Medical Conditions

Overview

Conditions: Childhood Cancer

Each year, 11,000 children and teenagers are diagnosed with cancer, yet the causes of most childhood cancers are unknown. One in every 330 Americans develop cancer by the age of 20. At the time of diagnosis, cancers in children are much more likely to be in advanced stages than for newly-diagnosed adults. The three most common types of childhood cancers are leukemias, brain/central nervous system cancers, and lymphomas. Following are brief descriptions of common childhood cancers. For additional information, please select from the topics shown on the right.

Leukemia. Leukemia is cancer of the cells of the bone marrow and blood. Leukemia is characterized by an excess of abnormal white blood cells, called blasts, that invade the marrow and crowd out the normal blood cells. This results in a low red blood cell count or anemia, a low platelet count or thrombocytopenia, a decrease in the number of normal white blood cells or leukopenia. Anemia causes tiredness, thrombocytopenia causes a bleeding tendency, and leukopenia causes susceptibility to infections. Often there is bone pain. The cancer cells spread through the blood invading other organs, including the lymph nodes, spleen, liver, causing them to enlarge or to not function properly. Leukemia can spread to the central nervous system (brain, spinal cord, and spinal fluid). There are two major types of childhood leukemia: acute lymphoid leukemia or ALL (also known as acute lymphoblastic leukemia), and acute myeloid leukemia or AML (also known as acute myeloblastic leukemia or acute non-lymphocytic leukemia or ANLL). ALL is the most common form of leukemia children.

Lymphomas. Lymphoma is cancer of the lymphatic system, the body’s circulatory network for filtering out impurities. Lymphoma is characterized by an excess of abnormal lymphoid cells (a type of white blood cell) that invade lymph nodes and other organs, causing them to enlarge or to not function properly. There are two main types of lymphoma: Hodgkin lymphoma or Hodgkin’s disease, and non-Hodgkin’s lymphoma or lymphocytic lymphoma. Non-Hodgkin lymphoma is the more common type of lymphoma in children. Non-Hodgkin lymphoma can arise in the lymph nodes or lymph glands, the neck, the chest, the abdomen, or the bones. The disease can spread to other lymph nodes, the central nervous system and the bone marrow. Hodgkin lymphoma usually arises in the lymph nodes of the neck or the chest, but can arise in any lymph node. Hodgkin lymphoma cells can spread to other lymph nodes, liver, spleen, bone marrow, and bones. Spread of lymphoma to the bone marrow can result in low blood counts as is seen in leukemia.

Central Nervous System Tumors. Tumors of the brain and spinal cord are the most common types of solid tumors in children. These tumors arise from nerve cells or from the cells in the tissue surrounding the nerve cells. The cells form a tumor mass that enlarges and interferes with the normal function of the brain or spinal cord. This can result in increased intracranial pressure, seizures, paralysis, headache, and other symptoms depending on the location of the tumor. In benign central nervous system tumors the cells do not spread beyond the site of origin. However, because of their location, benign tumors can cause significant problems. Malignant central nervous system tumors on the other hand are composed of cancerous or malignant cells, which have the capacity to spread to other sites within the brain, spinal cord, or spinal fluid, and sometimes even to organs outside the central nervous system, such as the bone marrow. These malignant tumors behave more aggressively.

Neuroblastoma. Neuroblastoma is a type of cancer that arises from embryonal (very primitive or undifferentiated) nerve cells located outside the central nervous system. Neuroblastoma can develop in the adrenal glands, which are hormone-producing organs located inside the abdomen on top of each kidney, or it can develop in the sympathetic nerve chains, which are located alongside the spinal column in the neck, chest, and abdomen. Neuroblastoma cells form a tumor mass that enlarges and interferes with organ function. This can result in a palpable mass, pain, bleeding inside the tumor. Neuroblastoma cells can spread through the blood and lymph to other organs, such as lymph nodes, bone marrow, spinal cord, liver, and bones. Spread of neuroblastoma to the bone marrow can result in low blood counts as is seen in leukemia. Neuroblastoma is often discovered after the disease is widespread.

