Treating children's cancers

Each type of cancer is treated differently. In some cases, several types of cancer treatments are given.

A child's treatment

Having treatment for childhood cancer means that many health professionals will be involved. This team consists of doctors, nurses, social workers, dietitians, pharmacists, psychologists and allied health professionals.

Before cancer treatment starts, a doctor will explain the treatment plan in detail and the aims of treatment. A checklist of things that are helpful to know include:

• the type of treatment that will be given
• how the treatment will be given (injection, tablet etc)
• who will give the treatment and where
• how long the treatment will take
• the risks of treatment
• side effects of treatment, both immediate and long term
• other possible treatments
• whether or not the treatment is part of a clinical trial.

Staging children's cancers

The stage of a cancer describes the size of the cancer as well as if it has spread from where it started in the body to other surrounding tissue and organs.

Knowing the stage of a child's cancer helps the team decide on the best treatment.

Although the meaning of each stage may be different for different types of cancer, in general:

• stage 1 means that the cancer has not spread to other parts of the body
• stages 2 and 3 usually mean that the cancer has spread to other tissues close to the main tumour
• stage 4 means that the cancer has spread beyond the main tumour to other parts of the body. Doctors call this metastasis or secondary cancer.

Treatments

There are three main types of treatment for childhood cancers: surgery, chemotherapy and radiotherapy (radiation therapy).

Some cancers will need more than one type of treatment. For example, a child may have radiotherapy and chemotherapy together. Many children may be given their treatment as part of a clinical trial.

Below is a short description of each type of treatment.

For more information, the following websites have information about children's treatments and their side effects:

• The UK Children's Cancer and leukaemia Group
• The Children's Oncology Group

Chemotherapy (cytotoxic drugs)

Chemotherapy uses drugs to help to kill cancer cells.

However, when chemotherapy kills cancer cells, it may also damage healthy cells. Side effects can be hair loss, nausea and vomiting, mouth sores, low blood counts and loss of appetite. Side effects vary depending on the type of medication and usually go away once the treatment stops.

Radiation therapy

Radiation therapy (also known as radiotherapy) uses high energy x-rays to kill or damage cancer cells to stop them from growing and multiplying. Radiation therapy damages cancer cells, but may also damage cells in the area being treated.

Before starting radiation therapy, the radiotherapy scientist/technician begins planning. This means working out the exact position to place your child. Small marks will be drawn on the area of the body where your child needs treatment. This allows the radiation therapy to be given at the same place each time. Radiation therapy usually takes a few minutes each session.

Radiation therapy side effects depend on how much is given and the part of the body being treated, and will be discussed in detail before treatment.

Surgery

Surgery might be used to remove all or part of a tumour at diagnosis. The type of operation a child has will depend on the type of cancer.

Biotherapy

Biotherapy uses the body's immune (defence) system to fight cancer cells. It may be used to help find the cancer cells in the body and help the body recover quickly from side effects, or prevent the spread of cancer cells.

Stem cell transplant

A stem cell transplant (SCT) is a procedure used as part of some cancer treatments when the doses of chemotherapy are so high that the cells in the bone marrow are permanently destroyed. A SCT is also used if the child has cancer cells in the bone marrow.

The transplanted cells may be from the child's own cells, a relative or someone not related to the child, dependant on the type of cancer. For more information visit the Royal Children's Hospital (RCH) website.

Complementary and alternative therapies

It is common for parents of children with chronic health conditions or with cancer to seek out complementary and alternative treatments.

Complementary therapies include massage, meditation and other relaxation methods that are used along with medical treatments. Some complementary therapies are useful in helping children to cope with the challenges of having cancer and cancer treatment.

Alternative therapies are unproven and can include some herbal and dietary remedies that are used instead of medical treatment. Some of these have been tested scientifically and found to be ineffective or even harmful, especially if:

• they are used instead of medical treatment
• herbs or other remedies make your medical treatment less effective
• these therapies are not discussed with the child's oncologist and team.

Be aware that a lot of unproven remedies are advertised on the internet and elsewhere without any control or regulation. Before choosing an alternative remedy, discuss it with the doctor or hospital pharmacist.

You can also speak with a cancer nurse at Cancer Council by calling 13 11 20. You may also find it helpful to read the Cancer Council booklet, Understanding complementary therapies:

Clinical trials

Clinical trials are used to try and find new and better ways of treating cancer and managing the side effects of treatment. Almost everything we have learnt to date about children's cancers has come from clinical trials.

For more information, see the clinical trials information page on the Australian and New Zealand Childrens Haematology/Oncology Group and speak with your child's oncologist.

You can also download our booklet Understanding clinical trials and research:

New treatments and research

Scientists and doctors are continually looking for new ways to prevent, diagnose and treat children's cancer and any late effects of treatment. New treatments are always being investigated and tested for different types of children's cancers.

Researchers are seeking to discover whether other factors, apart from the few known possible causes, may cause the disease. Research is focused on:

• the biology (function) of cancer cells, why cancer occurs and what new treatments can be used to fight it
• medications that target individual cancer cells directly
• working together with children's cancer centres across the globe to ensure new ways of treating cancer are measured and benefit as many children as possible.

For more information:

• Australian Children's Cancer Clinical Trials Registry or Children's Cancer Institute Australia for information about clinical trials going on in Australia