Treatment

The outlook for children with cancer has improved dramatically over the last fifty years.

In the early 1960s, three quarters of children diagnosed with cancer died. Today, three quarters of children survive.

However this high overall survival rate masks wide variation between different types of cancer.

Survival rates for the 12 main diagnostic groups vary between 96 per cent for retinoblastoma and 53 per cent for neuroblastoma. And within these main diagnostic groups, survival rates vary even more. Some rare sub-types of cancer have survival rates of zero.

As well as finding new ways to treat those forms of cancer which still have a poor outlook, a major challenge facing doctors today is how to make treatments safer and minimise the risk of treatment-related harm in young patients.

Treatment at specialist centresA major challenge facing doctors today is how to make treatments safer and minimise the risk of treatment-related harm in young patients.

Most children diagnosed with cancer in the UK will immediately be referred to one of 21 hospitals that are specialist centres for treating children’s cancer.

Doctors at the specialist centre will confirm the diagnosis and plan the child’s treatment. Some of the later treatment may be given at the family’s local hospital under the guidance of the specialist centre – this is known as shared care.

There are three main ways of treating cancer:

Solid tumours can be cut out during an operation (surgery)
Cancer cells can be killed with drugs (chemotherapy)
Cancer cells can be killed by radiation (radiotherapy)

Often a combination of these treatments is used.

Clinical trials

Many children have their treatment as part of a clinical research trial.

Trials aim to improve our understanding of the best way to treat childhood cancers – they usually compare the standard treatment with a new or modified version of the standard treatment. Information gathered from successive trials has been one of the most important factors in the increasing survival rates for childhood cancer.

Taking part in a clinical trial is entirely voluntary; the medical team will provide detailed information and you will be given plenty of time to decide whether it is right for your child. Children who do not take part will receive the current standard treatment.

Side effects and complications

Treatments for cancer involve high doses of toxic drugs and/or radiation. These therapies are effective in killing the deadly cancerous cells but unfortunately they can also damage normal, healthy cells, putting the child at risk of harmful side-effects.

Short-term side effects such as hair loss, nausea and anaemia are common but temporary problems. With good supportive care, they can be kept to a minimum.

But some children may experience more serious long-term effects, which persist for months or years after treatment, or ‘late’ effects which do not develop or become apparent until years after treatment ends. The risk of these effects varies from child to child, depending on the treatments used and the age and developmental stage of the child.

A major consideration in the development of new treatments is how to minimise the risk of harmful effects.

Read more: Side effects of treatment | Long-term and late effects of treatment

Treatments for different types of childhood cancer

Acute lymphoblastic leukaemia
Acute myeloid leukaemia
Bone tumours
Chronic myeloid leukaemia
Brain and spinal tumours (CNS tumours)
Gonadal and germ cell tumours
Hepatic tumours
Lymphomas
Neuroblastoma
Renal tumours
Retinoblastoma
Soft tissue sarcomas

For a child's perspective on leukaemia treatment:

Visit Chemo to the Rescue – a children's book on leukaemia

Read more: Stem cell transplantation | Commonly used terms in treatment | Childhood cancer