Childhood Cancer: An Overview

Childhood cancer is a type of cancer that occurs in children (age 0 to age 14) and teenagers (age 15 to 19). They are rare but usually curable, types of which include leukemias, lymphomas, brain tumors and solid tumors. More than 80% of patients diagnosed with childhood cancer live after 5 years of diagnosis.

A Frightening Thought: "Could my child have cancer?"(Statistics and Extent)

• Every year, approximately 400,00 children and adolescents between 0-19 year old are diagnosed with childhood cancer
• The common types of childhood cancer include leukemias, brain tumors, lymphomas, solid tumors like neuroblastoma and Wilms tumor
• More than 80% children are cured in high income countries ,however, less than 30% percent are cured in low and middle income countries.
• Accessibility of cancer medication is a key factor in treatment which often determines if a patient will be successfully cured or not. 29% of low income countries do not have this privilege ,however, 96% of high income countries have access to this crucial healthcare.

Types of Childhood Cancer:

• Osteosarcoma and Ewing Sarcoma (Bone Cancer)
• Brain Cancers (and Brain Stem Tumors)
• DIPG (a type of Brain Stem cancer)
• Leukemia (Blood Cancer)

1. Acute Lymphoblastic Leukemia
2. Acute Myeloid Leukemia

• Hepatoblastoma (Liver Cancer)
• Lymphoma

1. Hodgkin Lymphoma (nodular sclerosis and mixed cellularity Hodgkin lymphoma)
2. Non-Hodgkin Lymphoma ( Burkitt lymphoma, diffuse large B-cell lymphoma, anaplastic large-cell lymphoma and lymphoblastic lymphoma

• Neuroblastoma (Nerve Cancer)
• Retinoblastoma (Eye Cancer)
• Rhabdoid Tumors
• Sarcomas (Soft Tissue Cancer)
• Spinal Cord Tumors
• Wilms Tumor (Kidney Tumors)
• Choroid plexus carcinoma
• Embryonal tumor
• Ganglioglioma
• Glioma
• Medulloblastoma
• Pineoblastoma

Location and Stages

Childhood cancers usually begin in the bone marrow, central nervous system or lymphatic system.

Stages

• Stage 1

When the cancer is localised in one place of the body

• Stage 2 or 3

The proliferation of cancer into different parts of the body

• Stage 4

The cancer has become very large and taken over major parts of the body

Warning Signs (Symptoms)

• Paining bones, joints and back- usually prone to fractures
• swelling, bumps and lumps
• Weight Loss-sudden and extreme
• Lethargy and tiredness
• Headaches
• Continued fever
• Blindness, sudden squints, swelling of eye ball, new/erratic white spots in the eye
• Transformation in speech, balance, walk, and size of head

Risk Factors

• Exposure to radiation
• Exposure to tobacco smoke
• Family cancer syndrome
• Down syndrome

Causes:

1) Genetics

In a few special cases, children are born with a mutation in the RB1 gene; they can either inherit the gene from of their parents or it is the result of a change occurring to this gene during the phase of early development in the mother’s womb. This makes them prone to developing retinoblastoma.

Wilms tumor have a possibility of being linked to genetics, however, the connection isn’t as clear with retinoblastoma.

Particular genetic and heredity conditions can make a child susceptible to growing brain tumors but this is uncommon.

2) Problems in development in the womb

Childhood cancers can also begin in the mother’s womb, like retinoblastoma and Wilms tumor. In special cases, cells don’t mature and remain immature cells. Usually, these cells mature as the child grows 3 or 4 years old but in the rare case that they don’t, they may grow a into a cancerous tumor.

