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Pediatric cancer

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was reviewed on June 9, 2022.

Cancer develops when cells start to multiply and grow out of control. It can happen to almost any cell type, anywhere in the body. Cancer cells can form tumors and spread in the body, affecting the blood, lymph nodes or organs.

Some key takeaways:

  • Certain cancers are more common in children compared to adults. These cancers behave differently and tend to respond better to treatments than many adult cancers.
  • Children are treated in pediatric cancer centers, which have experts in pediatric cancer care and access to clinical trials and advanced treatments.
  • Children are very resilient and often otherwise healthy, helping them cope with and fight the disease.
  • It’s important to understand long-term side effects of treatments and be familiar with follow-up guidelines designed to help prevent and manage issues as early as possible.

What you need to know about cancer in children

More than 80 percent of children with cancer now live for five or more years after their initial diagnosis. The five-year survival rate for many common childhood cancers has increased dramatically over the past few decades. Five years is considered a significant milestone, as some types of cancers are unlikely to return after this period of time.

The medical community has made significant strides in treating children's cancer over the past few decades.

The National Cancer Institute reports:

  • In 1975, more than five per 100,000 children and teens died due to cancer. Between 1975 and 2015, that number declined by more than 50 percent. About two per 100,000 children and teens died of cancer in 2015.
  • Similarly, in the 1970s, 58 percent of children under 14 were still living five years after their cancer diagnosis. As of 2014, nearly 84 percent of these children survived for five years or more.
  • Still, an estimated 1,800 children and adolescents in the United States die of cancer every year, demonstrating that more work needs to be done before every child has hope of surviving a cancer diagnosis.

The most common types of child cancer (affecting those 15 and younger) are:

  • Leukemia
  • Brain and spinal cord tumors
  • Lymphoma (including both Hodgkin and non-Hodgkin)
  • Neuroblastoma
  • Wilms tumor
  • Rhabdomyosarcoma
  • Retinoblastoma
  • Bone cancer (including osteosarcoma and Ewing sarcoma)

Leukemias, brain and spinal cord tumors and lymphomas are the three most common cancers among children and adolescent teens in the United States.

After these three types, teens (ages 15 to 19) tend to more commonly develop:

  • Testicular or ovarian cancer
  • Thyroid cancer
  • Melanoma

What causes childhood cancer?

Like cancer in adults, childhood cancer is caused by DNA changes called mutations. DNA is the code for your genes. It tells your child’s cells what to do, like how to grow and multiply, or die and shed. These DNA instructions normally keep this process in balance, managing the number of cells. When DNA mutates, this process can go awry.

  • Mutations can be inherited, meaning they’re passed down from parent to child, but most child cancers are not linked to the genetic code inherited from parents.
  • Most cancers—in both children and adults—are caused by DNA changes that occur during one's lifetime—even before birth while in the womb. Some cells mutate randomly, while others are prompted by environmental factors (like smoking cigarettes).
  • Random mutations can occur when one of the trillions of cells in the body divide. When a cell divides into two, it copies its DNA. Sometimes, the DNA is copied incorrectly, and a mutation appears.

Other mutations are caused by exposure to factors in day-to-day life. While many adult cancers are linked to lifestyle factors like weight, exercise habits, diet choices and alcohol or tobacco use, these influences take time, often years, to have an effect on DNA. Experts have not been able to identify clear-cut links to lifestyle or environmental factors in children, though they acknowledge that it’s a challenge to develop the answers given the low numbers of children with each cancer type.

For the most part, cancer in children is thought to be caused by factors unrelated to lifestyle or environment. But still, a few environmental factors have been associated with an increased risk of some childhood cancers. For example:

  • Radiation exposure may increase a child's risk of developing certain types of cancer. This association became clear in the aftermath of World War II, when exposure to radiation from atomic bombs dropped in Japan elevated the risk of leukemia among children and teens. Similarly, when an accident occurred at the Chernobyl nuclear plant, causing radiation to leak into the air, children who were exposed had higher rates of thyroid cancer.
  • X-rays performed on pregnant women and CT scans performed on infants and young children have also been linked to a higher risk of childhood cancers.

