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?
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
Written by Ruixuan Jiang, UIC PharmD Candidates 2015