3) Exposure to radiation and infections

Exposure to Epstein Barr virus, glandular fever and radon gas help in the proliferation of childhood cancer

4) Previous Cancer Treatment:

Former treatments of cancer using chemotherapy can make a person prone to developing cancer, which can grow as acute leukemia

Prevention

• Lifestyle adjustments
• Limiting unnecessary radiation exposure
• Genetic counselling
• routine checkups
• Maintaining healthy weight
• Avoiding alcohol
• Vaccination for HPV (Human papilloma virus)

Diagnosis and Tests

1. Blood Tests- To test irregularities or differences in blood cells
2. Imaging Tests- CT scans, , MRIs, PET scans, ultrasounds
3. Biopsy- Pathologists check fluids or tissues for cancerous cells
4. Bone Marrow Biopsy and Bone Marrow aspiration- examines a sample of bone marrow
5. Lumbar puncture- checks cerebrospinal fluid for cancerous cells or tumor markers
6. Genetic tests- examines genetic mutations connected with particular types of childhood cancers

Treatment

Chemotherapy

Chemotherapy is the most common treatment where drugs are used to kill cancer cells in cycles. These cycles include days for treatment and recovery.

Stem Cell Transplant

This treatment can be adopted if the child is diagnosed with leukemia or lymphoma. High dose chemotherapy is used to destroy cancer cells followed by the infusion of healthy blood forming cells provided by a donor.

Surgery

Surgery can be used to eliminate solid tumors completely, or it can also be used to supplement other treatment techniques.

Immunotherapy and Targeted Therapy

Immunotherapy helps a patient’s immune system to battle against cancer more effectively. Targeted therapy attacks cancerous cells by focusing on its weaknesses, especially the ones related to gene mutations.

Late Effects

• organs, tissues, and body functionality
• growth and development
• mood, feelings, actions and behavior
• thinking, learning, and memory
• social and psychological adjustment
• risk of second cancers

Outlook & Prognosis:

• Regular follow up care
• Good health habits
• diet, exercise, medical and dental checkups
• self care
• prevention of smoking, excessive alcohol use, illegal drug use
• ample sun protection measures

FAQs:

Are there days dedicated to spreading awareness about childhood cancer?

Ans) 15 February- International Childhood Cancer Day; September- Childhood Cancer Awareness Month

What does the gold ribbon symbolize?

Ans) The gold ribbon symbolizes all types of cancer affecting children and adults

When does childhood cancer occur?

Ans) They can occur anytime between birth and adolescence, with 35% being diagnosed before the child turns 5 years old

How common is childhood cancer?

Ans) Although the rates of survival are significantly improving, it is still the leading cause of death in kids over the age of 1 years old in places like the EU.

Are there any differences in the survival rates?

Ans) Unfortunately, there has been little to no development in the survival rates of childhood cancer.

Sources

1. Introduction: https://my.clevelandclinic.org/health/diseases/24960-childhood-cancer
2. Statistics and Extent:https://www.who.int/news-room/fact-sheets/detail/cancer-in-children
3. Types: https://my.clevelandclinic.org/health/diseases/24960-childhood-cancer https://www.acco.org/types-of-childhood-cancer/
4. Symptoms:https://choc.org.za/childhood-cancer-early-warning-signs/?gad_source=1&gad_campaignid=21150994242&gbraid=0AAAAAoQByx_xAqo4oxnrETQzcrsdWmSOy&gclid=Cj0KCQiAhaHMBhD2ARIsAPAU_D4_CDaxVDMqDA4UWu_xBPaUlszVAtRWpRHqzUQOs8TFJgxrIdgauN4aAlpKEALw_wcB
5. Risk Factors:https://www.cancer.org/cancer/childhood-cancer/causes-risk-factors-prevention.html
6. Causes: https://www.cancerresearchuk.org/about-cancer/childrens-cancer/risks-causes
7. Prevention:https://www.starhealth.in/health-info/preventing-childhood-cancers/ https://www.cancer.org/cancer/childhood-cancer/causes-risk-factors-prevention.html
8. Diagnosis and Treatment:https://my.clevelandclinic.org/health/diseases/24960-childhood-cancer
9. Late effects, outlook and prognosis:https://www.cancer.gov/types/childhood-cancers/late-effects-pdq
10. Location and Staging:https://khar.hindujahospital.com/blogs/childhood-cancer-types-symptoms-treatmenthttps://www.cclg.org.uk/about-cancer/my-child-and-cancer/my-child-has-cancer/diagnosis/staging
11. FAQs:https://siope.eu/shinegold-faq