16 Things Every Parent Needs to Know About Childhood Cancer
No parent should ever hear the words, “Your child has cancer,” but unfortunately many do. In 2019, 11,060 children in the United States under the age of 15 will be diagnosed with cancer, but there is much reason for optimism given advances in treatment and high survival rates.
This is not your mother’s, father’s, or even your best friend’s cancer
Cancer in children is very different from cancer in adults, says Rabi Hanna, MD, a pediatric hematologist-oncologist at Cleveland Clinic Children’s Hospital in Ohio. For starters, children are affected with different types of cancer than adults, namely blood cancers like leukemia, brain tumors, and Wilms tumor (a type of cancer that starts in the kidney), according to the American Cancer Society. They also tend to respond better to treatment than adult cancers, he explains.
It’s time to wipe the slate clean
The first thing Jennifer Reichek, MD, an attending physician in the Hematology, Oncology, Transplant department of the Ann & Robert H. Lurie Children’s Hospital of Chicago, tells parents when their child is diagnosed with cancer is to forget everything they think they know about cancer. The social worker turned physician is also the director of the STAR (Survivors Taking Action and Responsibility) Program at the hospital and an assistant professor of medicine at Northwestern University Feinberg School of Medicine. More than 80 percent of children with cancer now survive five years or longer, according to the American Cancer Society. “We expect to cure your child and that is the outcome we are working toward,” she says.
Knowledge is power
Hearing your child has cancer is gut-wrenching, but the best thing to do for your child is to try and gather as much information on the cancer and its treatments as possible, Dr. Hanna says. Because it’s hard to process all this information, it’s a smart idea to bring a friend along to your child’s appointments. “Always bring a second set of ears to your doctor’s visits, take notes to review later, and ask the doctor if you can record the conversation,” he says.
Second opinions help
If you’re unsure about the diagnosis, treatment options or side effect profiles of the recommended treatment, get another opinion, Dr. Hanna suggests. “Not all cancer needs to be treated immediately. You can wait a week or two to make a long-term plan.”
You need a dream team
Your child’s cancer treatment team should include an oncologist and other doctors or surgeons who will administer the treatments, social workers, nurses, art therapists, and more. “You are not alone and should never feel that you are,” Dr. Hanna says. These are services offered at some of the 50 best cancer hospitals in the United States.
Your other children need support too
Support groups are also helpful for the child with cancer as well as any siblings, Dr. Hanna says. “Other siblings are often profoundly affected when their brother or sister has cancer.” They likely have a lot of questions and may also feel left out and guilty for feeling that way. Ask your doctor what resources are available to help them cope with what is happening.
Thinking ahead matters
It’s only natural that your initial focus is on treating and beating the cancer, but children who are treated for cancer may experience short- and long-term side effects down the road. Some chemotherapy regimens can impair their ability to have children of their own (even though they are just children themselves), for example. In a study of childhood cancer survivors, 70 percent of women had kids by the age of 45 compared to 80 percent of their healthier sisters. Fifty percent of male cancer survivors had fathered a child (or got a partner pregnant) by age 45 compared to 80 percent of the siblings who served as they control group. The findings appear in the Lancet Oncology. “Freezing sperm in boys is possible,” Dr. Hanna says. Girls don’t have mature eggs to freeze before they enter puberty, but ovarian tissue freezing, an experimental procedure for preserving fertility, may be an option in some cancer centers, Dr. Hanna says. “It’s important to know your options.”
It’s your story to share or not share
If your child has cancer, you don’t have to tell anyone until you are up to it. There are online blogs such as CaringBridge and services that can make it easier for you to share any news. “This way you don’t have to tell the same painful story over and over,” Dr. Hanna says.
There’s no room for blame and guilt
Parents also need to understand that there is nothing they did or didn’t do that caused their child’s cancer, and they certainly didn’t miss the signs. Unlike cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors. “These are not caused by diet or environment,” Dr. Hanna says. “Childhood cancers are most often due to abnormal gene development.”
And you didn’t miss the signs, Dr. Reichek adds. Sometimes there are no symptoms whatsoever. “Nobody instinctively thinks of cancer in kids. We tend to rule out common reasons before we go to cancer,” she says. One example: This 6-year-old was diagnosed with a brain tumor during a routine eye exam.
There is a crystal ball
Thanks to the Childhood Cancer Survivor Study, researchers have been able to track childhood cancer survivors for a long, long time. There is now data on 35,923 childhood cancer survivors diagnosed between 1970 and 1999 as well as 5,000 siblings who serve as the comparison group. “We have a lot of information on what happens as they age,” Dr. Reichek says. “This is why we are very specific about what drugs we use and the order in which we use them as well as the dosing schedules.”