UIC Pharmacy Blog

Information and tips for your health and wellness from UIC Pharmacy

Wednesday, September 10, 2014

Childhood Cancer

The late Robin Williams with a St. Jude Children’s Research Hospital (SJCRH) patient.1 St. Jude specializes in the research and treatment of childhood cancer and other catastrophic childhood diseases.2



What is cancer?

Our bodies are made up of many, many cells.3 All of these cells contain and are supervised by a substance called DNA. When there is damage in the DNA, the cells may not grow and divide as they were intended to.  The DNA damage can occur as the cell is dividing, be inherited (transmitted between parent(s) and child), or be induced by something occurring around us.  Sometimes, when these cells with DNA damage grow out of control and grow into other tissues abnormally, they can be classified as cancer cells.  These cancer cells can form a tumor or grow in the bloodstream.

How is cancer different between adults and children?

In adults, the DNA damage which leads to cancer may be linked to being exposed to something toxic in the environment around them or poor lifestyle habits, such as cigarette smoking or physical inactivity.3 Because these risk factors take a long time to build up, they are rarely associated with cancer in children.  The DNA damage which causes childhood cancer usually happens early in the child’s life and may have even occurred before birth.  The types of cancer which occur more frequently in children are also very different than the ones which are more common in adults.  The types of childhood cancer will be discussed in more detail in the next section.

What kinds of cancers occur in children?

The cancers which may occur in children are different than those which occur in adults.3 Some of the cancers which occur in children are listed below.

      Leukemias: cancers of the blood and bone marrow.  These are the most common childhood cancers
      Brain and other central nervous system tumors: second most common cancer type in children
      Neuroblastoma: forms in certain nerve cells
      Wilms tumor: forms on 1 or both kidneys in rare cases
      Lymphoma (Hodgkin and non-Hodgkin): begins in lymphocytes, a kind of cell found in the immune system
      Rhabdomyosarcoma: begins in certain muscle cells which are used to move the body
      Retinoblastoma: occurs in the eye
      Bone cancer (osteosarcoma and Ewing sarcoma): these are more common in older children and teenagers, but can occur at any age

How common is childhood cancer?

Although childhood cancer is rare, making up less than 1% of all cancer diagnoses, it is still the second leading cause of death in children.3 The American Cancer Society estimates that 10,450 children younger than 15 will be diagnosed with cancer in 2014.  Recently, the mortality rate for many childhood cancers has been cut in half, and over 80% of children with cancer will survive at least 5 years; these positive strides have been due to the latest advancements in the treatment of cancer.  The exact mortality and survival statistics vary by the type of cancer, and additional resources for more information can be found at the websites listed in a later section.

Prevention/screening

Because childhood cancer usually isn’t associated with risks that build over time (like smoking), it is difficult to prevent cancer in young children.3 Only very few factors (such as radiation) have been linked to an increase in childhood cancer risk, but radiation may even be unavoidable for a child who needs it to treat an existing cancer.

Checking children for cancer who do not otherwise have symptoms is referred to as cancer screening.3 Regular screening for cancer in all children is generally not done because it is so rare.  In rare instances, some children may be more likely to get certain cancers; doctors may recommend more frequent check-ups and/or regularly scheduled special tests for these children to check for the early signs of cancer. 

Cancer that develops in children may be hard to detect because the cancer’s physical features might be similar to ones that happen frequently in otherwise healthy children.3 Often, kids run into objects and get a bruise or bump, catch colds, or get stomach aches - but these might hide the early warning signs of cancer.  Some symptoms to watch out for are:
      Bruising easily
      Sudden eye or vision changes
      Weight loss that comes on suddenly and cannot be explained by other factors
      Continuous pain in one body part
      A swelling or lump that seems unusual
      Limping
      Unexplainable paleness and decrease in energy
      Unexplainable sickness/fever which doesn’t go away
      Frequent headaches which may come with vomiting
Depending on the type of cancer, other symptoms may be present.  It is important for parents and caretakers to be aware of unusual features that do not go away after a long period of time.

How do I deal with a diagnosis?

When a child is diagnosed with cancer, the lives of everyone involved in the child’s life and those who care about the child will change dramatically.4 They and the child who was just diagnosed may go through reactions such as shock, denial, fear, anxiety, guilt, depression, anger, and many other emotions.  These feelings are a normal part of the process, and there are ways to cope with the tough times.   Some important ways of coping with such a devastating diagnosis are: trusting the medical team treating the child and getting support from sources such as the community, place of worship and friends/extended family.  Family members should make sure to make time for themselves and express their emotions in healthy ways. 

For more information on coping, please see this website by the American Cancer Society:  http://www.cancer.org/acs/groups/cid/documents/webcontent/002592-pdf.pdf

How might your child’s cancer be treated?

There are a variety of ways to treat childhood cancer.3 The exact treatment will depend mostly on the type and severity of the cancer.  The severity of the cancer may also be referred to as the stage.  Frequently, a variety of treatment methods will be used to treat the cancer.  These methods include chemotherapy, surgery, radiation, and other treatments.  Mostly, treatments are effective against childhood cancers.  It is important for your child to receive care at a childhood cancer specialized center because these centers will have extensive experience treating such a rare condition.  There, the teams of professionals who will treat your child include professionals such as doctors, nurses, social workers, psychologists, chaplains, and pharmacists. 

There are both short-term and long-term consequences of the cancer and its treatment.3 A thorough discussion should occur between your family and the health-care team about these effects.  It is important to follow the directions of the health-care team and the follow-up schedule they suggest after finishing treatment.  As time goes on after the end of a successful treatment, the risk of the cancer happening again decreases, so the frequency of follow-up appointments may decrease. These appointments will still be highly important because some effects of treatment may not be seen until years after the end of treatment.  Some specific long-term effects which may occur are:
      Problems with the heart or lungs
      Slowed or delayed growth and development
      Learning issues
      Changes in sexual development and ability to have children
      Increased risk of other cancers later in life

How can I help or find out more information?
      http://www.stjude.org/

References:
1.     St. Jude mourns the loss of friend and supporter Robin Williams. St. Jude Children’s Research Hospital website. http://www.stjude.org/stjude/v/index.jsp?vgnextoid=b656abe3c96c7410VgnVCM100000290115acRCRD&vgnextchannel=fa1113c016118010VgnVCM1000000e2015acRCRD.  Accessed August 12, 2014.
2.     About St. Jude. St. Jude Children’s Research Hospital website. http://www.stjude.org/about.  Accessed August 12, 2014.
3.     Cancer in children. American Cancer Society website. http://www.cancer.org/acs/groups/cid/documents/webcontent/002287-pdf. Accessed August 6, 2014.

4.     Children diagnosed with cancer: dealing with the diagnosis. American Cancer Society website. http://www.cancer.org/acs/groups/cid/documents/webcontent/002592-pdf.pdf.  Accessed August 12, 2014.

Written by Ruixuan Jiang, UIC PharmD Candidates 2015

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