Childhood Cancers

Childhood cancer is a painful diagnosis for any family. While still relatively uncommon in comparison to cancer in adults, it is still one of the top causes of death in children globally. With advances in medicine, the prognosis for pediatric cancer has improved substantially, but the process is still difficult for affected children and families.

This blog delves into childhood cancers, causes, symptoms, diagnosis, treatment, prevention, complications, prognosis, and research while offering support resources for families taking this challenging journey.

Childhood cancers are malignancies that occur in children under the age of 15 years. Childhood cancers tend to occur due to genetic mutations and developmental issues, unlike adult cancers, which are often caused by environmental and lifestyle factors. The most common types include:

• Leukemia (blood cancer, e.g., acute lymphoblastic leukemia (ALL), acute myeloid leukemia (AML)
• Brain and central nervous system (CNS) tumors (e.g., medulloblastoma, gliomas)
• Neuroblastoma (arising from nerve tissue, commonly in infants)
• Wilms tumor (kidney cancer in young children)
• Lymphomas (Hodgkin and non-Hodgkin lymphoma affecting the lymphatic system)
• Rhabdomyosarcoma (muscle tissue cancer)
• Osteosarcoma and Ewing sarcoma (bone cancers)
• Retinoblastoma (eye cancer in young children)

Despite the challenging nature of childhood cancer, technological and medical advancements in diagnosis, treatment, and support care have significantly increased survival rates and improved the quality of life. Increasing awareness, research funding, and providing support to affected families are imperative in the war against childhood cancers. By promoting education and advocating for high-quality healthcare resources, we can guarantee that every child has an equal opportunity to combat cancer.

The exact causes of childhood cancers remain largely unknown, but several factors contribute to their development:

• Genetic mutations: Spontaneous mutations in DNA that lead to uncontrolled cell growth.
• Inherited genetic conditions: Syndromes such as Li-Fraumeni syndrome and Down syndrome increase cancer risk.
• Environmental factors: Though less common than in adults, exposure to radiation or chemicals during pregnancy may contribute.
• Weakened immune system: Conditions like HIV or immunosuppressive treatments may predispose children to cancer.

Symptoms vary depending on the type of cancer but commonly include:

• Unexplained fever or frequent infections
• Unexplained weight loss
• Persistent fatigue and weakness
• Lumps or swelling (especially in the abdomen, neck, or limbs)
• Paleness and easy bruising or bleeding
• Headaches and vision problems (for brain tumors)
• Bone or joint pain
• Difficulty walking or loss of motor skills
• Night sweats
• Persistent cough or difficulty breathing

Early diagnosis is crucial for effective treatment. The diagnostic process includes:

1. Medical history and physical examination
2. Blood tests: To detect abnormal blood cell counts.
3. Imaging tests: X-rays, MRI, CT scans, ultrasound, and PET scans to identify tumors.
4. Bone marrow aspiration and biopsy: To confirm blood cancers.
5. Lumbar puncture: To check for cancer in the spinal fluid.
6. Genetic testing: Identifying mutations that could influence treatment.

Treatment varies depending on cancer type and stage but generally involves:

• Chemotherapy: The most common treatment, using drugs to kill cancer cells.
• Radiation therapy: Targeted radiation to shrink or destroy tumors.
• Surgery: Removing tumors when possible.
• Immunotherapy: Boosting the immune system to fight cancer.
• Targeted therapy: Drugs that target specific cancer-causing molecules.
• Bone marrow/stem cell transplantation: Used in leukemias and lymphomas.
• Palliative care: Managing symptoms and improving quality of life.

Since the causes of childhood cancers are largely unknown, prevention is challenging. However, some measures may reduce risk:

• Avoiding radiation exposure during pregnancy.
• Maintaining a healthy lifestyle during pregnancy.
• Genetic counseling for families with a history of inherited cancer syndromes.
• Reducing environmental toxins (e.g., secondhand smoke, pesticides, industrial chemicals).

Prognosis depends on the type and stage of cancer, early detection, and response to treatment. Advances in treatment have significantly improved survival rates:

• Leukemia: 80-90% survival rate for ALL
• Brain tumors: 60-80% survival, depending on type
• Wilms tumor: Over 90% survival
• Lymphomas: 85-95% survival

Children with cancer require not only medical care but also emotional and psychological support. Families should:

• Stay informed about the condition and treatment options.
• Seek support groups for emotional strength.
• Encourage normalcy by allowing the child to engage in school and social activities.
• Ensure long-term follow-up care to monitor late effects of treatment.

Significant strides have been made in childhood cancer research:

• CAR-T cell therapy: A promising immunotherapy for leukemia.
• Personalized medicine: Tailoring treatments based on genetic profiling.
• New targeted drugs: Less toxic than chemotherapy.
• Proton therapy: More precise radiation with fewer side effects.
• Liquid biopsy: Non-invasive blood tests for early detection.

Numerous organizations offer support to children and families affected by cancer:

• American Childhood Cancer Organization (ACCO)
• St. Jude Children’s Research Hospital
• Make-A-Wish Foundation
• National Cancer Institute (NCI) Pediatric Oncology Branch
• Local hospitals and support groups