Cancer, once known as a disease primarily affecting the elderly, has become an alarming reality for children and adolescents. In the United States alone, cancer ranks as the primary cause of infant mortality following infancy. It is estimated that in 2024, over 9,000 children aged 0 to 15 will be diagnosed with cancer in the US, and globally, approximately 400,000 children face this daunting diagnosis each year. The most common types of childhood cancers include brain and other central nervous system (CNS) tumors, leukemias, and lymphomas. Despite advances in medical science, the reasons why children develop cancer remain elusive, making childhood cancer a profound scientific mystery.
Understanding Childhood Cancer: What We Know
Most childhood cancers' exact causes are unknown. Unlike adult cancers, which often result from the cumulative effects of aging and long-term exposure to carcinogens, childhood cancers appear without clear causative factors. A handful of about 10 percent of all cancers in children are linked to inherited genetic mutations. Most cases are believed to arise from gene mutations that lead to uncontrolled cell growth. However, pinpointing environmental causes has proved difficult due to the rarity of childhood cancer and the challenge of identifying early-life exposures. Several genetic mutations, including those in the RB1, TP53, and PTEN genes, have been implicated in childhood cancers. These mutations can lead to conditions such as retinoblastoma and Li-Fraumeni syndrome, which significantly increase the risk of other cancers. However, most children with cancer do not have a family history of the disease, underscoring the unpredictable nature of these genetic changes.
Developmental Problems and Childhood Cancer
Some childhood cancers begin in utero, such as Wilms tumor and retinoblastoma. Wilms tumor, a type of kidney cancer, and retinoblastoma, an eye cancer, both originate from developmental issues that occur during fetal growth.
Medical conditions such as Down's syndrome also increase the risk of certain cancers, indicating a link between genetic abnormalities and cancer predisposition. Additionally, infections and exposure to radiation have been implicated in the development of some childhood cancers, although these factors alone do not provide a complete explanation.
A ray of hope: Advances in treatment
Despite the uncertainties surrounding the causes of childhood cancer, significant progress has been made in treatment. Compared to adult cancers, many pediatric cancers are more responsive to therapy. The outlook for children and adolescents with cancer has improved dramatically over the last fifty years. Particularly noticeable is the improvement in survival rates for acute lymphoblastic leukemia (ALL), the most common childhood cancer. The introduction of improved treatments has raised the 5-year survival rate for children with ALL from 57% in 1975 to over 92% today. Correspondingly, survival rates for non-Hodgkin lymphoma have increased from 43% to 91% over the same period.
Ongoing Research and Future Directions
While survival rates have improved, a lot of childhood cancer survivors face chronic health conditions due to their cancer or its treatment. Ongoing research is essential to understand cancer therapies' long-term effects and develop strategies to mitigate these impacts. As science progresses, there is hope that the mysteries surrounding childhood cancer will eventually be unraveled, leading to better prevention, earlier detection, and more effective treatments.
Conclusion
Childhood cancer remains a profound enigma in medical science. While we have made remarkable strides in treatment and survival rates, the reasons why children develop cancer are still largely unknown. Continued research and international collaboration are vital to solving this mystery. By advancing our understanding of the genetic, developmental, and environmental factors involved, we can hope to provide better outcomes and a brighter future for children facing this formidable disease.
References
Cancer in children and adolescents. NCI. (n.d.-a). https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet
Childhood cancers. NCI. (n.d.-b). https://www.cancer.gov/types/childhood-cancers
Claire Johns, M. (2024, January 26). Childhood cancer genetics. Genomic Landscape and Mechanisms of Pediatric Cancers, Landscape of Cancer Genetics in Pediatrics Compared to Adults, Clinical Implications of Distinctive Genomic Landscape of Pediatric Cancers. https://emedicine.medscape.com/article/989983-overview?form=fpf
Risk factors and causes of childhood cancer. American Cancer Society. (n.d.). https://www.cancer.org/cancer/types/cancer-in-children/risk-factors-and-causes.html#:~:text=Some%20children%20inherit%20DNA%20changes,cells%20or%20other%20body%20cells.
Risks and causes of cancer in children. Cancer Research UK. (2024, February 12). https://www.cancerresearchuk.org/about-cancer/childrens-cancer/risks-causes Assessed and Endorsed by the MedReport Medical Review Board