You can limit your child's exposure to radiation by playing an active role in his or her medical care, because medical devices like computed tomography (CT) scans can emit radiation at levels that are potentially dangerous to children when used unnecessarily.

But, in many cases, when appropriately performed, the benefits outweigh the risks of using medical scans on a child. CT scans are crucial to detecting illness and injury and can be lifesaving. Still, these scans must be performed properly and only when necessary.

More research is needed to confirm links to causes of pediatric cancer. Other potential environmental risk factors are still under investigation. While some studies have identified possible links between certain childhood cancers and exposures to chemicals like pesticides, the evidence is inconclusive, and it seems that most childhood cancers do not have strong environmental causes.

Can you detect childhood cancers early?

Recognizing cancer's early symptoms can be difficult, because they are easily mistaken for other, more common illnesses. Symptoms may vary depending on the cancer type, but you should consider having your child checked by a doctor if you notice unusual and persistent symptoms, such as:

  • An unusual lump or swelling
  • Unexplained paleness and loss of energy
  • Easy bruising or bleeding
  • An ongoing pain in one area of the body
  • A limp
  • Unexplained fever or illness that doesn't go away
  • Frequent headaches, often with vomiting
  • Sudden eye or vision changes
  • Sudden unexplained weight loss

Diagnosing childhood cancer

Cancer in children is rare, and many symptoms associated with cancer are more likely due to other, more common causes. If you’re concerned, your child may benefit from a visit to the doctor, who can help determine what’s causing the symptoms and how to treat them appropriately.

How is cancer in children treated?

The pediatric treatment regimens for children with cancer are similar to those for adults, but they are sometimes a bit more aggressive early on. Common treatments include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
  • Stem cell transplant

There is no "best" treatment for childhood cancer. The appropriate therapy, or combination of therapies, for a child with cancer depends on their cancer type and how advanced it is.

Some children’s cancers respond better to chemotherapy, which tends to work well on pediatric cancers because they are often fast-growing.

Children may also be better equipped to handle more intense treatments, because they tend to be more resilient than adults and are less likely to have underlying health problems that can be made worse by cancer treatments.

What’s the longer-term outlook for survivors of childhood cancer?

The pediatric treatment regimens for children with cancer are similar to those for adults, but they are sometimes a bit more aggressive early on. Common treatments include:

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Immunotherapy
  • Stem cell transplant

There is no "best" treatment for childhood cancer. The appropriate therapy, or combination of therapies, for a child with cancer depends on their cancer type and how advanced it is.

Some children’s cancers respond better to chemotherapy, which tends to work well on pediatric cancers because they are often fast-growing.

Children may also be better equipped to handle more intense treatments, because they tend to be more resilient than adults and are less likely to have underlying health problems that can be made worse by cancer treatments.

Can anything be done to prevent cancer in children?

Because environmental factors don't play much of a role in influencing children's cancer, and inherited mutations are rarely at fault, the cause of cancer in children is most likely the random mutations that occur when cells divide. This is not something you can prevent, or see coming.

Show references
  • American Cancer Society (2019, October 14). Risk Factors and Causes of Childhood Cancer.
    https://www.cancer.org/cancer/cancer-inchildren/ risk-factors-and-causes.html.
  • National Cancer Institute (2018, September 4). Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers.
    https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation/pediatric-ct-scans.
  • American Cancer Society (2019, October 14). Finding Cancer in Children.
    https://www.cancer.org/cancer/cancer-in-children/findingchildhood- cancers-early.html.
  • National Cancer Institute (2020, August 28). Childhood Cancers.
    https://www.cancer.gov/types/childhood-cancers.
  • American Cancer Society (2019, October 14). Can Childhood Cancers Be Prevented?
    https://www.cancer.org/cancer/cancer-inchildren/ preventing-childhood-cancers.html.
  • Children’s Oncology Group. Survivorship Guidelines.
    https://childrensoncologygroup.org/index.php/survivorshipguidelines.