While childhood cancers are “very rare,” according to Dr. Kenneth E. Bujold III, DO, pediatric hematologist/oncologist at Baystate Children’s Hospital, he says there are three most common types of cancer typically seen in children: leukemias, lymphomas, and brain tumors.
“The three types are vastly different and mostly curable,” says Dr. Bujold. “Our care of young cancer patients is continually evolving.”
He says leukemias are more common in younger children (toddlers and young children), while lymphomas are more commonly seen in older children (teens). However, any type of childhood cancer can start at any age. Dr. Bujold cites that about 17,000 children are diagnosed with cancer across the United States each year which constitutes about 43-45 new cases per day. While that might seem like a lot, when considering the 70 million children living in the United States, it remains a rare disease.
“But it doesn’t seem rare to a parent or guardian living through it with their child, of course,” he says. “To them, it remains ever-present in their daily lives. Today though, we see an 80 percent overall survival rate. Approximately, four out of five children survive cancer. That’s good, but not nearly good enough. We want to see 100 percent.”
How is a Child Diagnosed with Cancer?
Typically, a child who is diagnosed with cancer often first visits their pediatrician or primary care provider who sends them for tests based on symptoms the child has been feeling and for how long. Pediatric oncologists, experts in childhood cancers, then become involved to help determine a diagnosis. Depending on the type of pediatric cancer suspected, different types of tests are performed. For leukemia, specialized blood work is done by checking the marrow inside the bones. A biopsy, which involves getting a small piece of the suspected tumor, is typically done for lymphomas and brain tumors. If a child is suspected of having a cancer, many will have X-rays, CT or MRI scans in addition to their blood work and biopsies.
Treatments for Childhood Cancer
Treatment of childhood cancer can involve multiple different methods and include chemotherapy, radiation therapy, surgery and stem cell transplant. Chemotherapy is utilized in the vast majority of cancers and often is the only treatment that is needed. However, certain diseases such as brain tumors may require all four treatments to achieve a cure.
“Every treatment is based on the individual child and their cancer,” says Dr. Bujold. “We customize treatment to focus on a particular patient’s needs. The goal is remission and cure.”
A care team works with each child and their family. As a multidisciplinary group, the team works together throughout diagnosis, treatment, and recovery. The team includes board-certified pediatric hematologists and oncologists, a certified pediatric nurse practitioner, oncology-certified registered nurses, medical assistants, child life specialists, social workers, nutritionists, pediatric surgeons, pediatric radiologists, pathologists, pediatric anesthesiologists, and intensivists, pharmacists, radiation oncologists and neuropsychologists.
A cancer diagnosis and its treatment do not exist in a vacuum. The disease can impact every member in the family.
“We work with families not only to educate them on the cancer but help them navigate through its treatment, ” he says. “Having a dedicated social worker to help families with the financial challenges and stress they are going through is essential to the complete care of the patient and family. We also work on nutrition and other things the family can do to help their child stay well.
“Our nurses and medical assistants, for instance, who specialize in this type of medicine, are with these children every day. They are making lifelong, strong bonds with the patients and families. They are always the trusted voice on the other end of the phone whenever there are questions or concerns.”
“Children with cancer are not only dealing with the disease, but are adjusting to a new way of life, they are not seeing their friends like they did, they are losing their hair. They need support and our team provides it all the way through.”
Dr. Bujold says treatment can take up to about two-and-a-half years. Sometimes, treatments take as little as six months to complete.
“Leukemia tends to take a long time, while lymphoma tends to take the shortest amount of time,” he explains. “We continue to monitor all of our patients closely by doing blood work, CT and MRI scans, X-rays, whatever is necessary.”
During and After Cancer Treatment
Children are monitored closely throughout their treatment, as well as after treatment.
“We continue to monitor children by doing blood work,” says Dr. Bujold. “We also continue doing CT and MRI scans, X-rays, and anything else that needs to be done. As time passes and things are looking ‘good,’ there are survivor clinics.
“We educate parents and older children on what might happen during or after treatment by providing a treatment summary, teaching them how to remain healthy, and teaching them about what to look for – we are actively caring for them well beyond treatment. We might diagnose a child when they’re in elementary school and follow them through high school or even college.”
Baystate Health keeps impeccable records of each patient, like the medications they received and details of surgeries they had so that those records are at their fingertips.
“We spend hours and hours with every family, building trust and discussing treatment,” says Dr. Bujold. “You have to do that because our relationship with each child and family can last for years.”
What to Expect if Your Child Needs to Stay in the Hospital
Depending on your child’s condition and treatment, he or she may need to stay in the hospital for a period of time. Baystate Children’s Hospital is the region’s only full-service, accredited children’s hospital. The family friendly environment of our Children’s and Adolescents’ Unit comforts kids and support from our Child Life Program helps ease the stress of a hospital stay. Plus, it is located in the same facility as the Sadowsky Center for Children, so it will be a familiar and seamless transition for you and your child.
Working Toward a Cure
Bujold says Baystate Health tends to see about twenty-five new cases per year.
Dr. Bujold says there’s good news: more than 200 institutions worldwide are working together, researching childhood cancers together, trying to find cures.
“We’re always looking for the next best treatments and that’s why we are a member of the Children’s Oncology Group,” he explains. “In 1960, all childhood cancers were terminal. Today, many of them are fully curable.”
“That’s pretty good news,” he says. “Of course, not for parents going through this with their child, but we’re seeing much better outcomes and medications are getting better and better with less toxicity. We can offer more than just hope now. We can provide a cure.”
What sets Baystate Health apart from others is the personalized treatment from a small group of providers who stay with the child all the way through.
“Our providers know our patients,” he says. “And patients know them. They get to hear the same voice deliver news. Patients and their families don’t have to retell their stories to someone new every time. We provide a warm, inviting, friendly atmosphere, but we also provide privacy for patients and their families when they desire. There’s a real community feel here. We are a community. That’s wonderful because this becomes their second home for a while.”
Resources for Families Coping with Childhood Cancer
Survivorship Program
Baystate Health offers a Survivorship Program. As a patient in the program, you can expect your team to:
- Provide a summary of your child’s cancer treatment
- Evaluate your child for late effects from treatments (chemotherapy, radiation, surgeries, stem cell transplants)
- Share information with you about treatment risks and related late effects
- Stay in touch with your primary care doctor and any other specialists
Passport for Care
You can find a summary of your diagnosis and treatment through the Passport for Care website. It is a secure website that allows oncologists to upload treatment summaries and other important information about your care. You will be able to find the most current information about your child’s diagnosis, treatment, and other related medical issues. You can find information about college scholarships, financial and legal resources, and support groups.