Treating Childhood Cancer
Treatment typically begins right away because of how aggressive some pediatric cancers can be, so, as you make these timely treatment decisions, also think about getting a second opinion. Getting another opinion from a pediatric oncologist (preferably one who is experienced in treating your child’s type of cancer) will either confirm the original diagnosis and treatment recommendations or offer new information to consider. Treating cancer in children is different than treating it in adults because, simply put, children are not just small adults. They react to treatments differently than adults and, therefore, must be treated appropriately. Because cancer in children is relatively rare and doctors and researchers have not had as many opportunities to study it, clinical trials are often recommended for treating childhood cancer.
Surgery, chemotherapy, radiation therapy, immunotherapy, targeted therapy and stem cell transplantations are standard treatment options. Typically, a combination of these treatments is the best approach, and sometimes the best treatment option depends on the type of cancer. Your doctor will create your treatment plan based on many factors, including the type, stage and location of the cancer, as well as the child’s age and overall health.
Clinical trials are research studies that explore whether a treatment is safe and effective and which strategies work best for certain illnesses or groups of people. Clinical trials may offer your child access to promising new treatments that aren’t available outside of the trial. It may comfort you to know that your child will receive high-quality care and be closely monitored throughout the trial. And, by simply participating, your child will help others who will need cancer treatment in the future.
When people consider a clinical trial, they receive detailed information about the trial in a document known as an Informed Consent form. This form details the purpose of the research, including the participant’s role in the trial, how the trial will work, risks, benefits and other pertinent information. They are required to review the form during the Informed Consent process. Legally, they must be 18 years old to give consent. Children with cancer who are under 18 are also asked to give their assent, and they go through a similar information process. The child’s treatment team and research team work with the child and the parents/guardians to ensure everyone understands all parts of the trial. Ask your doctor if clinical trials are an option for your child. To learn more, (see Clinical Trials).
Many children with cancer receive treatment or participate in clinical trials at places that specialize in treating cancer in children, such as children’s hospitals, pediatric oncology centers, university medical centers or cancer centers.
A pediatric oncology team is typically made up of these and other specialists:
- Pediatric oncologists
- Pediatric surgeons
- Radiation oncologists
- Pediatric oncology nurses
- Nurse practitioners (NPs) and physician assistants (PAs)
- Social workers
- Nurse navigators
- Physical therapists
AYAs often have unique medical, social and emotional needs that differ from younger children, and they may choose to be treated at a cancer center instead of a pediatric oncology center. Your doctor will consider the patient’s age, diagnosis and other factors before making a recommendation for the best place for treatment.
Cancer and its treatments may cause physical and emotional side effects and late effects. Side effects generally occur during treatment, while late effects may occur after treatment ends or even decades later. Ask your doctor about the potential side effects for each type of treatment, and keep in mind that not everyone experiences the same side effects (see Side Effects).
Because of the age at which the diagnosis was made, childhood cancer survivors require follow-up care for life. Your doctor will talk with you about a recommended follow-up schedule. Your child will likely be followed by the treatment team for many years, then transitioned to a survivorship clinic managed by nurse practitioners. These visits, over time, eventually become annual visits, but they usually continue for the rest of your child’s life. This is because the treatments that were needed to get your child cancer-free can cause late effects, which need to be diagnosed early so they can be appropriately managed. So, even if you and your family move away from where your child’s treatment originally was given, either plan to return to the original treatment team for these visits or get referral information about where to continue these types of survivorship visits after your move. In addition, it’s important to keep a copy of your child’s medical records so you can share them with any new doctors in the future.
You can find teams of childhood cancer specialists at children’s hospitals and pediatric cancer centers (see Understanding Cancer Treatment Facilities).