Facts and Figures Report Outlines Progress and Challenges in Childhood Cancer

Article date: January 31, 2014

By Stacy Simon

A new report from the American Cancer Society describes the progress that has been made and the challenges that remain in fighting childhood cancer. The report estimates the number of new cancer cases and deaths for children and adolescents ages 19 and younger in the US. The report is published in CA: A Cancer Journal for Clinicians and also as a Special Section in Cancer Facts and Figures 2014.

According to the report, “The news of a cancer diagnosis is never welcome, but may be even more unexpected and difficult when the disease is diagnosed in a child or adolescent.” In 2014, an estimated 15,780 children and adolescents will be newly diagnosed with cancer and an estimated 1,960 children and adolescents will die from cancer.

While advances in treatment have increased the survival rate for many childhood cancers, the disease is still the second leading cause of death (following accidents) in children ages 5-14. Today, about 1 in 530 adults between ages 20 and 39 is a childhood cancer survivor.

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Childhood cancer differs from adult cancer

The types of cancers that develop in children and adolescents differ from those that develop in adults. The most common types of childhood cancers areleukemia, cancers of the brain and central nervous system, and lymphoma.

Progress in survival has been substantial for some cancer types, but not others. For example, improved treatment for acute lymphocytic leukemia (ALL) in childhood has increased the 5-year survival rate from 57% in 1975-1979 to 90% in 2003-2009. While there has been progress in survival for brain and spinal cord tumors overall, there has been little progress for some subtypes, such as DIPG (diffuse intrinsic pontine glioma), for which the median survival time after diagnosis remains less than 1 year.

“Progress in childhood cancer has been dramatic for some sites, but we cannot let that blind us from the fact that progress has been disappointingly slow for other sites, and that cancer remains the second leading cause of death in children,” said Otis W. Brawley, M.D., American Cancer Society chief medical officer, in a prepared statement. “There is much work to be done to improve outcomes, to reduce side effects associated with cancer and its treatment, and, we hope, to understand more about the molecular events that lead to childhood cancer in order to come up with ways to prevent or detect it early.”

Major challenges ahead

Unlike adult cancers, most childhood cancers have no known preventable causes. In addition, it is often difficult to detect cancer in children and adolescents early, when it’s easier to treat. This is partly because many childhood cancer symptoms are similar to the symptoms of common, ordinary childhood diseases and injuries. Symptoms may include: an unusual lump or swelling, unexplained paleness and loss of energy, easy bruising, an ongoing pain in one area of the body, limping, unexplained fever or illness that doesn’t go away, frequent headaches – often with vomiting, sudden eye or vision changes – and sudden unexplained weight loss. These symptoms should always be checked by a doctor, especially if they persist.

Treatment of childhood cancer presents another ongoing challenge. While surgery, radiation, and chemotherapy have saved many lives and increased survival rates for many childhood cancer types, they can also raise the risks for long-term health problems. For example, some children treated for brain tumors may experience long-term problems such as seizures, weakness in the arms and legs, blindness, hearing loss, growth disorders, hormone-related problems, and impaired brain function.

In an editorial accompanying the report published in CA, Jennifer Cullen, PhD, MPH, a cancer epidemiologist, mother of a child diagnosed with cancer, and a board member of the American Childhood Cancer Organization , writes that “[a]s a cancer epidemiologist, I was better equipped than most parents to face down this crisis. But that realization frequently left me wondering: how did families with little medical knowledge or inflexible work schedules manage their fears and navigate the numerous daily unknowns? …Having to choose between treatment strategies that are terrible and terrible really presents no choice at all.”

Citations:

Cancer Facts and Figures 2014. Published early online January 31, 2014. American Cancer Society, Atlanta, Ga.

Childhood and Adolescent Cancer Statistics, 2014. Published early online January 31, 2014 in CA: A Cancer Journal for Clinicians. First author: Elizabeth Ward, PhD, American Cancer Society, Atlanta, Ga.

Because Cancer Statistics Don’t Tell the Whole Story: A Call for Comprehensive Care for Children With Cancer. Published early online January 31, 2014 in CA: A Cancer Journal for Clinicians. Jennifer Cullen, PhD, MPH, American Childhood Cancer Organization.

Reviewed by: Members of the ACS Medical Content Staff