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Treating cancer in children

This page was reviewed under our medical and editorial policy by

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

This page was updated on June 9, 2022.

Navigating cancer care for families and children can be a challenging task. There are many comprehensive and evidence-based treatment options available to your child, as well as innovative and advanced care options, and hope, through clinical trials to assess. Your child’s cancer care team can help you determine the best course of treatment, lay out a blueprint for fighting the cancer and explain what each treatment is along the way. As a parent, you’ll want to know what each treatment is doing for your child, and you have the right to ask questions and share decision making.

The most common treatments for childhood cancers are:

  • Surgery
  • Radiation therapy
  • Chemotherapy

Other treatments include stem cell transplant after chemotherapy and newer types of treatments like targeted therapy and immunotherapy for some types of childhood cancers.

Treatment of children’s cancer, like adult cancer, depends on the type of cancer and how advanced it is, called the cancer stage. However, children’s cancer does not always act exactly like an adult cancer. That’s why children’s care plans are guided by a child cancer expert, called a pediatric oncologist. In addition, children’s cancer care is often provided at expert childhood cancer centers.

Clinical trials for children

Children’s Oncology Group (COG) is the world’s largest organization that conducts clinical trials for childhood cancer. A clinical trial is a research study that evaluates a new cancer drug, or combination of drugs, or new methods of current treatments like surgery or radiation. It helps to see if a new approach is safe or works better than something else.

COG member centers share their research to help find the best treatments. Clinical trials for the newest treatments for most types of childhood cancer are available. Along with your doctor, you and your child can consider joining a clinical trial after you understand the benefits and possible side effects and risks.

Although these trials are voluntary, they offer access to either the best available approved treatment or a new treatment that may be as good or better than current treatment. Most of the improvements in childhood cancer survival can be traced back to a clinical trial.

Common types of children’s cancer

Common childhood cancers are different from the most common adult cancers. The most common childhood cancer is leukemia, which is cancer of the blood and bone marrow. About 3 out of 10 childhood cancers are leukemia. Other common cancers in children include:

  • Brain and spinal cord tumors
  • Lymphoma (cancer of the immune system)
  • Neuroblastoma (cancer from developing nerve cells)
  • Wilms tumor (a type of kidney tumor)
  • Rhabdomyosarcoma (muscle cancer)
  • Retinoblastoma (a type of eye cancer)

Common children’s cancer treatments

While this is a challenging time, know that many cancer treatments in children have been very successful, and adjustments and newer treatments can be considered along the way. Staying in the moment at each step will help you and your child continue to determine the best course of action based on your child’s response to treatment.

The type of treatment depends on your child’s type of cancer, the stage of the cancer, your child’s age and overall health. In many cases, a combination of treatments is needed. Treatment may include:

Chemotherapy. These are medications that destroy cancer cells or stop them from growing.

Chemotherapy may be used:

  • Alone to treat cancer
  • Before surgery to decrease the size of a tumor
  • After surgery to kill any remaining cancer cells
  • Along with radiation therapy for more comprehensive treatment

Chemotherapy can be injected into the bloodstream or into the body. It can also be taken as an oral medication. Chemotherapy causes side effects because it damages normal cells along with cancer cells. Side effects can include fever, hair loss, nausea and vomiting. Managing side effects is an important part of treatment.

Radiation. Radiation therapy uses high-energy X-rays to kill cancer cells. Pediatric oncologists try to focus radiation therapy only on cancer cells at just the right dose. This helps prevent side effects caused by killing normal cells near the cancer. Radiation therapy can be used before or after surgery, or along with chemotherapy. It can be given from outside the body or placed inside the body. Side effects depend on where the cancer is, but the most common side effect in children is fatigue.

Stem cell transplant. Also called a bone marrow transplant, this treatment is used to destroy cancers that are inside bones in the bone marrow. Before the transplant, cancer cells are destroyed, usually with a high dose of chemotherapy. Stem cells that can move into the bone marrow to start producing healthy blood cells are given through a type of blood transfusion. Until the new cells start to make red and white blood cells, doctors must guard against side effects like infection and anemia.

Surgery. The most common reason for surgery is to remove a solid tumor. Surgery can be done through an open incision, or through small incisions using specially designed instruments, called minimally invasive surgery. Primary surgery removes all or as much of a tumor as possible. Second-look surgery may go back to check for or remove any remaining tumor. Side effects of surgery include bleeding, infection, pain and reactions to pain medications like nausea and constipation.

Immunotherapy. This treatment uses the body’s own immune system to fight cancer. Immunotherapy drugs are natural substances that occur in the body. These substances may stimulate the immune system to seek out and destroy cancer cells, called active immunotherapy. These treatments are usually given along with chemotherapy. Because they are more natural, they have less side effects. The most common side effects are flu-like symptoms that go away after treatment.

Targeted therapy. This is the newest type of cancer treatment. It is an active area of research and is commonly used in clinical trials for children. These therapies target and aim to interrupt specific processes that cancer cells use to grow. A targeted therapy may interfere with a tumor’s blood supply or interfere with the way tumors grow. Targeted therapies may improve the effects of chemotherapy drugs. Like immunotherapy, side effects of targeted therapies are milder and go away after treatment.

Precision medicine. This novel approach to cancer treatment holds promise. It is another active area of research and examined in clinical trials for children. With this care, genetic testing is used to understand the makeup of the tumor or cancer cells and tailored drugs are designed to fight it. It’s also sometimes referred to as “personalized medicine” or “precision oncologic medicine.” Clinical trials are underway in this area, and a number of advances in this area have been made.

Supportive and integrative therapies. An important part of any comprehensive treatment plan for childhood cancer is emotional support for children and their families as well as support for education, nutrition and physical recovery. That’s why child psychologists, social workers, child life specialists, physical therapists, dietitians and other supportive care providers are all important members of your child’s care team.

Finally, a key part of a treatment plan includes long-term support, called survivorship care. Children who survive cancer can develop emotional and physical health problems long after treatment. Survivorship care helps children and parents prepare for these problems and manage them as they occur.

Show references
  • American Cancer Society (2019, October). Treating Children with Cancer.
    https://www.cancer.org/cancer/cancer-in-children/how-are-childhood-cancers-treated.html.
  • National Cancer Institute (2020, August). Childhood Cancers.
    https://www.cancer.gov/types/childhood-cancers#treating-childhood-cancer.
  • American Cancer Society (2019, October). Types of Cancer that Develop in Children.
    https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html.
  • Children’s Oncology Group. Treatment Options.
    https://childrensoncologygroup.org/index.php/treatmentoptions.
  • Forrest, S. J., Geoerger, B., & Janeway, K. A. (2018). Precision medicine in pediatric oncology. Current opinion in pediatrics, 30(1), 17-24.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770114/.