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Because September is Childhood Cancer Awareness Month, we’re taking a look at the three most common childhood cancers: acute lymphocytic leukemia, brain tumors and neuroblastoma.
Leukemias are the most common type of cancer, and acute lymphocytic leukemia (ALL) accounts for 75% of all leukemias.
We give the basics for how your doctor might diagnose and treat all three of these diseases.
While it is rare for a child to be diagnosed with cancer, it is the second leading cause of death in children ages 1 to 14 after accidents. According to the American Cancer Society, about 10,470 children in the United States under the age of 15 will be diagnosed with cancer in 2022. Childhood cancer is particularly heartbreaking for families across the world because parents often feel helpless when they see their children in pain. During this Childhood Cancer Awareness Month, we sat down with Judy Felgenhauer, MD, medical director for pediatric oncology and hematology at Providence Sacred Heart Medical Center to discuss the three most common types of childhood cancer — neuroblastoma, acute lymphocytic leukemia and brain tumors.
When a fetus is growing in its mother’s uterus, it develops nerve cells called neuroblasts. Usually, these cells develop normally, but sometimes they become cancerous, causing neuroblastoma. Neuroblastoma can start in several different areas of the body, including the adrenal glands, belly, chest, or neck. Almost all cases occur in infants and children younger than 5 years old, and the success of treatment depends on the cancer’s type and how much it has spread.
Symptoms of neuroblastoma can vary widely depending on the location of the cancer. Doctors usually discover it when a hard lump appears in the neck or other part of the body, but other symptoms can include:
- Stomach pain
- Bone pain
- Leg weakness
- Loss of appetite
- Constipation or diarrhea
- Being very tired
Neuroblastoma can be difficult to diagnose because most of the above symptoms are possible signs of other childhood illnesses, as well. If the tumor presses on other parts of the body, such as organs in the chest, the child may experience other symptoms.
Diagnosis and treatment
If your doctor suspects your child may have neuroblastoma, they will order a number of tests to confirm the diagnosis and rule out other conditions, including:
- Urine tests
- A bone marrow biopsy
- Imaging studies, such as a computed tomography (CT) scan, X-rays or a magnetic resonance imaging (MRI) scan
When a doctor diagnoses neuroblastoma, they order an MIBG scan, which is a nuclear test that uses injected radioactive material to find the precise location of the neuroblastoma.
There are several different ways a doctor can treat neuroblastoma, including:
- Surgery – They can surgically remove the cancer if it has not spread to other parts of the body.
- Chemotherapy – This type of treatment kills cancer cells or stops them from growing. Chemotherapy can be injected into the bloodstream or given by mouth.
- Radiation – This therapy can be administered either externally or via tubes injected into the body to deliver radiation directly to the affected cells.
- Immunotherapy – This therapy uses medicine to help the patient’s own immune system recognize and destroy cancer cells more effectively.
Acute lymphocytic leukemia
Leukemias are the most common type of childhood cancer, and acute lymphocytic leukemia (ALL) accounts for about 75% of all leukemias. ALL is a blood cancer that forms in immature white blood cells called lymphocytes in the bone marrow. Among children, it is most likely to occur in children under age 5.
Some of the most common symptoms of acute lymphocytic leukemia include:
- Unusual bruising
- Frequent or severe nosebleeds
- Shortness of breath
- Pale skin
- Frequent infections
- A decrease in energy
- Swollen lymph nodes
Diagnosis and treatment
When a doctor suspects a child has ALL, they will order a complete blood count, which determines the number of blood cells they have. A person with acute lymphocytic leukemia has either a very high or very low white blood cell count, a low red blood cell count and a low platelet count. Doctors may also perform a bone marrow biopsy and a spinal tap.
Chemotherapy is the most common treatment for ALL. Patients receive four to six months of intense chemotherapy, and if they go into remission with no signs or symptoms of disease, they will have 18-24 additional months of less intensive chemotherapy. Some children who have a high risk of recurrence may need a bone marrow transplant, which restores the bone marrow so it can produce new blood cells and give them a new immune system.
There are many different types of brain tumors in children; they are usually classified by the types of brain cells they affect, and where they are found in the brain. The most common type of brain tumor at all ages is a glioma, which consists of cells that form the connective tissue of the brain.
Brain tumor symptoms vary according to the size, type and location of the tumor. They can include:
- Memory problems
- Balance problems
- Muscle jerking and twitching
- Problems with speech, vision or hearing
- Changes in mood
- Numbness or tingling
Diagnosis and treatment
Doctors use a combination of methods to diagnose brain cancer, including various imaging tests (such as a CT or MRI scan), a neurological exam and a spinal tap. Once they have made the diagnosis, surgery is usually the first step in treatment. The doctor wants to remove as much of the tumor as possible without impacting the child’s brain function.
Treatment may also include chemotherapy, radiation therapy, steroids to treat and prevent swelling in the brain and rehabilitation to regain strength and motor skills.
Childhood cancer is frightening, but every day researchers are discovering new treatments that are bringing them closer to a cure. “Keep in mind that most children with these symptoms do not have cancer,” said Dr. Felgenhauer. “Always check with your physician or advanced practice provider if you are concerned about your child, however. Today, 80% of children who are treated for cancer will be cured of their disease.”
Find a doctor
If you are looking for a pediatric oncologist, you can search for one who’s right for you in our provider directory.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
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