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Dr. Richard O'Reilly Chair, Department of Pediatrics; Chief, Pediatric Bone Marrow Transplant Service; Claire L. Tow Chair in Pediatric Oncology Research |
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Any parent of a child who has cancer struggles with why it happened and wonders if in some way, they might be responsible.
While there are aspects of pediatric cancers that we still don't understand, there is a great deal that we do know. One important fact to keep in mind is that genetic forms of cancer that can be passed from a parent to a child are very rare. Parents too often feel somehow responsible for a cancer that develops in their child. For most kinds of cancers that affect children, they are not.
Another source of concern many parents have is whether their other children will be susceptible to cancer.
Again, genetically defined cancers in children are rare. The likelihood of cancer occurring in other children in the family is extremely rare. For the vast majority of cancers in children, there is no evidence of a particular genetic susceptibility.
Cancer treatment has changed.
It's important for parents to know that treatment approaches have radically improved from what they were only a few years ago. Currently, over 70 percent of children who develop cancer can expect to be cured with modern forms of treatment. Cure rates are higher or lower for specific cancers depending on the type of cancer and its stage at diagnosis. Many of the innovations responsible for these high cure rates were pioneered here at Memorial Sloan-Kettering Cancer Center.
A top priority for us -- that a child's quality of life while undergoing treatment be improved -- is constantly being addressed. For example, most of the treatments needed can now be given in a day-hospital setting. Many new approaches have been developed to reduce the unpleasant side effects of treatment, including central lines to avoid repeated needle sticks, and new drugs to prevent mouth sores and to speed recovery of blood cell counts. Furthermore, new, more effective medicines have been introduced to combat nausea and prevent vomiting. Total parenteral nutrition has allowed children to maintain their weight. More effective use of antibiotics has reduced the problems of infection. The use of G-CSF, a drug that was discovered at Memorial Sloan-Kettering, boosts the production of white blood cells in patients who are undergoing chemotherapy.
And as an example of new treatment approaches, surgical limb-sparing techniques developed here have made an enormous difference for children with bone tumors. As a result, our surgeons now perform fewer amputations.
None of this is meant to imply that a child will have an easy time, because having cancer is never easy. There is no question that modern, curative therapy of cancer often requires intensive treatment and that this treatment can be toxic. But most of the immediate side effects are reversible.
Will a child be able to lead a normal life after he or she completes treatment?
The answer is yes. Children often respond extraordinarily well to treatment.
Parents often express concern about the possible effects of cancer treatments on their child's growth or development.
Some therapies can affect ultimate growth, but many adjustments have been made in the way these treatments are given to try and reduce those complications. We at Memorial Sloan-Kettering Cancer Center have an exceptional knowledge base about potential problems that may occur, for two reasons. First, we treat more children with cancer than any other institution in the world. Second, our unique Pediatric Long-Term Follow-Up Program was designed to meet the health-care needs of childhood cancer survivors and has become a model for such programs around the world. In addition, through our program's connection with the Childhood Cancer Survivor Study, we continue to gather information on the well-being of over 10,000 survivors of pediatric cancer and the effects of any late complications on these individuals and their families. Recently, we have also established a new program for former patients over the age of 25 who had cancer as a child. Through this Adult Survivor Program, we are evaluating individuals and developing guidelines to ensure that internists throughout the world are aware of the potential long-term effects of childhood cancer and its treatment.
One of the questions I am frequently asked is: "Are kids with cancer really cured?"
And again the answer is, yes, they are.
What may follow quickly is: "What do you mean by cured?"
What I mean by cured is that these kids grow up to become healthy adults and may have kids of their own.
