better ways to treat children with cancer. To make scientific advances, doctors develop research studies involving volunteers, called clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current or standard treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

Children who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment. Talk with your child’s doctor about clinical trials regarding side effects.

Parents and children decide to participate in clinical trials for many reasons. For some children, a clinical trial is the best treatment option available. Because standard treatments are not perfect, parents and children are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other parents/children volunteer for clinical trials because they know that these studies are the only way to make progress in treating childhood cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future children with cancer.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or “sugar pill.” The use of placebos in cancer clinical trials is rare. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

To join a clinical trial, parents and children must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each parent/child in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

For specific topics being studied for childhood cancer, learn more in the Latest Research section or in the individual cancer type section.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that parents of patients participating in a clinical trial talk with their child’s doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

The next section helps explain the areas of research going on today about this type of cancer. Use the menu on the side of your screen to select Latest Research, or you can select another section, to continue reading this guide.  

Childhood Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of cancer and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about childhood cancer, ways to prevent it, how to best treat it, and how to provide the best care to children diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your child’s doctor about the diagnostic and treatment options best for your child.

Advances in treatment and follow-up care. The Children’s Oncology Group conducts large clinical trials for most types of pediatric cancer. It also conducts studies on quality of life and late effects of cancer after successful treatment. The Childhood Cancer Survivor Study conducts long-term, follow-up studies of people who were treated many years ago to determine the late effects of childhood cancer and its treatment, so new treatments can be developed to avoid serious side effects. Other groups, including the Pediatric Brain Tumor Consortium and the New Approaches to Neuroblastoma Therapy Consortium, perform studies of new drugs for specific types of cancer.

Reducing a child’s exposure to radiation. Because children have an increased risk of developmental damage and second cancers from radiation therapy, doctors prefer to use radiation therapy less often whenever possible. In place of radiation therapy, doctors may use chemotherapy with a combination of drugs after surgery or use new drug combinations. Researchers are also investigating new techniques such as proton therapy that more precisely focus radiation treatment at the tumor and not the surrounding healthy tissue.

Supportive care. Clinical trials are underway to find better ways of reducing other symptoms and side effects of current childhood cancer treatments in order to improve patients’ comfort and quality of life. For example, drugs called filgrastim (Neupogen) and pegfilgrastim (Neulasta) may help patients produce more white blood cells after radiation treatment and chemotherapy. Doctors are also studying chemoprotective drugs that may help protect the body from the harmful effects of chemotherapy, especially mucositis (mouth sores). Additionally, this area of research includes studies in cardioprotection (protecting the heart and cardiovascular system from chemotherapy) and otoprotection (protecting against damage to the ear).

Looking for More About Latest Research?

If you would like additional information about the latest areas of research regarding childhood cancer, explore these related items that take you outside of this guide:

The next section addresses how to cope with the symptoms of the disease or the side effects of its treatment. Use the menu on the side of your screen to select Coping with Side Effects, or you can select another section, to continue reading this guide.  

Childhood Cancer - Coping With Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of cancer, but it may help to know that preventing and controlling side effects is a major focus of your child’s health care team. This is called palliative or supportive care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

Common side effects from each treatment option for childhood cancer are described in detail within the Treatment Options section. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the cancer’s stage, the length and dosage of treatment(s), and your child’s overall health.

Before treatment begins, talk with your child’s doctor about possible side effects of each type of treatment your child will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them. And, ask about the level of caregiving your child may need during treatment and recovery, as family members and friends often play an important role in the care of a child with cancer. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your child’s cancer care.

During and after treatment, be sure to tell the health care team about the side effects your child experiences, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect. Treatment of both types of effects is an important part of survivorship care. Learn more by reading the After Treatment section or talking with your child’s doctor.

The next section helps explain medical tests and check-ups needed after finishing cancer treatment. Use the menu on the side of your screen to select After Treatment, or you can select another section, to continue reading this guide.  

Childhood Cancer - After Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will read about your child’s medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for cancer ends, talk with your child’s doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your child’s recovery for the coming months and years. All children treated for cancer should have life-long, follow-up care.

