6 facts you should know about childhood cancer

Unless a family member or friend has been diagnosed with childhood cancer, you may not know much about the topic. These 6 key facts can help you learn more.

1. Childhood cancer is relatively rare: Approximately 10, 270 children under the age of 15 were diagnosed with some form of cancer in 2017 according to statistics gathered by the American Cancer Society. One in 285 children in the U.S. will be diagnosed with cancer by the time they’re 20.
2. Lifestyle isn’t a key risk factor: Unlike with the types of cancer that affect adults, in childhood cancer lifestyle-related risk factors, such as being overweight, eating an unhealthy diet, and not taking part in regular exercise, have not been linked to an increased risk of developing cancer. Most of the types of cancers that affect children are related to acquired genetic mutations, which means that the mutations happen when a cell divides and incorrectly copies its DNA.
3. Childhood cancer isn’t a single disease: There are 12 major types of childhood cancer and more than 100 subtypes. The most common types of cancers in children include:
   • Leukemia
   • Brain and spinal cord tumors
   • Neuroblastoma
   • Wilms tumor (a type of cancer that starts in cells in the kidneys)
   • Lymphoma (including both Hodgkin and non-Hodgkin)
   • Rhabdomyosarcoma (a type of cancer that forms in soft tissues anywhere in the body)
   • Retinoblastoma (cancer that forms in the tissues of the retina)
   • Bone cancer
4. Childhood cancer is often diagnosed at a later stage than many adult cancers: For the types of cancer that adults are most often diagnosed with, for example, breast, skin, and colon cancer, there are regular screenings that can help detect the cancer in its earlier stages when it may be more treatable. There are no similar screenings for childhood cancer and because it’s relatively rare and most parents are not familiar with the symptoms of the different types of cancer that affect children, cancer in children is at risk of being misdiagnosed or diagnosed at a later stage. In addition, the symptoms of some types of childhood cancer are similar to more common childhood illnesses. The symptoms that parents and caregivers should be aware of include:
   • An unusual lump or swelling, including swollen lymph nodes
   • Bone and joint pain
   • Unexplained paleness and loss of energy
   • Easy or excessive bruising
   • Ongoing pain in one area of the body
   • Limping
   • Persistent unexplained fever or illness
   • Night sweats
   • Frequent headaches, often with vomiting
   • Sudden eye or vision changes
   • Sudden unexplained weight loss
   • Dizziness and balance problems
   • Speech or hearing problems
   • Loss of appetite
5. Treatment for cancer in childhood can increase the risk of health problems later in life: It’s important to talk with your child’s oncologists to learn what possible health effects cancer treatment may cause later in life. Depending on the treatment your child had, these late effects can include:
   • Heart or lung problems related to certain chemotherapy drugs or radiation of the chest
   • Slowed or delayed growth and development, including learning disabilities
   • Issues with sexual development (changes in testosterone levels in boys and estradiol in girls), infertility, and early menopause
   • An increased risk of other cancers later in life, with skin, breast, and thyroid cancers being the most common types of secondary cancer
6. There are new tests and treatments: Depending on the type of cancer, there are new tests that can help reduce the risk of the cancer returning and determine how well a certain treatment will work. For children with acute lymphoblastic leukemia (ALL), the most common type of cancer in children, a test called a minimal residual disease assay can determine whether any leukemia cells remain in the child’s blood after treatment, which can ensure that the child is not undertreated. Another test, molecular sequencing, determines the genetic makeup of the cancer, which can help physicians know whether a specific therapy will be effective. New targeted treatments are also available. Tyrosine kinase inhibitors (TKIs) are helping children with chronic myelogenous leukemia live significantly longer. These therapies also increase the likelihood of a cure into the 70% range for children with a form of ALL that includes a rare gene defect. CAR T-cell therapy, a type of immunotherapy that was approved by the FDA last year to treat B-cell acute lymphocytic leukemia that does not respond to first line treatments, re-engineers that patient’s t-cells so that they can recognize and kill cancer cells. For children and adults with locally advanced or metastatic solid tumors with certain genetic changes, a new drug called larotrectinib has been granted priority review status by the FDA, which speeds up the process of FDA approval.