- Types of Cancer
- Side Effects of Treatment
- How to Manage in the Classroom
Cancers are made up of cells that divide and grow in an uncontrolled manner so that they invade nearby parts of the body. Metastasis occurs when cancer cells spread to distant parts of the body through the blood stream or lymphatic vessels. Except for some genetic abnormalities, such as Down syndrome, the cause of almost all childhood cancers is unknown.
The most common types of cancers in children are leukemia and lymphoma, brain tumors, and tumors of the kidney, eye, muscle, and bone. Unlike adults, children rarely get skin, prostate, breast, lung or colon cancer.
For every 10,000 children in the United States, approximately 1-2 will develop cancer annually. This amounts to about 10,000 new cases yearly. The chance that a child will develop cancer before age 19 is only 1 in 330. Leukemia, lymphoma, and brain tumors account for over 50% of all cancers in children.
The child’s symptoms will depend on the type of cancer. Any of the findings listed below should be evaluated by a doctor.
- Weight loss, poor appetite
- Persistent fatigue, irritability, or personality change
- Night sweats
- Unexplained persistent fever, repeated infections
- Headaches and vomiting, especially early in the morning
- Vision changes
- Pains in the bones or joints
- A lump or mass in the belly, neck, or armpits
- Bruising, bleeding, odd rashes
- Pale skin from anemia
Again, the types of tests that will be used to diagnose a childhood cancer will depend on the specific symptoms. Commonly, physicians will get blood tests. Regular X-rays or advanced imaging tests, such as Cat Scans, MRIs, or PET scans may be done. Often the doctor will need to get a sample of the bone marrow to diagnose leukemia or take a biopsy to diagnose a solid tumor.
The treatment of childhood cancers is complicated and needs a team of very specially trained doctors and nurses, along with support from psychologists, nutritionists, physical and occupational therapists, and other medical personnel. For this reason, most children with cancer are treated at special cancer centers where everyone has a great deal of experience providing the special services needed by these children.
Some children can have their cancer completely removed by surgery, but most will require chemotherapy and/or radiation treatments. These treatments are generally determined by special protocols developed by national organizations that are constantly trying to determine the most effective care for each type of cancer. The chemotherapy may be medicine taken by mouth, but also often includes intravenous infusions done several times a week or month. For this reason, a child with cancer will often get a special intravenous line, called a “port”. The port will stay in place for many weeks or months while the child is getting chemotherapy. Sometimes there is intrathecal administration of chemotherapy. This means that medicine is injected into the spinal canal, which affords the advantage of avoiding the blood-brain barrier as it disperses in the cerebrospinal fluid.
A portion of children with cancer, especially those with leukemia or lymphoma may need a bone marrow transplant. Only a very few centers are able to perform this highly technical procedures that is often associated with many medical complications.
Side effects will depend on the specific medications being used, but common side effects of chemotherapy and radiation are:
- Nausea and vomiting
- Hair loss
- Mouth ulcers
- Rashes or sores on the anus and buttocks
- Hearing loss
- Nutrition and weight problems
- Anemia and bleeding
- Weak immune system and infections with unusual germs
- Infected “ports” (see above in Treatment section)
It is important that a teacher (or school nurse) caring for a child with cancer knows:
- Which medicines the child needs and how and when to give them
- How to use special devices and equipment
- What kinds of problems to watch for
- Whom to call with questions and contact information
Teachers should watch out for cancer symptoms and the side effects of treatment. Fever is a particular problem for children with cancer and should be evaluated without delay. Teachers should notify the parents of any infectious disease that has affected a classmate. Children with weak immune systems from chemotherapy and radiation can become extremely ill if they develop chicken pox. If exposed, they need special preventive treatment and they need it fast. If any child or adult with whom the cancer patient may have had even brief contact develops chickenpox, the parents of the cancer patient must be notified immediately.