Our Science Surgery series answers your cancer questions.
dr Francis Mussai, a Cancer Research UK-financed pediatric cancer researcher and consultant oncologist at Birmingham Children’s Hospital, says that tthe types of cancer we see in children are very different from the cancers we see in adults. “Canchor types Which we often hear about in adults, such as breast, prostate, gutmelanoma, and lung cancer, are extremely rare in children.
“Instead, it is more common to see leukemia, brain cancer and cancers in developing structures, such as muscle, nerve tissue and kidney” Mussai explains.
But Whichdoes not mean that childhood cancerso themselves are common. Grateful, thise number of cancer cases in children and young people (0-24 years) make up less than 1% of total cancers cases diagnosed each year in the UK.
In children, leukemia is the most commonly diagnosed cancer, accounting for nearly a third of all cases in Britain. Brain and other central nervous system tumors and intracranial tumors are responsible for more than a quarter of all childhood cancers and lymphomas (a type of blood cancer), about a tenth. But it’s not just the types of cancer that differ, it’s the biology too.
Why do children get cancer?
“Adult cancers generally develop through some sort of wear and tear or the impact of our lifestyle” says Mussai, “that damage and guide our DNAso to a cell that becomes abnormal and cancerous.”
The biggest risk factor for cancer in adults is age. The older a person is, the more cells will have divided, increasing the chance of DNA errors. And as life progresses, people are also exposed to other factors that can damage them DNA – Like it alcohol, tobacco smoke and obesity.
Understanding why children get cancer is a daunting task and extremely complex. In general, the cause of these changes in the DNA that can: result in childhood cancers are unknown, but many are likely to arise as a single random event taking place in a growing cell, without an external or environmental source. And therefore, unfortunately, there is no successful way to prevent cancer in children.
Mussai explains, “rresearch points to cancer in children developing from DNA errors that occurred during development in the womb, or because infection or inflammation in early life leads to a second level of damage in the cells, which can cause cells to become abnormal and trigger the cancer process.”
Consciousness is the key
It’s not just the biology of the cancer that’s different, but different conditions mean adults and children can be diagnosed in different ways.
Mussai explains how there is a lack of attentiveness of childhood cancer, especially with symptoms. With 1 in 2 adults developing cancer in their lifetime, “ppeople are aware that cancer in adulthood is possible and often know what the associated symptoms are. If an adult has an abnormal lump or discoloration on the skin, hopefully they will see their GP attention”, says Mussai.
But cchildren’s party cancers are very rare diseases. “ppeople are usually not aware that symptoms in a child such as a lump, headache or bone pain could be cancer.” More often than not it isn’t, but it can affect how people initially go to the hospital.
Mussai explains that young children may not be able to articulate clearly their symptoms, such as a lump or pain. This means that a child’s diagnosis can often be discovered accidentally, “solike when a child becomesing washed or when they fall over during a game of football and get an X-ray”.
Teens and young adults to have different challenges. “They are often afraid of what they have found. A lump can be something bad and this leads to difficulty communicating that something is wrong with their parents or GP.”
A different and dedicated approach
From the first conversations between doctor and patient, caring for children with cancer needs a different and dedicated approach.
“With an adult, when making the diagnosis, we have an extensive conversation with the patient about what a certain treatment entails, what the chance is of getting better and what the side effects are,” says Mussai. “The adult can then make a conscious decision whether they really want that therapy or not. A young child can’t say I don’t want treatment A or treatment B.
“tthe golden outcome, of course, whether you treat an adult or a child with cancer, it is that the cancer is cured” explains Mussai. “But for children, we are well aware that we are trying to achieve a really long-lasting healing so that a child can grow up to be an adult and live 30, 40, 50 years or more.”
thisis difference creates a different set of challengeso for doctors in to create new treatments for children.
“WIf drugs are approved for adults with cancer, the benefit may include: sometimes marginal in terms of general survival. And that is a success. But in children we need a much longer success. We needed, years, decades.”
Life after cancer
More today children and young people survive cancer than ever before, with 8 out of 10 children living for 5 years or more after their cancer diagnosis.
Over there‘much to celebrate. ssince the 50s, groundbreaking pediatric cancer specialists to have fantastic progress made in improving the outlook for children with cancer. “We would say that most childhood cancers can be cured‘ says Musai.
“In the 1950s, almost everyone with acute lymphoblastic leukemia died of it. Noow, more than 90% of the patients are cured.”
But for these kids, the focus should be on life after cancer. And we know that survivors can experience serious long-term side effects.
“Ppeople forget the price for the patients that survive‘ said Musai. we have blogged before about the side effects of childhood cancer treatments children, which may include: hear disorders or eeffectis on their growth.
And while 8 in 10 children survive their cancer for more than 5 years year represents huge progress, it is not good enough. That’s true research comes in.
The journey does not end eindigt there
There is still a lot of work to be done to increase our to understandfrom childhood cancer. “By understanding thisthe biology better, we will be able to design better treatment methods that lead to really good lung–term Results with low toxicity for our young patients.”, says Mussai.
“and that underlies everything we really try to do”.
We are committed to raising awareness of childhood cancer and developing a strong, long-term community of doctors, nurses and scientists to develop new treatments for children and young people with cancer.
“Proving that cancer exists in children is important, aAlthough they are rare, we all know of a family affected by childhood cancer,” Mussai concludes.
Sheona Scales is the pediatric leader of Cancer Research UK