You will face many hard decisions if your child has been diagnosed with cancer. Including several questions like where should you go for treatment? What are the available treatment options? How to maintain your child's quality of life? We have tried to describe the common pediatric or childhood cancers and the available treatment options, which will help you decide.
What Are the Common Pediatric (Childhood) Cancers?
Childhood cancers are rare, and advances in treatment have improved survival rates drastically. Still, pediatric cancer remains the second leading cause of death in children (between 1 and 14 years of age). Here are some of the major pediatric cancer types:
- Pediatric Liver Tumors - Hepatoblastoma (in younger children) and hepatocellular carcinoma (in older children) are the two most common malignant liver tumors seen in children. Other rare malignant liver tumors include angiosarcoma, biliary rhabdomyosarcoma, rhabdoid tumor, and undifferentiated sarcoma. The common benign liver tumors in children are mesenchymal hamartoma, infantile hemangioma, and focal nodular hyperplasia. Teratoma, a rare benign tumor, is also seen in infants. The complex nature of liver tumors in children makes them challenging to treat.
- Pediatric Leukemia - Leukemia is the commonest type of cancer found in children, and it accounts for almost 30 % of all childhood cancers. Mostly, children between 2 and 10 years are diagnosed with leukemia. This cancer develops from the tissues that produce blood cells. Thanks to recent advances, about 90 % of pediatric leukemia can be cured.
- Pediatric Lymphoma - When lymphocytes, the white blood cells in the immune system, multiply uncontrollably, they result in lymphoma. Lymphomas are more common in adults but still are the third most common type of cancer seen in children. The first two being leukemia and brain tumors. The good news is, around 90 % of children with lymphoma (Hodgkin lymphoma and non-Hodgkin lymphoma) lead a cancer-free life after treatment.
- Pediatric Brain Tumors - Abnormal growth of cells in the brain or spinal cord, which accounts for almost 20 % of all pediatric cancers, forms the brain and spinal cord tumors (also known as central nervous system or CNS tumors). Brain tumors in children can be benign or malignant.
Pediatric Sarcomas - These cancers can develop in any of the supporting structures of the body, like the bones, muscles, and connective tissues. They commonly occur in children, teens, and young adults and can be very challenging to treat. The common pediatric sarcomas are:
- Desmoplastic Small Round Cell Tumors (DSRCT) - Desmoplastic small round cell tumors (DSRCTs), also called small blue round cell tumors, develop in the pelvis or belly. They are commonly diagnosed in young men (10 and 30 years of age).
- Ewing Sarcoma - It is a rare type of cancer that affects bones in children and teenagers. The bones that are commonly affected are ribs, pelvic bone, upper arm bones, and thighbone. This tumor was named after an MSK pathologist, James Ewing, in 1921.
- Rhabdomyosarcoma - Rhabdomyosarcoma or RMS is a rare cancer that forms in skeletal muscle tissue or hollow organs. It can occur at any age, but it is most often seen in children.
- Osteosarcoma - It is a type of cancer that originates in the cells that form bones and commonly affects the long bones of the legs and arms. Rarely it occurs in soft tissue present outside the bones.
- Pediatric Neuroblastomas - It is rare cancer that develops in the sympathetic nervous system, a part of the peripheral nervous system. As sympathetic nervous system cells are concentrated in the adrenal glands (a gland present above the kidneys), neuroblastomas are often seen there. Neuroblastoma can also develop in babies' premature nerve cells, so it is most commonly seen in infants.
- Pediatric Retinoblastoma - This is the most common type of cancer affecting the eyes in children. Most children with retinoblastoma survive and lead healthy lives. This cancer occurs most often in children younger than five. Retinoblastoma can occur in one eye (unilateral retinoblastoma) or both eyes (bilateral retinoblastoma).
- Pediatric Kidney Tumors and Wilms' Tumor - Wilms' tumor, renal cell carcinoma, rhabdoid tumor, renal medullary carcinoma, congenital mesoblastic nephroma, and clear cell sarcoma of the kidney are some of the common types of kidney tumors seen in young adults and infants. Amongst these, Wilms' tumor, otherwise called nephroblastoma, is the most common. This tumor is diagnosed more commonly in children between 2 and 5 years of age.
Pediatric Blood Disorders - Apart from blood cancers, various other noncancerous blood disorders can affect children. Examples include:
- Inherited and acquired bone marrow failure syndromes like Fanconi anemia, paroxysmal nocturnal hemoglobinuria, and acquired aplastic anemia.
- Inherited hemoglobin disorders like beta-thalassemia and sickle cell disease.
- Primary immune deficiencies and white blood cell disorders.
- Autoimmune blood cell disorders.
- Inherited metabolic disorders.
- Pediatric Histiocytosis -It is a group of diseases that cause higher levels of histiocytes, a type of immune cell. Langerhans cell histiocytosis (LCH), a rare blood cancer, is the most common type of histiocytosis in children.
What Are the Treatment Options for Pediatric Cancers?
For children, diagnosis and treatment for cancer at MSK involves a team of experts in radiology, pathology, surgery, chemotherapy, radiation therapy, and symptom management. Only a specially-trained multidisciplinary team of pediatric oncology physicians and specialists can properly treat such cancers. This approach at MSK ensures that your child receives the treatment, supportive care, and rehabilitation therapies that will give them the best chance at both survival and a better quality of life.
The following are the treatment options for pediatric cancers:
- Bone marrow transplantation and cellular therapies.
- Pediatric surgery
- Pediatric radiation therapy
- Pediatric chemotherapy.
The most advanced treatment option - chimeric antigen receptor (CAR) T cell therapy is also available at MSK. CAR T is often used to treat children suffering from recurrent or persistent B-cell acute lymphoblastic leukemia (ALL). Your child can also benefit from the thousands of clinical trials ongoing at MSK that explore new therapies.