Childhood Cancers Cancer, the leading cause of death by disease in children in the United States, will account for about 1,700 deaths in 1997 in children under age 15. More than 8,500 children are diagnosed with cancer eachyear ­ 30 percent with leukemia, 12 percent with Hodgkin's and non-Hodgkin's lymphoma, and the remainder with solid tumors. The most common kind of childhood leukemia is acute lymphocytic leukemia (ALL). The most common solid tumors are brain tumors, such as gliomas and medulloblastomas; neuroblastomas, which developfrom nervous system tissue and commonly occur in the abdomen; Wilms' tumor in the kidney; and rhabdomyosarcoma, a soft tissue tumor of muscle that may occur in various places in the body. The number of children diagnosed with cancer each year has risen from 12 per 100,000 in the early 1970s to 14 per 100,000 today. At the same time, death rates have dropped and survival rates have risen sharply. Five-year survival for all childhood cancers is now at 71 percent, compared with about 51 percent in 1973. This improvement is one of the major payoffs from the nation's investment in cancer research. Advances Leukemia Step-by-step refinements in chemotherapy have boosted survival and cure rates through intensive multidrug treatments, followed by several years of chemotherapy to consolidate and maintain remission, and use of radiation or chemotherapy directed at leukemia cells that have infiltrated the central nervous system. More improvements have come with the use of high-dose chemotherapy for relapsed leukemia, along with transplantation of bone marrow or blood stem cells. Lymphoma Cures have stemmed from high-dose, multidrug chemotherapy regimens. These attack both tumors and microscopic cancer cells that have spread through the body. Other steps forward came with the tailoring of chemotherapy to the different kinds of lymphoma. For example, in non-Hodgkin's lymphoma, such tailoring took five-year survival rates from less than 30 percent 20 years ago to about 70 percent today. Solid Tumors Improvements have come with the use of combination therapies, such as chemotherapy before or after surgery or radiation therapy. For example, multidrug chemotherapy for Wilms' tumor following surgery has taken five-year survival rates from 74 percent in the mid-1970s to morethan 90 percent today. This approach has made it possible to reduce or omit radiation therapy, which is more toxic than chemotherapy, in the earlier stages of the disease. High-dose chemotherapy for bone cancers has proved effective in many cases. Quality of Life Limb-sparing surgery for many sarcomas has had a major impact. The testing and development of ICRF-187 (Zinecar[r]) as a cardioprotectant for anthracylines has been shown in children to reduce the risk of development of cardiotoxicity. Specialized Care Most children with cancer go to specialized pediatric oncology units or centers for treatment. About 70 percent enter studies where they receive the most advanced care. Statistics show that care in children's cancer centers is linked to higher survival rates.   Opportunities Bone Marrow Transplantation. Researchers are continuing to refine bone marrow and stem cell transplantation for leukemia. For example, the use of umbilical cord blood and marrow transplants from siblings is under study. Immunologic Therapies. Treatments that boost or direct the body's immune system show promise for lymphomas and leukemias. Genetics. Scientists are pursuing leads to the genetic and molecular markers of childhood cancers. They will use that knowledge to refine diagnosis, staging, and therapy. Adolescents and Cancer Centers. The number of adolescents (aged 15 and older) who receive treatmentat children's cancer centers is low compared with the number of younger children who do. It is important that more adolescents be referred to centers of excellence and into studies at these centers.   Additional Reading Lukens, J.N. "Progress Resulting from Clinical Trials: Solid Tumors in Childhood Cancer," Cancer Supplement (74)9, November 1, 1994. Sandlund, J.T., et al. "Medical Progress: Non-Hodgkin's Lymphoma in Childhood," New England Journal of Medicine (334)19, May 9, 1996. Fernback, D.J. and Vietti, T.J. Clinical Pediatric Oncology, 4th edition. Mosby-Year Book, Inc., 1991.   Statistics are from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database (January 1997) and from the American Cancer Society's Cancer Facts and Figures­1997, which contains estimates based on SEER data. The Cancer Information Service provides a nationwide telephone service for cancer patients, and their families, the public, and health care professionals. The toll-free number is 1-800-4-CANCER (1-800-422-6237); services are provided in English and Spanish. People with TTY equipment may call 1-800-332-8615. Back to How to Get It Return to Cancer Research Main Page