Many of the current treatments that are effective in curing childhood cancer are associated with short-term and long-term side effects, including cognitive (thought-process) and developmental side effects. These side effects can appear or change as a child grows older. As most children with cancer are cured, the schedule of follow-up care is based on specific treatments given, such as the dosage and specific drugs used and/or the dosage of radiation therapy. Recommendations for follow-up care according to the risk of possible late effects of treatment have been developed by the Children’s Oncology Group and can be found at www.survivorshipguidelines.org.

Based on the type of treatment your child received, the doctor will determine what examinations and tests are needed to check for long-term side effects and the possibility of secondary cancers. Your child’s doctor can recommend the necessary screening tests. Follow-up care should also address your child’s quality of life, including any developmental or emotional concerns. Learn more about childhood cancer survivorship.

The child’s family is encouraged to organize and keep a record of the child’s medical information. That way, as the child enters adulthood, he or she has a clear, written history of the diagnosis, the treatment given, and the doctor’s recommendations about the schedule for follow-up care. The doctor’s office can help you create this. This information will be valuable to doctors who care for your child during his or her lifetime. ASCO offers cancer treatment summary forms to help keep track of the cancer treatment your child received and develop a survivorship care plan once treatment is completed.

Children who have had cancer can also enhance the quality of their future by following established guidelines for good health into and through adulthood, including not smoking, maintaining a healthy weight, eating a balanced diet, and participating in regular physical activity. Talk with the doctor about developing a plan that is best for your child’s needs. Learn more about the next steps to take in survivorship.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.  

Childhood Cancer - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find some questions to ask your child’s doctor or other members of the health care team, to help you better understand your child’s diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your child’s health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your child’s care. 

  • What type of cancer has been diagnosed?
  • What stage is the cancer? What does this mean?
  • Can you explain my child’s pathology report (laboratory test results) to me?
  • What treatment options are available?
  • What clinical trials are open to my child? Where are they located, and how do I find out more about them?
  • What treatment plan do you recommend? Why?
  • What is the goal of each treatment? Is it to eliminate the cancer, help my child feel better, or both?
  • Will this treatment take place at a pediatric cancer center? Why or why not?
  • Who will be part of my child’s health care team, and what does each member do?
  • Who will be coordinating my child’s overall treatment and follow-up care?
  • How much experience does my child’s health care team have in treating this specific type of childhood cancer?
  • What are the possible side effects of this treatment, both in the short term and the long term?
  • How will this treatment affect my child’s daily life? Will he or she be able to go to school and perform his or her usual activities?
  • Could this treatment affect my child’s ability to become pregnant or have children? If so, should my family talk with a fertility specialist before cancer treatment begins?
  • If I’m worried about managing the costs related to my child’s cancer care, who can help me with these concerns?
  • What are the chances that the cancer will recur?
  • What follow-up tests will my child need, and how often will he or she need them?
  • What support services are available to my child? To my family?
  • Whom should we call for questions or problems?

The next section offers some more resources that may be helpful to you. Use the menu on the side of your screen to select Additional Resources, or you can select another section, to continue reading this guide.  

Childhood Cancer - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 03/2014

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Childhood Cancer. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the child and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond. Here are a few sections that may get you started in exploring the rest of Cancer.Net:

- Search for a cancer specialist in your local area using this free database of doctors from the American Society of Clinical Oncology.

Review dictionary articles to help understand medical phrases and terms used in cancer care and treatment

- Read more about the first steps to take when your child is newly diagnosed with cancer.

- Find out more about clinical trials as a treatment option.

Learn more about coping with the emotions that cancer can bring, including those within a family or a relationship.

Find a national, not-for-profit advocacy organization that may offer additional information, services, and support for children and teens with cancer.

- Explore next steps a person can take after active treatment is complete.

This is the end of Cancer.Net’s Guide to Childhood Cancer. Use the menu on the side of your screen to select another section, to continue reading this guide.