While it is true that the risk of cancer increases with age, possibly due to the cumulative risk of DNA damage brought on successive cell divisions, long term exposure to toxins and the like, younger people are also known to develop cancer, and sometimes even the very young. Childhood cancer presents the challenges of adult cancer with some additional challenges unique to dealing with serious illness in persons not yet fully grown (emotional, educational, developmental and reproductive, for example). Understandably, but heartbreakingly, the long survival times for young people who are successfully treated for malignancy means a greater risk for recurrence, second primary, or disease related to the toxicities of treatment. In children, the mortality related to these subsequent factors is approximately 20%.
Different cancers predominate in children as compared to adults. According to the American Cancer Society, the most common childhood cancers are:
- Leukemia (approximately 30% of all cancers in children)
- Brain and spinal cord tumors
- Neuroblastoma (develops from immature nerve cells, especially around the adrenal glands)
- Wilms tumor (originating in the kidneys)
- Lymphoma (Hodgkin and non-Hodgkin)
- Rhabdomyosarcoma (usually beginning in muscles of movement)
- Bone Cancer (including osteosarcoma and Ewing sarcoma)
Research hurdles are high when it comes to childhood cancer:
- Ethical considerations in informed consent
- The rarity of childhood cancers making drug companies unenthusiastic about developing drugs for this population
- Difficulty of achieving large enough numbers of participants to lead to statistically significant results.
Still, the clinical trial accrual numbers are impressive. According to a 50 year overview recently published by the National Center for Biotechnology Information (https://www.ncbi.nlm.nih.gov), which highlighted the Children’s Oncology Group (an international research organization, supported by the NCI): “In the United States, 90-95 percent of all children under age 15 with a newly diagnosed malignancy are seen at a COG institution. If a clinical trial is available, 50-60 percent of children eligible are enrolled. For young children (less than 5 years of age) enrollment rates are much higher, 90 percent. In 2007, the COG has over 70,000 children with cancer who were being managed with research protocols or were in active follow-up.” These numbers are even more astonishing when, overall, “Less than 2% of patients diagnosed with cancer participate in a clinical trial in the United States” (Front Oncol. 2016; 6: 103).
Since 2012, by presidential proclamation, September has been recognized as Childhood Cancer Awareness Month. Efforts focus on education regarding the types of cancer affecting children, fundraising for family support, and assisting research efforts. A gold ribbon serves as the emblem for Childhood Cancer Awareness.
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