Nephroblastoma (Wilms Tumor). Wilms tumor develops from embryonal (very primitive or undifferentiated) kidney cells. Wilms tumor usually arises in the kidney forming a palpable tumor mass. This mass is often discovered by the parent while the child is bathing or by the doctor during a routine physical examination. There can be pain or blood in the urine. Nephroblastoma cells spread through the blood to the lungs causing lung masses and interfering with breathing.

Rhabdomyosarcoma. Rhabdomyosarcoma is the most common soft tissue sarcoma in children. Rhabdomyosarcoma develops from primitive muscle cells and can originate in any skeletal muscle in the body, such as the head and neck, trunk, or extremities. This causes a mass and often pain. Rhabdomyosarcoma cells spread through the blood to other organs, such as the lungs, liver, bone marrow, bones, and even to the central nervous system. Spread of rhabdomyosarcoma to the bone marrow can result in low blood counts as is seen in leukemia.

Bone Cancer. Bone cancer arises from bone tissue. Bone cancer in children occurs often during teenage growth spurts. There are two major types of bone cancer in children: osteosarcoma (or osteogenic sarcoma) and Ewing sarcoma. The bones can also be the site to which other cancers spread. Osteosarcoma, the most common bone cancer in children, develops from bone cells. Although osteosarcoma can occur in any bone in the body, it most often occurs in the extremity bones. Often there is pain and swelling in the area of the tumor. Osteosarcoma cells spread through the blood to other organs such as lungs or other bones. Ewing sarcoma is actually a tumor that originates from primitive nerve cells located in the bones or in the soft tissues of the body. Ewing sarcoma can occur in the bones of the trunk or the extremities. The tumor causes pain and often swelling of the area involved. Ewing sarcoma cells spread through the blood to other organs such as bone marrow, lungs, and other bones. Spread of Ewing sarcoma to the bone marrow can result in low blood counts as is seen in leukemia.

Childhood Cancers

Although cancer is rare in children, it is still the leading cause of death by disease in children ages 1 to 14.

Descriptions of the most common childhood cancers include the following:

• Leukemia forms too many white blood cells and impairs normal blood cell functions
• Kidney cancer affects the functions of the kidneys
• Brain tumors and other tumors invade the nervous system
• Bone cancer affects the growth of bones
• Sarcoma causes an abnormal growth (or tumor) of muscles and other soft tissues
• Lymphoma affects the lymph nodes

What causes these cancers in children is not known. Certain chemicals and viruses may foster the onset of some of them. Heredity may be a factor in some cancers.

Medical treatment for cancer may require more than one therapy. Therapies include surgery, chemotherapy, and radiation. Treatment is often hard on a child and their family. The focus of cancer treatment centers on trying to slow and eventually kill abnormal cells while sparing healthy ones.

A surge of well-being, activity, and weight gain may occur once a child is cured. It is a dramatic change for the child and the family. Re-integrate the child into school and social activities with children of the same age as soon as possible. School performance is one of the best indicators of the child’s ability to deal with the trauma resulting from the disease and treatment.

Children cured of cancer have an increased rate of developing a second cancer later in life. The risk depends on the type of cancer and how it was treated. Family history and the age of the child when first treated are also factors. Long-term follow-up health assessments are vital to these children; so are counseling and support groups because they assess a child`s coping abilities and help the family readjust to a new lifestyle.

Candlelighter’s Childhood Cancer Foundation is a national support organization. It provides support for children with cancer, their parents, and individuals in the pediatric oncology field. Local chapters are in all 50 states and 30 countries. They provide support groups for parents, funding for transportation, and send child cancer patients to special summer camps. Call 800-366-2223 for more information and for the telephone number of the local chapter near you.

Your local Ronald McDonald House can provide information about lodging for your child and family during cancer treatments.

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