20 Childhood Cancer

 Introduction

Cancer is when the body’s cells mutate and start to form tumors that harm the body (NCI, 2015). Cancer can be a hard health condition to deal with and can be scary for many families. Childhood cancer (CC) negatively affects a child’s mental, emotional, spiritual, and physical health. Many parents also find it difficult to deal with their child’s cancer as well as their own health. Each case is different from the next. Childhood cancer occurs before the age of 18 years old, with the average age of diagnosis being five years old (American Cancer Society, 2019). While cancer is more common in adults, some forms are more frequent in children. In 2022, about 10,470 children will be diagnosed with cancer when they are under the age of 15 (American Cancer Society, 2022). Childhood cancer rates have been increasing in the past few decades, but now, 85% of children diagnosed with cancer will live five or more years (American Cancer Society, 2022). Although treatment has continued to improve, childhood cancer remains the second leading cause of death in children (American Cancer Society, 2022).

Leukemia and brain or spinal cord tumors are the most common types of childhood cancers and make up 54% of all cases (American Cancer Society, 2019). Leukemia is cancer that affects the blood. The brain and the spinal cord make up the central nervous system (CNS), tumors in these areas will affect neurological function. While Table 19.1 reflects the more common CCs, other types can exist in children.

Symptoms to Watch Out for and When to See a Doctor

Table 19.2 shows many of the common cancer signs and symptoms. Signs of cancer can be hard to detect in children because they can look like other, less severe illnesses or injuries (American Cancer Society, 2019). Due to these similarities, parents need to listen to their children when they tell them that something doesn’t feel right. Being aware of the common signs and symptoms of childhood cancer allows for early detection, improving a child’s chance of recovery (American Cancer Society 2019). Always discuss any concerning, abnormal, or long-lasting symptoms with a doctor.

What to Expect if Your Child Gets Diagnosed

CC can cause issues in areas beyond just the child’s physical health. Families may have financial, emotional, and/or supportive problems that can occur when the child is diagnosed.

Treatment

Treatment for cancer in children can be a long and hard process. The most common treatment methods are chemotherapy and radiotherapy. While the purpose of these treatments is to kill cancer cells, there is also damage to healthy cells which leads to side effects. Some common therapeutic side effects can include fatigue, flu-like symptoms, pain, hair loss, increased risk of infection, and skin irritation (CHOC, 2021). Many of these symptoms will only last while treatment is ongoing, but some may continue after treatment has stopped. Long-term complications may include damage to the heart, lungs, kidneys, reproductive organs, or delayed development (CHOC, 2021). Before beginning any form of treatment, discuss potential side effects with the doctor as well as precautions that can be taken to minimize them.

Economic Hardships

Paying for cancer treatment is difficult and often includes unexpected costs. This financial burden includes the direct costs of treatment and indirect costs such as unexplained hospital visits or lack of insurance (Warner et al., 2015). On average, these direct and indirect costs total $40,400 (Warner et al., 2015). Many parents will also leave or stop working to take care of their child (Warner et al., 2015). Hospital social workers are knowledgeable in local and national resources that may assist with some of these expenses. National resources include St. Jude and the NCCS (see the resources section of this chapter for more information). Many communities have local organizations that can help reduce CC’s expenses (Warner et al., 2015). The community and support networks can help caregivers when a child has cancer.

Learning Disabilities and School-Related Issues

Children that get cancer have a harder time in school than their peers. Some children may need to miss days for treatment or due to their side effects. This may cause children to fall behind or find it harder to learn.  Caregivers can assist by recognizing that a child is struggling in school. These signs include a decrease in grades, a low desire to attend, or being overwhelmed with schoolwork. Asking the school for additional time or resources will help the child. Twenty-five percent of parents whose children had cancer reported that their child had a lower school performance (Hocking et al., 2018). However, 36.7% had their child evaluated for a learning issue, and only 45% asked the school for extra help for their child (Hocking et al., 2018). Schools will support the child with their education during treatment, but a caregiver needs to ask for it. School guidance counselors assist with navigating this process.

Supportive Care

Supportive care is assistance with health aspects beyond the physical disease for both the child and the family. Professionals outside the medical team address emotional, spiritual, and mental health needs. This support helps a family and/or child deal with their diagnosis. It is helpful to identify the impacts of childhood cancer on the family as well as places they can find support.  The healthcare team assists in identifying religious organizations or cancer support groups that offer coping strategies.  Mental health professionals provide therapy and other treatment options if a child develops depression or anxiety (Marusak, 2018).

Resources

Many resources exist to help with a childhood cancer diagnosis, especially national resources that help with financial hardships and some school-related issues. Most assistance will likely come from the child’s community, so discussing options with a local social worker or the school will help the family to get the most support.

• UC Irvine School of Medicine – CHOC
  • UC Irvine School of Medicine explains treatment-specific information on side effects and their longevity or how to manage the side effect. CHOC also discusses ways to talk to a child about their diagnosis as well as complications due to medical therapies.
• CancerCare
  • CancerCare includes a list of places that provide travel and financial assistance specific to childhood cancer. They include application information as well as places to find general assistance or scholarships (e.g., NCCS and St. Jude).
• USA Government Services
  • USA.gov website is a state-specific social services database that will connect the public to state social workers.

References

National Cancer Institute. (2015, November 15). Pediatric support care (PDQ)-patient version. NIH. https://www.cancer.gov/types/childhood-cancers/pediatric-care-pdq

American Cancer Society. (2019, October 19). Finding cancer in children. https://www.cancer.org/cancer/cancer-in-children/finding-childhood-cancers-early.html

American Cancer Society. (2019, October 14). Types of cancers that develop in children. https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html

American Cancer Society. (2022, January 12). Key statistics for childhood cancers. https://www.cancer.org/cancer/cancer-in-children/key-statistics.html

Children’s Health Orange County. (2021, March 29). Side effects of chemotherapy and radiation in children. https://www.choc.org/health-topics/side-effects-of-chemotherapy-and-radiation-in-children/

Hocking, M. C., Paltin, I., Belasco, C., & Barakat, L. P. (2018). Parent perspectives on the educational barriers and unmet needs of children with cancer. Children’s Health Care: Journal of the Association for the Care of Children’s Health, 47(3), 261–274. https://doi.org/10.1080/02739615.2017.1337516

Marusak, H. (2018). Understanding the Psychological Effects of Childhood Cancer. Scientific American.

Warner, E. L., Kirchhoff, A. C., Nam, G. E., & Fluchel, M. (2015). Financial burden of pediatric cancer for patients and their families. Journal of Oncology Practice, 11(1), 12–18. https://doi.org/10.1200/jop.2014.001495