Think Beyond Cancer
Children & Cancer

Cancer in childhood is very rare and it affects only 1 in every 650 children. The cure rate for childhood cancer is 65%. Cancer happens when the cells in the body grow too quickly. Cancer is a group of diseases that occur when cells in the body grow out of control.

Some cancers form growths called tumors, but not all tumors are cancerous. Benign (noncancerous) tumors can often be removed and, unlike malignant (cancerous) tumors, are rarely threats to life. Cancer is life-threatening because it can spread to other parts of the body (metastasize). The most common childhood cancers are;

Women with the greatest risk of sexual side effects include those being treated for:

  • Leukemia - cancer of the white blood cells
  • Lymphoma - cancer of the lymph nodes
  • Brain tumors - cancer that can be found in many parts of the brain
  • Osteosarcoma - bone cancer

Talking to your child:
It is very important to talk calmly, honestly, and openly to your child about his or her illness. Depending on your child's age, he or she will be able to understand varying amounts of information. Below are some general guidelines by age group; however, every child is different, and the guidelines for your child's age group might not be appropriate for your child. Be sure to allow for this.

  • Children up to 2 years of age cannot understand cancer. They may cry or seem uncooperative during examinations or treatments. Provide comfort and let them know it is okay to cry when something, such as a needle stick, hurts.
  • Two- to 7-year-olds might think that their illness is a punishment for something they have done, said, or thought. Explain that this is not true, and that treatments and tests are to help get rid of the cancer and make them well. You may want to tell them that cancer is "bad" cells and that treatment helps "good" cells win.
  • Seven- to 12-year-olds can understand more details about cancer and can grasp that getting treatment and going to the doctor can help them get better, even though the treatments may cause temporary pain and discomfort.
  • Children 12 years and older usually can understand that cancer causes symptoms such as feeling tired. Explain in detail how their treatment can help them and how medicines work to make them eventually feel better.
  • Children with cancer may have a lot of questions about their illness but might be afraid to ask. Talk to your child's doctor and make sure you understand the treatment and side effects from the beginning so you can explain these to your child. Provide lots of love and support and answer questions honestly.

Warning signs and symptoms
Warning signs are various and non-specific because they can also be observed during minor diseases. It can be tiredness, fever, loss of appetite, articular or bone pain, haematomas, abdominal pain, headache, walking disorders, sight disorders, vomiting etc. However, if those symptoms don't disappear and become recurrent, complementary exams have to be done.

For leukaemias, diagnosis is done after the analysis of blood cells and bone marrow cells. In case of suspected tumour, it's necessary to do a biopsy in order to analyse the tissues and determine if they are cancerous or not. For brain tumours, it's sometimes needed remove directly the tumour, before any other exam, because it can be dangerous for brain functioning. Some rare tumours secrete tumourous markers that can be found in blood or urine.

When the diagnosis is found, complementary exams have to be done in order to evaluate the child general state, precise the location and size of the tumour, and find eventual metastasis. Those exams are the same than adults: medical imaging (radiography, scan, scanner, Magnetic Resonance Imaging, scintigraphy), biopsies and analysis of different organs functioning. They can be done again during the treatment in order to evaluate its efficiency.

Cancer treatment
After that, the best treatment is chosen. The most common treatments are surgery, radiotherapy and chemotherapy.

Chemotherapy has a very important place in child cancer treatment: it's used for leukaemias and some lymphomas, and it's often used as a complementary treatment of surgery and radiotherapy. Chemotherapy medicines are administrated in the same way than adults, and the doses, the frequency and length of sessions are determined functions of each patient.

In some cases (often for leukaemias) a stem cell transplant can be done, according to the same protocol than adults.

For the diagnosis and the beginning of treatment, children need to be hospitalised, either in complete hospitalisation (day and night) or in day hospitalisation. After the acute stage of the disease, the treatments can be continued in day hospitalisation or sometimes at home.

During the procedure
You and your child may want to establish a special plan for procedure days; for instance, who will go to the hospital, what you will bring with you, or what special treat you will give your child after the procedure. Older children may want to write plans down on paper. Having a plan helps children feel more in control of the situation. Be sure to discuss your plan with a member of your child's health-care team to make sure it will not interfere with the procedure itself.

Below are tips for helping your child to remain as calm as possible during procedures.

  • Comfort your child with soothing words and gentle touches. Offer to hold your child's hand.
  • Provide distraction by telling a story, singing, or reading a book. Older children may want to listen to music on headphones. Some hospitals have video players in treatment rooms. Sometimes children like to imagine pleasant scenes during a procedure, such as going shopping, playing at the beach, or scoring the winning goal. These types of experiences can help pass the time.
  • Encourage your child to bring along a favorite object, such as a teddy bear or blanket. This is especially helpful for radiation procedures when your child must be alone in the room. You may want to give your child something of yours, such as a scarf or keys. For procedures involving radiation therapy, it is a good idea for the child to bring his or her own music or book on CD to listen to during the treatment.
  • Give your child an achievable goal, such as holding still. Tell your child that is OK to cry, but that his or her job is to keep still during the procedure.

Most children count on their parents for support during procedures and want a parent to stay with them. This may not be possible in some situations, so ask the doctor for guidance and identify who will be present, so you can ask them to comfort and support your child.

It is important to make arrangements for the siblings in advance of the procedure day and inform them in an age-appropriate manner of what will be happening with their brother or sister. Try to keep their routine as regular as possible, but make sure that the siblings know how to contact you on that day.

Pain management
Even the best preparation cannot eliminate all of the pain associated with some procedures. Talk with your child's doctor about pain management during procedures and insist that every effort is made to avoid or minimize pain. For procedures that involve injections or intravenous (IV) insertions, pain medication is usually rubbed on the skin or injected just under the skin to numb the area. Longer procedures, such as spinal taps or bone marrow aspirations, usually require sedation or general anesthesia.

Chemotherapy side effects
- Aphasia (decreasing of the quantity of blood cells) that leads to tiredness, haemorrhagic risk and infectious risk. Haematopoietic growth-factors can be given to favour maturation and proliferation of blood cells, as well as antibiotics, fungicides or antiviral medicines to decrease the infectious risk

- Nausea and vomiting can be treated with anti-emetics

- Digestive disorders and lack of appetite: if your child really can't eat, he can receive a parental nutrition (nutriments are given intravenously) or an enteral nutrition (the food is given through a tube placed in the nose, the stomach, or the small intestine)

- Dental disorders in case of head and neck radiotherapy: fluorine can be given to prevent from tooth decays, and a dental follow-up has to be done regularly

- Alopecia

- Muscular fatigue caused by the tiredness and the inactivity. This state is transitory and disappears after the end of treatment

Nutrition is an important part of the health of all children, but it is especially important for children getting cancer treatment. Children with cancer need protein, carbohydrates, fat, water, vitamins, and minerals. A dietitian can help you understand your child's specific needs and develop an eating plan. Your child's baseline nutritional status (Is he overweight? underweight?), diagnosis, treatment plan, age, activity levels, and the medicines he gets are all used to make a nutrition plan.

It's the disappearance of the signs and symptoms of the disease. It can be temporary or permanent. There is a complete remission when there are no more detectable cancerous cells in the organism.

We can talk about recovery when the length of remission seems sufficient to avoid the risk of relapse. This length depends on the kind of cancer, but most of the time it's around several years.

If a relapse happens, a new treatment strategy is proposed.

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