In the early 1960s, three quarters of children diagnosed with cancer died. Today, more than three quarters of children survive. However this high overall survival rate masks wide variation between different types of cancer. The treatments used for childhood cancer are toxic, unpleasant and uncertain. 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.
Retinoblastoma, a cancer of the eye, can now be cured in almost every young patient, with a 99% 5-year survival rate for children in England. Neuroblastoma has the worst overall survival of the 10 main diagnostic groups – at 67%. Within the main diagnostic groups, there are some rare sub-types of cancer that still have appallingly low survival rates. High grade astrocytoma, a type of brain tumour, sees only 1 in 4 patients alive 2 years after diagnosis, and only 5% to 10% of patients alive at 5 years.