A cancer diagnosis is upsetting at any age, but especially for children and their families. When a child is diagnosed with cancer the entire family is affected.
The good news for these childhood cancer patients and their families is that many types of cancer that were once fatal now have cure rates exceeding 80% – which actually surpasses that of adult cancers – thanks to research and the development of new therapies.
Although childhood cancer is rare, more children age 1 – 19 years of age die from cancer every year than from heart disease, influenza and pneumonia, chronic respiratory disease, cerebrovascular disease, septicaemia and diabetes mellitus combined.
While rare, the incidence rate of childhood cancers has also risen slightly from 13 children per 100,000 in 1975 to over 17 children per 100,000 since 2007.
Thankfully, rates of survival have been improving for children diagnosed with the disease because of better treatments and follow-up care, especially in developed countries like the United States. It is estimated that mortality rates from cancer among children 14 years of age and younger have declined by 65% from 1970 to 2016 in the USA.
Overall, more than 80% of children with cancer survive 5 years or more, but the percentage can be much lower for specific cancer types. Research is essential in addressing this and in increasing survival rates among all types of childhood cancer, which is very different from adult cancer.
Leukaemias and lymphomas, both cancers of blood cells, as well as brain and other central nervous system tumours are the most common cancers diagnosed in children 14 years of age and younger.
What causes childhood cancer to develop is largely unknown, especially since environmental factors, which often play a role in the development of cancer in adults, is typically not a factor in children.
A mutation in a gene controlling cell growth is what contributes to the development of all cancers. However, the genetic alterations leading to cancer in children often differ from those in adults. The types of cancer that result call for different forms of treatment.
Most treatment of childhood cancers today involves standardised protocols – receiving the same treatment as another child with the same cancer elsewhere – often involving a combination of surgery, radiation, and chemotherapy, for which there are new and better drugs, and methods to help children deal with the side effects of treatment.
In 2017, the US FDA approved a type of immunotherapy called chimeric antigen receptor (CAR) T-cell therapy for patients up to the age of 25 whose B cell ALL has not responded well to other treatments or has returned.
The therapy – which genetically modifies part of a patient’s own immune system (antibody-producing cells called T cells) to fight the cancer – has shown success in terms of disease remission in patients who had little hope from other therapies for such an outcome. The success, combined with the more than 90% 5-year survival rate of children with ALL who respond to more traditional treatment such as chemotherapy, has helped statistically boost the overall 5-year survival rate for childhood cancer.
Unfortunately, while advanced treatments today result in more than 80% of children surviving their cancers, these very survivors are at a lifelong risk for health problems — called late effects — that can develop months or even years after their treatment.
As a result, they will require follow-up care and increased surveillance for the rest of their lives so that any complications that may result from their earlier treatment can be identified and treated.