Types of Childhood Cancer

There are many types of childhood cancer with different symptoms and treatments. Childhood cancer survival rates in the United States have increased from less than 20 percent in the 1960s to almost 80 percent today. Parents are the best advocates for their children so being informed will help guide a family to make the best decisions for the child battling cancer.

Bone Cancer

Primary bone cancers (cancers that start in the bones) occur most often in children and adolescents.

Primary bone cancer is different from metastatic bone cancer, which is cancer that has spread from another site to the bone. Metastatic bone cancer is named for the place the cancer came from. For instance, it might be described as prostate cancer that has spread (metastasized) to the bone, or prostate cancer with bone metastasis. Metastatic bone cancer is more common than primary bone cancer because many types of cancer can spread to the bone.

Types

Osteosarcoma

This is the most commom cancer that develops in bone. Like osteoblasts of normal bone, the cells that form this cancer make bone matrix. But the bone matrix of an osteosarcoma is not as strong as that of normal bones.

Most osteosarcomas occur in children and young adults. Teenagers are the most commonly affected age group, but osteosarcoma can occur at any age. In children and young adults, osteosarcoma usually develops in areas where the bone is growing quickly, such as near the ends of the long bones. Most tumors develop in the bones around the knee, either in the distal femur (the lower part of the thigh bone) or the proximal tibia (the upper part of the shinbone). The proximal humerus (the part of the upper arm bone close to the shoulder) is the next most common site. However, osteosarcoma can develop in any bone, including the bones of the pelvis (hips), shoulder, and jaw. This is especially true in older adults.

Ewing Sarcoma

Ewing’s Sarcoma is a very rare form of bone cancer that strikes children and adolescents. Actually, it is a group of four different types of cancer, known collectively as the Ewing’s Family of Tumors (EFT). About 250 cases are diagnosed every year in the U.S. Two-thirds of patients are long-term survivors of the disease. Although it can occur at a younger age, most Ewing’s sarcoma cases are found in children aged 10 to 20. Caucasian children, particularly boys, are much more likely to have EFT than any other racial or ethnic group.

Ewing’s sarcomas are caused by chromosome changes that occur after birth. In a process known as translocation, chromosomes 11 and 22 “swap” small pieces of each other, resulting in an abnormal gene that can be detected with DNA testing. However, it’s not known why this translocation takes place. There are no identifiable risk factors that increase a child’s susceptibility to Ewing’s sarcomas, and it’s not passed along from parent to child like some inherited childhood cancers. In fact, it’s extremely rare for it to happen more than once in the same family.

Erwing’s bone sarcoma accounts for about 85% of all cases. It is usually found in the long bones in the arm or leg, although it can occur in the pelvis or ribcage. Extraosseous sarcomas are tumors that occur outside the bone. Only about 8% of EFT cases are of this type.

Primitive neuroectodermal tumor (PNET), also known as peripheral neuroepithelioma, can occur in bone and/or soft tissue. Askin’s tumor is a PNET that occurs in the marrow cavities of the chest wall. It often spreads to the surrounding soft tissue and is a highly malignant tumor with guarded prognosis, which is dependent upon the extension of tumor at the time of diagnosis.

Symptoms

Of Osteosarcoma

The most common complaint is a constant dull ache in the bone or joint, often increasing at night when sleeping. The pain tends to increase over time rather than subside. At the site of the tumor, there may be swelling or a lump. If the tumor is in the leg, a child may limp. Osteosarcoma may make the muscles in the affected leg or arm appear smaller.

Of Ewing Sarcoma

Ewing sarcoma often goes unnoticed or misdiagnosed as growing pains (due to its subtle, gradual onset) or a sports injury because symptoms often mimic those of injuries kids can get out on the field.

Soreness at the tumor site, accompanied by swelling or warmth, is common. Pain may be worse during exercise or at night, and a tender lump may develop in the affected area a few weeks after pain begins. If the tumor grows in a leg bone, the child may have an unexplained limp. A low-grade fever also can develop.

If cancer has spread, or metastasized, to other areas of the body like the lungs or bone marrow, symptoms may appear there as well. In some cases, the first sign of the disease is a broken arm or leg that occurs for no reason at all (or after a minor accident) because the cancer has weakened the bone, making it vulnerable to a break.

Typical Treatments

For Osteosarcoma

Standard Osteosarcoma Treatment (additional new types of treatments are being tested in clinical trials and can be found on the NCI Web site): The treatments listed below are to be used as a suggestion of what you may expect. Please speak with your doctor about specific treatment plans he or she may have for your child.

  • Chemotherapy
  • Surgery
  • Radiation therapy
  • Hormone or biological therapy
For Ewing Sarcoma

Standard Ewings Sarcoma Treatment (additional new types of treatments are being tested in clinical trials and can be found on the NCI Web site): The treatments listed below are to be used as a suggestion of what you may expect. Please speak with your doctor about specific treatment plans he or she may have for your child.

  • Chemotherapy
  • Surgery
  • Radiation therapy

In addition, new types of treatments are often being tested in clinical trials and can be found on the National Cancer Institute Website.

Remember, you’re not alone.
Use our Forums to ask other parents what they’ve experienced.

Stages

The stage of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type, and stage, of the cancer helps the doctors to decide on the most appropriate treatment.

Most patients are grouped depending on whether cancer is found in only one part of the body (localised disease), or whether the cancer has spread from one part of the body to another (metastatic disease).
A commonly used staging system for osteosarcomas is described below:

  • Stage 1A: The cancer is low grade and is found only within the hard coating of the bone.
  • Stage 1B: The cancer is low grade, extending outside the bone and into the soft tissue spaces that contain nerves and blood vessels.
  • Stage 2A: The cancer is high grade and is completely contained within the hard coating of the bone.
  • Stage 2B: The cancer is high grade and has spread outside the bone and into surrounding soft tissue spaces that contain nerves and blood vessels. Most osteosarcomas are stage 2B.
  • Stage 3: The cancer can be low or high grade and is found either within the bone or extends outside the bone. The cancer has spread to other parts of the body, or to other bones not directly connected to the bone where the tumour started.

If the cancer comes back after initial treatment, this is known as recurrent or relapsed cancer.

References:

MD Anderson Childhood Cancer Types. Houston, TX: MD Anderson. Retrieved August 15, 2011 from http://www.mdanderson.org/patient-and-cancer-information/
cancer-information/cancer-types

National Institute of Health. Types of Cancers 2011. Retrieved September 13, 2011 from http://www.cancer.gov/cancertopics/pdq/treatment

American Cancer Society. Cancer Facts and Figures 2009. Atlanta, GA: American Cancer Society. Retrieved September 1, 2011, from http://www.cancer.org/downloads/STT/CAFF2009PWSecured.pdf.

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