Tammy Darling
While no parent wants to hear that their child has been diagnosed with cancer, parents today can take comfort in the fact that survival rates for childhood cancer have risen sharply over the past 20 years. Even though childhood cancer is relatively rare, just one child affected by it is one too many. But knowledge is not only power, it's also comforting.
Children can get cancer in the same parts of the body as adults do, but some types of cancer are more common in children. The most common form of childhood cancer is leukemia. Leukemia is cancer of the blood. It develops in the bone marrow.
Other cancers often found in children are brain tumors, childhood lymphomas, Hodgkin's disease, Wilms' tumors, neuroblastomas, osteogenic sarcomas, Ewing's sarcomas, retinoblastomas, rhabdomyosarcomas, and hepatoblastomas.
Children's cancers do not always act like, get treated like, or respond like adult cancers. Therefore, avoid reading about adult cancer to learn about your child's prognosis. Childhood cancers can occur suddenly, without early symptoms, and have a high rate of cure.
According to the National Cancer Institute (NCI), more than 75% of children with cancer are now alive five years after diagnosis, compared with about 60% in the mid-1970s. Much of this dramatic improvement is due to the development of better therapies at children's cancer centers, where the majority of children with cancer have their treatment.
After a child's cancer has been diagnosed, a series of tests will be done to help identify the specific type of cancer. Called staging, these tests are sometimes done during diagnosis. Staging determines how much cancer is in the body and where it is located. Staging must be done to determine the best treatment. Many different tests can be used in staging, such as x-rays, MRIs, CT (or CAT) scans, and others.
The doctor will explain treatment options to you - their benefits, risks, and side effects. Each child with cancer has a treatment plan that is chosen just for that child. Even children with the same type of cancer may receive different treatments. Depending on how your child responds to treatment, the doctor may decide to change the treatment plan or choose another plan.
Types of treatment used most often are surgery, chemotherapy, radiation therapy, immunotherapy, and bone marrow or peripheral blood stem cell transplantation. Doctors use these treatments to destroy cancer cells. Depending on the type of cancer, the child may have one kind of treatment or a combination of treatments. Most children receive a number of treatments, called combination therapy.
All cancer treatments have side effects, which often include nausea, hair loss, and diarrhea. Side effects occur because the cancer treatment that kills cancer cells can hurt normal cells as well. The kinds of side effects and how severe they'll be depend on the kind of drug, the dosage, and the way your child's body reacts to it.
The doctor plans treatment so that the child has as few side effects as possible. Most side effects go away soon after treatment ends. Not every child gets every side effect and some children get few, if any. How serious the side effects are varies from child to child, even among children who are receiving the same treatment.
Depending on your child's age, you may be tempted to protect him by not telling him about the cancer, but children usually know when something is wrong - he may not be feeling well, may be seeing the doctor more often than normal, and may have already had some tests. Your child may also sense your fear.
Be open and honest with him, using age-appropriate terms and without going into too much detail, unless he asks for more information. Children are naturally curious and are bound to have some questions.
A child who is not told honestly about his illness may imagine things that are not true. For instance, he may think he has cancer as punishment for doing something wrong, in which case you can reassure him that not even the doctors know exactly what caused the cancer.
Health professionals generally agree that telling kids the truth leads to less stress and guilt. And children who know the truth are also more likely to cooperate with treatment.
Children under seven can be told that cancer is a contest between "good" cells and "bad" cells and that having treatment will help the good cells be stronger so that they can beat the bad cells. Older children can be given more details according to their age and specific questions. Explain that there are many different types of cancer and that even when two children have the same cancer, what happens to one child will not always happen to the other.
Because childhood cancer is rare, it's important to seek treatment in centers that specialize in the treatment of children with cancer. Specialized cancer programs follow established protocols (step-by-step guidelines for treatment). These protocols are carried out using a team approach.
In addition to the pediatric oncologists, other members of the health team usually include pediatric surgeons, specialist surgeons, radiation oncologists, pathologists, nurses, consulting pediatric specialists, psychiatrists, oncology social workers, nutritionists, and home health care professionals - all with expertise in treating children with cancer. Together, these health professionals offer comprehensive care.
Often the diagnosing doctor will recommend a comprehensive children's cancer center. Most children's cancer centers treat patients up to the age of 20. There centers participate in specially designed and monitored research studies that help develop more effective treatments and address issues of long-term childhood cancer survival.
For more information about childhood cancers, treatments, and centers, contact the National Cancer Institute at 1-800-4-CANCER (1-800-422-6237) or visit their Web site at www.nci.nih.gov. The NCI's Cancer Inforamtion Service (CIS) provides information about children's cancer centers that belong to the Children's Cancer Study Group and the Pediatrics Oncology Group. All of the cancer centers that participate in these Groups have met strict standards of excellence for childhood cancer care. You may also visit the American College of Surgeons Web site at www.facs.org or call 312-202-5000 to find an approved cancer program near you.
Most children's cancer centers treat patients up to the age of 20. These centers also participate in specially designed and monitored research studies that help develop more effective treatments and address issues of long-term childhood cancer survival.
Tammy Darling is a regular contributor to Pediatrics for Parents. She writes on health issues. Her articles have appeared in many publications.
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