Pediatric Cancer Treatment Has Seen Huge Advances

LEXINGTON, Ky. (Feb. 19, 2013) - The following column appeared in the Lexington Herald-Leader on Sunday, Feb. 17, 2013.

By Dr. Lars Wagner

Although cancer is a leading cause of life-threatening disease in children, treatment has improved dramatically over the past four decades. This is because childhood tumors are often more responsive to therapy than adult cancers, and children can tolerate more intense treatment regimens. Additionally, children are often treated on large national clinical trials that pool results and allow for effective regimens to be identified more rapidly.

What causes cancer in children?

While some cancers run in families, the majority arise in previously healthy children and families. Changes in the genetic material of certain cells make them become cancerous, but the cause remains mostly unknown.

How is pediatric cancer treated?

As with adults, the main methods include surgery, chemotherapy and radiation. Some cancers can be successfully treated with surgery alone, but most require chemotherapy for the best chance of long-term cure.

Radiation is often used for treatment of brain tumors, and is combined with chemotherapy to treat tumors in other organs. Leukemia comprises up to one-third of all childhood cancers, and is generally treated solely with chemotherapy.

Bone marrow transplantation can increase the intensity of chemotherapy and is reserved for patients with very high-risk leukemia or neuroblastoma.

Because treatments are becoming more successful, and because children are at risk for long-term complications, the challenge in pediatric oncology is to use just enough treatment to be successful, while reducing risks from excessive therapy.

Pediatric cancers have a unique biology, and these young patients are best treated with specialized care from a multidisciplinary group of pediatric physicians, nurses, and staff.

How deadly is pediatric cancer?

Cure rates for acute lymphoblastic leukemia, the most common type of childhood cancer, have increased from less than 20 percent in the 1960s to the current rate of more than 80 percent.

Nevertheless, progress remains slow for certain types of cancer, particularly if the tumor has already spread at the time of diagnosis or returns after initial therapy, and much work remains to be done.

Are pediatric cancer survivors more likely to develop cancer again later in life?

Unfortunately, yes. Children who have been treated for one type of cancer are at a greater risk for developing other cancers as they grow older. They are also at a greater risk for other health issues, including heart and lung problems, altered growth and development, and learning problems.

Dr. Lars Wagner is the chief of the Division of Pediatric Hematology/ Oncology at UK HealthCare.

You Can Help

Feb. 22-23 marks the 8th DanceBlue 24-hour dance-athon to raise money to fight pediatric cancer. This student-run event has raised more than $3.5 million to support research and patients and families affected by cancer. For more information, visit DanceBlue.org  .