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Overview of Pediatric Cancer

By

Renee Gresh

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

Last full review/revision Jun 2021| Content last modified Jun 2021
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Overall, childhood cancer is relatively rare. In 2021 in the US, an estimated 10,500 children aged 0 to 14 years will be diagnosed with cancer and slightly over 1100 children will die of it. An estimated 5090 adolescents will be diagnosed with cancer and about 590 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 (1 General references Overall, childhood cancer is relatively rare. In 2021 in the US, an estimated 10,500 children aged 0 to 14 years will be diagnosed with cancer and slightly over 1100 children will die of it... read more ).

In the US in 2015, it was estimated that there were 429,000 adult survivors of childhood cancer (ie, first diagnosed before age 20; 2 General references Overall, childhood cancer is relatively rare. In 2021 in the US, an estimated 10,500 children aged 0 to 14 years will be diagnosed with cancer and slightly over 1100 children will die of it... read more ). Children who survive cancer have more years than adults to develop long-term consequences of chemotherapy, surgery, and radiation therapy, which include

  • Infertility

  • Poor growth

  • Cardiac damage

  • Development of second cancers (in 3 to 12% of survivors, varying with their initial cancer and type of treatment)

  • Psychosocial effects

  • Developmental and/or neurologic deficits

Consensus guidelines on screening for and management of long-term consequences are available from the Children's Oncology Group.

Because of the severe consequences and complexity of treatment, children with cancer are best treated in centers with expertise in childhood cancers.

Treatment of childhood cancer depends on the type of cancer, stage Staging A diagnosis of cancer may be suspected based on history and physical examination but requires confirmation by biopsy and histopathologic examination. Sometimes the first indication is an abnormal... read more , and/or risk classification. Common treatments include chemotherapy Chemotherapy Systemic cancer therapy includes chemotherapy (ie, conventional or cytotoxic chemotherapy), hormone therapy, targeted therapy, and immune therapy (see also Overview of Cancer Therapy). The number... read more , surgery Surgery for Cancer Surgery is the oldest effective cancer therapy. It can be used alone or in combination with other modalities (see also Overview of Cancer Therapy). The size, type, and location of the cancer... read more , radiation therapy Radiation Therapy for Cancer Radiation therapy can cure many cancers (see also Overview of Cancer Therapy), particularly those that are localized or that can be completely encompassed within a radiation field. Radiation... read more , and stem cell transplantation Hematopoietic Stem Cell Transplantation Hematopoietic stem cell (HSC) transplantation is a rapidly evolving technique that offers a potential cure for hematologic cancers (leukemias, lymphomas, myeloma) and other hematologic disorders... read more . Immunotherapy Immunotherapy of Cancer A number of immunologic interventions, both passive and active, can be directed against tumor cells. (See also Immunotherapeutics.) In passive cellular immunotherapy, specific effector cells... read more is a newer type of treatment that helps the person's own immune system attack the cancer and may be helpful for certain childhood cancers. Different types of immunotherapy include monoclonal antibodies, oncolytic virus therapy, cancer vaccines Active Specific Immunotherapy A number of immunologic interventions, both passive and active, can be directed against tumor cells. (See also Immunotherapeutics.) In passive cellular immunotherapy, specific effector cells... read more , chimeric antigen receptor T-cell therapy Passive Cellular Immunotherapy A number of immunologic interventions, both passive and active, can be directed against tumor cells. (See also Immunotherapeutics.) In passive cellular immunotherapy, specific effector cells... read more (CAR T therapy), and bispecific T-cell engagers. The U.S. Food and Drug Administration (FDA) has recently approved the use of CD19 CAR T therapy for pediatric pre-B cell acute lymphoblastic leukemia.

Children who are newly diagnosed with cancer should be evaluated for a cancer predisposition syndrome (a genetic mutation that increases the chances of developing cancer at an earlier age compared to the risk for the general population) by a pediatric genetics team.

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 given the need for frequent hospitalizations and outpatient visits and potentially painful procedures. 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. The situation is even more difficult when the child is being treated at a specialty center far from home.

General references

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.

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