Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Overview of Childhood Cancer

By

Renee Gresh

, DO, Nemours A.I. duPont Hospital for Children

Last full review/revision Jun 2021| Content last modified Jun 2021
CLICK HERE FOR THE PROFESSONAL VERSION

Cancer is rare among children. In 2021 in the United States, an estimated 10,500 children aged birth to 14 years will be diagnosed with cancer and slightly over 1,100 children will die of it. An estimated 5,100 adolescents aged 15 to 19 years will be diagnosed with cancer and about 600 will die of it. In comparison, an estimated 1.9 million adults will be diagnosed with cancer and about 608,000 will die of it. However, cancer is the 2nd leading cause of death among children, following only injuries.

Cancers that occur only in children are

In contrast to many adult cancers, cancers in children tend to be much more curable. Over 80% of children with cancer survive at least 5 years. In the United States, it is estimated that there are about 483,000 adult survivors of childhood cancer (that is, they are adults who were first diagnosed with cancer before 20 years of age).

Complications of cancer treatment

As in adults, doctors use a combination of treatments, including surgery Surgery for Cancer Surgery is a traditional form of cancer treatment. It is the most effective in eliminating most types of cancer before it has spread to lymph nodes or distant sites (metastasized). Surgery may... read more , chemotherapy Chemotherapy Chemotherapy involves the use of drugs to destroy cancer cells. Although an ideal drug would destroy cancer cells without harming normal cells, most drugs are not that selective. Instead, drugs... read more , and radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle (linear) accelerator. Radiation preferentially... read more . Immunotherapy Immunotherapy for Cancer Immunotherapy is used to stimulate the body's immune system against cancer. These treatments target specific genetic characteristics of the tumor cells. The genetic characteristics of tumors... read more (a newer type of treatment that uses the immune system to attack the cancer) and targeted therapy (drugs that target specific parts of the cancer cells and destroy them) are being studied and are being used more often to treat cancer in children. However, because children are still growing, these treatments may have side effects that do not occur in adults. For example, in children, an arm or a leg treated with radiation may not grow to full size. If the brain is treated with radiation, intellectual development may not be normal. (See also Cancer Treatment Principles Cancer Treatment Principles Treating cancer is one of the most complex aspects of medical care. It involves a team that encompasses many types of doctors working together (for example, primary care doctors, gynecologists... read more .)

Children who survive cancer also have more years than adults to develop long-term consequences of chemotherapy, surgery, and radiation therapy, which include

  • Infertility

  • Poor growth

  • Damage to the heart

  • Development of second cancers (which occur in 3 to 12% of children who survive cancer)

  • Psychologic and social problems

  • Developmental or neurologic problems or both

Because such severe consequences are possible and treatment is complex, children with cancer are best treated in centers where experts have experience treating childhood cancers.

How often second cancers develop depends on what the first cancer was and on which chemotherapy drugs were used to treat the first cancer.

Care team for cancer treatment

The impact of being diagnosed with cancer and the intensity of the treatment are overwhelming to the child and family. Maintaining a sense of normalcy for the child is difficult, especially because the child may have to be hospitalized frequently and go to a doctor’s office or outpatient center for treatment of the cancer and its complications. Overwhelming stress is typical, as parents struggle to continue to work, be attentive to siblings, and still attend to the many needs of the child with cancer (see Chronic Health Problems in Children Chronic Health Problems in Children Severe illness, even if temporary, can provoke a great deal of anxiety for children and their families. Chronic health problems are those that last longer than 12 months and are severe enough... read more ). The situation is even more difficult when the child is being treated at a specialty center far from home.

Did You Know...

  • In 2021 in the United States, it is estimated that cancer will kill about 1,700 children and adolescents.

Children and parents need a pediatric treatment team to help manage this difficult situation. Pediatric doctors are doctors who specialize in the care and treatment of babies, children, and adolescents. The team should include the following:

  • Pediatric cancer specialists (pediatric oncologist and radiation oncologist)

  • Pediatric oncology nurse, a registered nurse who cares for and educates children who have cancer and their families

  • Other needed specialists, such as a pediatric surgeon with expertise removing or biopsying childhood cancers, a pediatric radiologist with expertise reviewing radiology (imaging) studies in children with cancer, and a pathologist with expertise diagnosing childhood cancers

  • The primary care doctor

  • Child life specialists, who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness, and disability

  • A social worker, who can provide emotional support and help with financial aspects of care

  • A teacher, who can work with the child, the school, and the health care team to make sure that the child’s education continues

  • A school liaison, who can also help the child and family interact with the teacher and school

  • A psychologist, who can help the child, siblings, and parents throughout treatment

Children who are newly diagnosed with cancer should be evaluated by a pediatric genetics team for genetic mutations that can predispose people to cancer.

Many treatment teams also include a parent advocate. A parent advocate is another parent who had a child with cancer and who can offer guidance to families.

More Information

The following is an English-language resource that may be useful. Please note that THE MANUAL is not responsible for the content of this resource.

  • American Cancer Society: If Your Child Is Diagnosed With Cancer: A resource for parents and loved ones of a child who has cancer that provides information about how to cope with some of the problems and questions that come up just after a child is diagnosed

NOTE: This is the Consumer Version. DOCTORS: CLICK HERE FOR THE PROFESSONAL VERSION
CLICK HERE FOR THE PROFESSONAL VERSION
Others also read
Test your knowledge
Separation Anxiety and Stranger Anxiety
An important part of normal development is an infant’s growing attachment to its parents. As this bond strengthens, the infant may express fear or anxiety when the parents leave. This “separation anxiety” typically begins at around 8 months of age and resolves at around 24 months of age. Which of the following is the normal and expected infant behavior in reaction to a parent leaving the room during the time period of separation anxiety?
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID

Also of Interest

Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
Download the Manuals App iOS ANDROID
TOP