Friday, October 23, 2015

Pediatric Cancer: Science Is Making Headway

Childhood Diseases

More Work: Ossola writes:“Researchers test samples as part of the St. Jude Pediatric Cancer Genome Project.”
Photo CreditSt. Jude Children’s Research Hospital, Memphis, Tennessee

An article, by Alexandra Ossolain Popular Science has given me a good reason to (re)think my views on childhood cancer, which I have long considered as a dreaded disease that robs young children of life, and unfairly so. And while I still view cancer as unfair, particularly when it affects children, there is some good news mixed in with the bad: pediatric cancer has a higher five-year survival rate than adult cancer: 80 per cent.

In “Learning From The Children,” Ossola begins by writing about the story of Maggie, who about 20 years ago was diagnosed at age four-and-a-half with with stage 3 nephroblastoma, a kidney cancer diagnosed in just 500 kids per year. After many rounds of chemo, at age six she was officially in remission, with no evidence of disease (NED)—the best news a person (or the parent of a young child) with cancer can hear.
Maggie is one of thousands of children who develop cancer and, through rigorous treatment and holistic care by doctors and families, beat the disease. Treatment for cancer has increased dramatically since the 1950s, and nowhere is that more evident than in pediatric oncology; of the thousands of children treated in the U.S. for cancer every year, 80 percent of them will go into remission and go on to live productive lives—significantly higher than the five-year survival numbers for general oncology, which are 63 percent chance of survival for female patients and 66 percent for men.
This disparity exists in part because of biology—the types of cancers that kids get, the strength of their immune systems—and because pediatric oncologists treat patients very differently than do general oncologists. The field isn’t perfect; some of the kids who survive have health issues later in life, and curing the remaining 20 percent of patients won’t be easy. But general oncologists can learn a few things about how pediatricians achieved this remarkable cure rate, and may be able to collaborate with them to discover new, less toxic treatments to benefit patients of any age.
“Childhood cancer is a different animal. Even though it has a similar end point [as adult cancers], the body in which it occurs is quite different than that of an adult,” says Alan Gamis, a pediatric oncologist at Children’s Mercy Hospital.
This article is nicely written and researched; my only quibble is that when it comes to a disease like cancer, the word “cure” is incorrect, in that cure implies that there is no possibility of the disease returning, that it has been eradicated. It is true that once a person has reached five years without any evidence of cancer, that its likelihood of returning is diminished.

Other than this, the article explains well why children generally fare better than adults. One reason is that the cancer is different in children than in adults; another is that children are generally more resilient and can take more chemo drugs than adults. Such is important, but the greatest difference might lie in the protocols revolving around pediatric cancers; Ossola writes:
From the start, pediatric oncologists created a unique culture of collaboration that exists in few other places in medicine. Childhood cancers are rare diseases, affecting around 16,000 children and adolescents per year but making up only 2 percent of all cancer cases. Over the past three decades, this collaboration has coalesced most clearly in clinical trials. About 60 percent of all kids with cancer participate in clinical trials, and have done so for decades.
Work has to continue on reducing the use of chemo drugs, which have long-term deleterious effects on the human body. Medical science has to continue looking at newer and better treatment options like immunotherapy, which aids and allows the human body’s immune system to take on cancer.

For more, go to [PopularScience]