Treatment Modalities: Pediatric Cancers

Pediatric Cancers

There are many different treatments for childhood cancers. Some children receive only one type of treatment, others a combination of therapies. The treatment each child receives, and the sequence in which the treatments are given, will depend on the type of cancer and the stage of the disease. The stage of disease refers to whether or not the cancer has spread, and if so, how far. Pediatric cancers are generally treated according to national or institutional protocols, in order to standardize the treatment patients receive, and to collect data on the effectiveness of treatments.

Some type of surgery is usually part of the diagnosis or treatment course. The three main types of surgery are biopsies, line placements or removals, and the actual surgical removal of the tumor. A surgical biopsy may be excisional, incisional, or done with a needle. A larger surgery for tumor removal is also performed on some patients. Another common type of surgery performed is the insertion or removal of a long catheter that is set into a large vein to deliver medicine or take blood samples.

Chemotherapy is the use of medications to treat cancer. The drugs are sometimes given orally, sometimes through a vein, or sometimes by injection. Chemotherapy may consist of just one drug, or a combination of drugs, whichever method is the treatment standard and will kill the cancer cells in the most effective way.

Chemotherapy is usually given in cycles: a treatment period (one or more days when treatment is given) followed by a recovery period (several days or weeks), then another treatment period, and so on.

However, sometimes chemotherapy is given intrathecally. In this treatment approach, the patient is under anesthesia and anticancer drugs are inserted into the spinal fluid through a needle placed in the spinal column or a device placed under the scalp.

Radiation therapy, such as we perform in our department, uses high-energy x-rays to destroy or damage cancer cells. Radiation can be given at various phases of cancer treatment. In early stage cancers, radiation therapy may be used to attempt to cure or control the disease. It can also be used before surgery to shrink a tumor, or following surgery to prevent the cancer from returning. In advanced cancer, radiation therapy may be used to treat symptoms that are caused by the cancer, such as pain.

Side effects from radiation depend on where the radiation is aimed. Always discuss any side effects with the child’s physician. Side effects may include:

  1. Damage to the skin, so treated areas should be protected from sunlight and irritation.
  2. Sore mouth (if the head and neck area is treated).
  3. Temporary hair loss in the area receiving radiation.
  4. Diarrhea, nausea, vomiting or headaches. Medicines given before or following treatment can alleviate some of these side effects. Small meals eaten three to four hours before treatment can sometimes lessen nausea. Over-the-counter medications can help with diarrhea.