How Childhood Cancers Differ From Adult Cancers
We sometimes look at children and only see smaller versions of ourselves. But when we look deeper, we know that children have needs, wants, likes, dislikes, and even medical issues that vary greatly from their adult counterparts. Pediatric oncologists and other physicians who work with children are very aware of these differences. Childhood cancers are quite different from cancers in adults.
Differences Between Childhood and Adult Cancers
Childhood cancers differ from adult cancers in almost every respect.
Prevalence:Childhood cancers are much less common than cancers in adults. Cancers in children and adolescents account for only 0.3% of all cancers that are diagnosed.
Diagnosis: At the time of diagnosis, cancer is usually much more advanced in children than in adults. Only 20% of adults, versus 80% of children, have cancer that has spread to other parts of the body at the time of diagnosis.
Risk factors and causes: Many cancers that affect adults are related to lifestyle risk factors such as tobacco or alcohol use, poor diet, or sedentary lifestyle. On the other hand, the causes of most childhood cancers are not known.
Types of cancers: Childhood cancers tend to occur at different sites from those common in adults. Among the most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancer. Each of these cancers also occurs in adults, but adult cancers tend more commonly to strike the lung, colon, breast, prostate, and pancreas. There are some childhood cancers that almost never occur in adults and some cancers that affect adults but virtually never occur in children. At the same time there are cancers that, while more common at one age than another, can affect both adults and children.
Treatment facility: Most adults who are diagnosed with cancer are treated in their local community by their primary care physicians and cancer specialists. Children’s cancers are much more rare than those of adults, so specialists in many smaller communities do not have continuing experience with the management of these diseases. For this reason, children usually are best treated by teams of doctors who specialize in the diagnosis, treatment, and management of childhood cancers. Such teams are much more likely to be found in eminent children’s hospitals, university medical centers, and cancer centers.
Prognosis: Over the past 20-30 years the prognosis for many childhood cancers has improved greatly. Tumors that would have lead to fatality only a few years ago are now successfully managed so that children live full, productive lives into adulthood. Acute lymphocytic leukemia and osteosarcoma (bone cancer) have been particularly important treatment success stories. While there are still childhood cancers for which cures remain elusive, at least 80% of children with most cancers survive tumor-free into adulthood.
Common Childhood Cancers
The most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancers.
Leukemia is a cancer of the white blood cells. It affects bone marrow, causing it to produce large numbers of abnormal white blood cells. These white blood cells crowd normal, healthy blood cells out of the bone marrow and blood, leading to the common symptoms of leukemia: pale skin, bleeding, bruising, and serious infection.
Young children are most likely to have a type of leukemia called acute lymphoblastic leukemia (ALL).
Lymphoma is a cancer of the lymph nodes, part of the body’s immune system that helps fight infection. Lymphoma occurs when lymphocytes, a type of white blood cell, become malignant and multiply out of control. The abnormal cells crowd out healthy cells and create tumors that may occur in lymph nodes or in other organs such as the liver or spleen. Lymphomas are divided into two categories, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma which differ to some extent in their treatment and prognosis.
Non-Hodgkin’s lymphoma is more common in very young children, while Hodgkin’s disease is more common in adolescents.
Tumors of the brain and spinal cord comprise the most common types of solid tumors in children. Not all brain tumors are cancers, but even the non-malignant ones may affect one or several of the functions controlled by the brain including memory and learning, the senses, and emotions. Tumors may also affect body movement and may lead to seizures or other complex symptoms.
Twenty percent of all tumors that originate in the brain occur in children younger than age 15. The incidence of brain tumors peaks between the ages of 5-10. Brain tumors occur somewhat more often in boys than girls.
The bone cancer known as osteosarcoma originates in the bones. It is commonly found in the legs or arms, and around the knees. Bone cancer in children most likely occurs during adolescent growth spurts. Osteosarcoma occurs twice as often in boys than girls. While cancer is very rare and pain is common, children who have unexplained persistent pain in a bone or joint should generally have an x-ray to make sure there is no cancer.
There are many other uncommon childhood cancers that cancer specialists are called upon to diagnose and treat. Fortunately, effective therapies exist for many of these cancers. The diagnosis of cancer can be a trying time for a child and family, but helpful and caring treatment can make a difference.
American Cancer Society
National Cancer Institute
National Institutes of Health
BC Cancer Agency
Canadian Cancer Society
American Cancer Society. What are the differences between cancers in children and adults? Available at: http://www.cancer.org/ . Accessed December 30, 2002.
American Cancer Society. What are the risk factors and causes of childhood cancer? Available at: http://www.cancer.org/ . Accessed on January 3, 2003.
Cancer and children: JAMA patient page. JAMA . 2002;287:1890.
The Leukemia & Lymphoma Society. Non-Hodgkin lymphoma. Available at: http://www.leukemia-lymphoma.org/all_page?item_id=8965 . Accessed January 3, 2003.
The National Cancer Institute. Childhood brain tumors. Available at: http://www.cancer.gov/ . Accessed on January 3, 2003.
The National Childhood Cancer Foundation. Childhood cancer is different. Available at: http://www.nccf.org/childhoodcancer/different.asp . Accessed January 3, 2003.
The Nemours Foundation. Childhood cancer: osteosarcoma. Available at: http://kidshealth.org/parent/medical/cancer/cancer_osteosarcoma.html . Accessed January 3, 2003.
Last reviewed May 2008 by Igor Puzanov, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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