• How Childhood Cancers Differ From Adult Cancers

    We sometimes look at children and only see smaller versions of ourselves. But when we look deeper, we know that children have needs, wants, likes, dislikes, and even medical issues that vary greatly from their adult counterparts. Pediatric oncologists and other physicians who work with children are well aware of these differences. Childhood cancers are quite different from cancers in adults.

    Differences Between Childhood and Adult Cancers

    IMAGE Childhood cancers differ from adult cancers in many ways.

    Prevalence

    Childhood cancers are much less common than cancers in adults. Cancers in children and adolescents account for a small percentage of all cancers that are diagnosed.

    Risk Factors and Causes

    Many cancers that affect adults are related to lifestyle risk factors, such as tobacco or alcohol use, poor diet, or sedentary lifestyle. On the other hand, the causes of most childhood cancers are not known.

    Types of Cancers

    Childhood cancers tend to occur at different sites from those common in adults. Among the most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancer. Each of these cancers also occurs in adults, but adult cancers tend to strike the lung, colon, breast, prostate, and pancreas. There are some childhood cancers that almost never occur in adults, and some cancers that affect adults but virtually never occur in children. At the same time, there are cancers that, while more common at one age than another, can affect both adults and children.

    Treatment Facility

    Most adults who are diagnosed with cancer are treated in their local community by their primary care physicians and cancer specialists. Children’s cancers are much more rare than those of adults, so specialists in many smaller communities do not have continuing experience with the management of these diseases. For this reason, children usually are best treated by teams of doctors who specialize in the diagnosis, treatment, and management of childhood cancers. Such teams are much more likely to be found in eminent children’s hospitals, university medical centers, and cancer centers.

    Prognosis

    Over the past 20 years, there has been an increase in the number of children diagnosed with cancer. But, according to the National Cancer Institute, the death rate has decreased and the five-year survival rate has increased.

    Common Childhood Cancers

    The most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancers.

    Leukemias

    Leukemia is a cancer of the white blood cells. It affects bone marrow, causing it to produce large numbers of abnormal white blood cells. These white blood cells crowd normal, healthy blood cells out of the bone marrow and blood, leading to the common symptoms of leukemia: pale skin, bleeding, bruising, and serious infection.
    Young children are most likely to have a type of leukemia called acute lymphoblastic leukemia (ALL) .

    Lymphoma

    Lymphomas is a cancer of the lymph nodes, part of the body’s immune system that helps fight infection. Lymphoma occurs when lymphocytes, a type of white blood cell, become malignant and multiply out of control. The abnormal cells crowd out healthy cells and create tumors that may occur in lymph nodes or in other organs such as the liver or spleen. Lymphomas are divided into two categories, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma, which differ to some extent in their treatment and prognosis.
    Non-Hodgkin’s lymphoma is more common in very young children, while Hodgkin’s disease is more common in adolescents.

    Brain Tumors

    Brain tumors of the brain and spinal cord comprise the most common types of solid tumors in children. Not all brain tumors are cancers, but even the non-malignant ones may affect one or several of the functions controlled by the brain, including memory and learning, the senses, and emotions. Tumors may also affect body movement and may lead to seizures or other complex symptoms.
    The incidence of brain tumors peaks between the ages of 5-10. Brain tumors occur somewhat more often in boys than girls.

    Bone Cancer

    Bone cancer is commonly found in the legs or arms, and around the knees. Bone cancer in children most likely occurs during adolescent growth spurts. Osteosarcoma, a type of bone cancer, occurs more often in boys than girls. While cancer is very rare and pain is common, children who have unexplained persistent pain in a bone or joint should generally have an x-ray to make sure there is no cancer.
    There are many other uncommon childhood cancers that cancer specialists are called upon to diagnose and treat. Fortunately, effective therapies exist for many of these cancers. The diagnosis of cancer can be a trying time for a child and family, but helpful and caring treatment can make a difference.

    RESOURCES

    American Cancer Society http://www.cancer.org

    National Cancer Institute http://www.nci.nih.gov

    CANADIAN RESOURCES

    BC Cancer Agency http://www.bccancer.bc.ca/default.htm/

    Canadian Cancer Society http://www.cancer.ca/

    References

    Brain stem giloma. St. Jude Children's Research Hospital website. Available at: http://www.stjude.org/stjude/v/index.jsp?vgnextoid=b86c061585f70110VgnVCM1000001e0215acRCRD. Accessed May 21, 2012.

    Cancer and children: JAMA patient page. JAMA . 2002;287:1890.

    Childhood brain tumors. The National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/treatment/childhoodcancers . Accessed on May 21, 2012.

    Childhood cancer: osteosarcoma. The Nemours Foundation website. Available at: http://kidshealth.org/parent/medical/cancer/cancer%5Fosteosarcoma.html . Updated August 2012. Accessed May 21, 2012.

    Childhood cancers: questions and answers. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/factsheet/Sites-Types/childhood. Accessed May 21, 2012.

    Non-Hodgkin lymphoma. The Leukemia & Lymphoma Society website. Available at: http://www.leukemia-lymphoma.org/all%5Fpage?item%5Fid=8965 . Updated January 31, 2012. Accessed May 21, 2012.

    What are the differences between cancers in children and adults? American Cancer Society website. Available at: http://www.cancer.org/Cancer/CancerinChildren/DetailedGuide/cancer-in-children-differences-adults-children . Updated January 9, 2012. Accessed May 21, 2012.

    What are the most common types of childhood cancers? American Cancer Society website. Available at: http://www.cancer.org/Cancer/CancerinChildren/DetailedGuide/cancer-in-children-types-of-childhood-cancers. Updated January 9, 2012. Accessed May 21, 2012.

    What are the risk factors and causes of childhood cancer? American Cancer Society website. Available at: http://www.cancer.org/Cancer/CancerinChildren/DetailedGuide/cancer-in-children-risk-factors-and-causes . Updated January 9, 2012. Accessed on May 21, 2012.

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