Cancer is never an easy diagnosis but it is an especially hard blow when given to a child. Cancer is the leading cause of childhood death in the United States, with 13,500 new diagnoses each year according to the American Cancer Institute. One out of every 300 boys and one out of every 333 girls will develop cancer before their 20th birthday, according to the American Society of Clinical Oncology.
Experts say there is cause for optimism in the fight against childhood cancer. National Cancer Institute statistics show that in the U.S. the combined, an overall five-year cancer survival rate for children under 19 with cancer has increased from 62 percent in the mid-1970s to 84 percent today. For the most common type of childhood cancer, acute lymphoblastic leukemia, the cure rate is now over 90 percent.
"We've made amazing progress on pediatric cancers in just one generation. It's the biggest success story in cancer right now," said James Downing, M.D., co-chair of the American Association for Cancer Research's special conference on pediatric cancer; and scientific director at St. Jude Children's Research Hospital in Memphis.
Downing said one of the reasons such great strides have been made in pediatric cancer is that treatment protocols for younger patients tend to be vastly different from adult protocols. With adult cancer, there is a tendency to take breaks in treatment and back off if it gets too intense, he said. But many pediatric oncologists are aggressive about having their patients push through treatment until there is a cure -- sometimes for up to three years without a break.
Another reason for the high success rate is that up to 60 percent of pediatric cancer patients are treated as part of a research trial, compared to just 5 percent of adults, Downing said. Such trials offer access to cutting-edge treatments and a chance for oncologist to confer with a team of oncologists, other specialists and researchers.
But Downing said he thinks the biggest advances in treatment have come from the sequencing of the human genome.
"DNA sequencing of tumors helps us define the mutations that underlie pediatric cancer to help us attack cancers where we are not yet winning and will be a major catalyst to make progress in the next several years in how to treat those cancers," he said.
Downing admitted there are some unique challenges when treating young ones stricken with cancer.
Most cancer drugs were developed for use with older, more mature bodies so proper dosages and side effects can be tricky, he said. The cancers seen in children are vastly different from the ones seen in adults, so they aren't always as completely studied or well understood. And it's also difficult to know whether the chemotherapy, radiation and surgery children receive might lead to health problems later in life.
"Our challenge is to cure them so they can reduce long-term complications and live a normal life," he said.