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.

Lymphoma

Non-Hodgkin lymphoma and Hodgkin lymphoma (sometimes called Hodgkin disease, Hodgkin’s disease, or Hodgkin’s lymphoma), are cancers that start in lymph tissues, such as the tonsils, lymph nodes, and thymus.

These cancers may spread to bone marrow and other organs, which can cause different symptoms depending on where it is growing. They also can cause fever, sweats, weakness, and swollen lymph nodes in the neck, armpit, or groin.
Childhood lymphomas are also classified by how fast they spread. Low-grade (indolent) lymphomas progress very slowly, but tend to be more widespread in the body. Intermediate (aggressive) and high-grade lymphomas spread more quickly, but usually respond well to intensive treatment, and are more common in children

Types

  • Hodgkin’s Lymphoma (HL) mostly occurs in adolescents and young adults aged 15 to 35. It’s slightly more common in males and tends to be more aggressive in older patients. Hodgkin lymphoma accounts for about 4% of childhood cancers. It is more common, though, in 2 age groups: early adulthood (age 15 to 40, usually people in their 20s) and late adulthood (after age 55). Hodgkin lymphoma is rare in children younger than 5 years of age. This is one type of cancer that is very similar in children and adults, including which types of treatment work best. 
  • Burkitt’s Lymphoma (BL) is an aggressive, fast-moving cancer affecting B cell lymphocytes. It is quite rare in the U.S., but much more common in countries near the equator, particularly Africa and South America.
  • Lymphoblastic Lymphoma (LBL) mostly affects T cell lymphocytes and is similar to acute lymphoblastic leukemia (ALL). It makes up about one-third of all childhood NHL, and is more common in boys.
  • Large Cell Lymphoma (LCL) includes two subtypes: diffuse large B-cell lymphoma (DLBCL) mostly affects pre-adolescent and teenaged children; and anaplastic large cell lymphoma (ALCL) is more common in adolescents.

Symptoms

Specific lymphoma symptoms vary according to disease type, but most have the following symptoms in common:

  • Painless swelling or enlargement of lymph nodes, especially in the neck, armpits and groin
  • Excessive night sweats
  • Unexplained fever
  • Undetermined weight loss
  • Loss of appetite
  • Itchy skin

Typical Treatments

Standard Lymphoma 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
  • 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 following stages are used for childhood non-Hodgkin lymphoma:

Stage I
In stage I childhood non-Hodgkin lymphoma, cancer is found:
• in one group of lymph nodes; or
• in one area outside the lymph nodes.
No cancer is found in the abdomen or mediastinum (area between the lungs).

Stage II
In stage II childhood non-Hodgkin lymphoma, cancer is found:
• in one area outside the lymph nodes and in nearby lymph nodes; or
• in two or more areas above or below the diaphragm, and may or may not have spread to nearby lymph nodes; or
• to have started in the stomach or intestines and can be completely removed by surgery. Cancer may or may not have spread to certain nearby lymph nodes.

Stage III
In stage III childhood non-Hodgkin lymphoma, cancer is found:
• in at least one area above the diaphragm and in at least one area below the diaphragm; or
• to have started in the chest; or
• to have started in the abdomen and spread throughout the abdomen, and cannot be completely removed by surgery; or
• in the area around the spine.

Stage IV
In stage IV childhood non-Hodgkin lymphoma, cancer is found in the bone marrow, brain, or cerebrospinal fluid. Cancer may also be found in other parts of the body.

Stages of childhood Hodgkin lymphoma may include A, B, E, and S.
Childhood Hodgkin lymphoma may be described as follows:

• A: The patient has no symptoms.
• B: The patient has symptoms such as fever, weight loss, or night sweats.
• E: Cancer is found in an organ or tissue that is not part of the lymph system but which may be next to an involved area of the lymph system.
• S: Cancer is found in the spleen.

The following stages are used for childhood Hodgkin lymphoma:

Stage I
Stage I is divided into stage I and stage IE.
• Stage I: Cancer is found in one or more lymph nodes in one lymph node group.
• Stage IE: Cancer is found outside the lymph nodes in one organ or area.

Stage II
Stage II is divided into stage II and stage IIE.
• Stage II: Cancer is found in two or more lymph node groups above or below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
• Stage IIE: Cancer is found in one or more lymph node groups above or below the diaphragm and outside the lymph nodes in a nearby organ or area.

Stage III
Stage III is divided into stage III, stage IIIE, stage IIIS, and stage IIIE+S.
• Stage III: Cancer is found in one or more lymph node groups above and below the diaphragm (the thin muscle below the lungs that helps breathing and separates the chest from the abdomen).
• Stage IIIE: Cancer is found in lymph node groups above and below the diaphragm and outside the lymph nodes in a nearby organ or area.
• Stage IIIS: Cancer is found in lymph node groups above and below the diaphragm, and in the spleen.
• Stage IIIE+S: Cancer is found in lymph node groups above and below the diaphragm, outside the lymph nodes in a nearby organ or area, and in the spleen.

Stage IV
In stage IV, the cancer:
• is found outside the lymph nodes throughout one or more organs, and may be in lymph nodes near those organs; or
• is found outside the lymph nodes in one organ and has spread to lymph nodes far away from that organ; or
• is found in the lung, liver, or bone marrow.
Untreated, classical Hodgkin lymphoma is divided into risk groups.
Untreated, classical childhood Hodgkin lymphoma is divided into risk groups based on the bulk of the tumor (tumors that are 5 centimeters or larger are considered “bulky”) and whether the patient has “b” symptoms (fever, weight loss, or night sweats). Treatment is based on the risk group.
• Low-risk disease:
o Patients with stage I or stage II disease; and
o No bulky tumors or “b” symptoms.
• Intermediate-risk disease:
o Patients with stage I or stage II disease, with bulky tumors, or with “b” symptoms; or
o Patients with stage III or stage IV disease without “b” symptoms.
• High-risk disease: Patients with stage III or stage IV disease with “b” symptoms.

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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