Treating Children with Cancer

When your child is diagnosed with cancer, it's normal to feel overwhelmed and unsure about what lies ahead. Understanding that treating childhood cancer is different from treating adult cancer can help you navigate this journey. Children often respond better than adults to certain treatments, but these treatments can be more intense and may come with their own set of challenges.

How is treating cancer in children different?

Treatment is often more intense and more successful

With some exceptions, childhood cancers tend to respond better than adult cancers to certain treatments. This might be because of differences in the cancers themselves, as well as because children often get more intense treatments. Also, children usually don’t have many of the other health problems that adults with cancer might have, which can often get worse during cancer treatment.

Chemo is used more often, and radiation therapy is used less often

Chemotherapy (chemo) often works better on childhood cancers. This might be because most childhood cancers tend to grow quickly (and chemo works better against fast-growing cancers). Children’s bodies are also usually better able to recover from higher doses of chemotherapy than adults’ bodies. Using more intense treatments gives doctors a better chance of treating the cancer effectively, but it can also lead to more short- and long-term side effects.

Radiation therapy, on the other hand, can often cause more serious side effects in children (especially very young children) than in adults. Because of this, its use sometimes needs to be limited. Doctors do their best to balance the need for intense treatment with the desire to limit side effects as much as possible.

Children with cancer are treated at pediatric cancer centers

In the United States, most children and teens with cancer are treated at a center that is a member of the Children’s Oncology Group (COG). All of these centers are associated with a university or children’s hospital. These centers offer the advantage of being treated by a team of specialists who know the differences between adult and childhood cancers, as well as the unique needs of children and teens with cancer and their families.

What treatments are used for childhood cancers?

There are many ways to treat cancer because different types of cancers need different approaches. The treatment plan your child’s cancer care team recommends will be based on:

• The type of cancer
• How far the cancer has spread
• How fast the cancer is growing
• Your child’s needs and your family’s preferences

Usually, more than one type of cancer treatment is used. For example, a child might have radiation or chemotherapy to shrink a tumor before surgery. Or chemotherapy might be given after surgery to kill any remaining cancer cells.

Choose a cancer type to learn how it is treated.

Surgery

Sometimes surgery is used to remove part or all of a tumor. It can also be used to remove a part of the tumor for testing (biopsy). Surgery might also be used to place a device such as a central line for chemo or a feeding tube for nutrition.

Radiation therapy

Radiation therapy uses high-energy beams to destroy fast-growing cells including cancer cells. Radiation is often used to shrink a tumor before or after chemotherapy or surgery. The number of treatments needed and the possible side effects will depend on what part of the body is treated, but the radiation treatment itself is painless (similar to getting an x-ray).

Chemotherapy and other drugs

There are many different types of drugs used to treat childhood cancer. Chemotherapy (chemo) drugs are the most common, but there are also other drugs that work differently and have different side effects. Depending on the drug, these treatments might be given into a vein (IV), by mouth, as an injection (shot) or into the spinal fluid.

Treatment schedules depend on the type and stage of cancer and the drugs needed. For example, treatment for blood cancers such as acute lymphocytic leukemia (ALL) typically lasts 2 to 3 years. Learn more about how chemo and other cancer drugs are scheduled and given.

Chemotherapy (chemo) drugs work by killing fast-growing cells. This includes cancer cells, but it can also include  some fast-growing healthy cells. When these are damaged it can cause side effects.

Targeted therapy drugs are designed to “target” specific genes or proteins (called biomarkers) on a person’s cancer cells. Even two people with the same type of cancer might have different markers. Since targeted therapy can find specific types of cells, it doesn’t kill healthy normal cells. Targeted therapy can still cause side effects, but they’re usually different from the types of side effects that chemo causes. Not all cancers have known markers that can be treated with targeted therapy.

Immunotherapy drugs help a person’s own immune system find and kill cancer cells. One type of immunotherapy used for some childhood leukemias is CAR T-cell therapy. 

Stem cell transplant (bone marrow transplant)

A stem cell transplant (SCT), also known as a bone marrow transplant (BMT), allows doctors to give very high doses of chemo or other treatments. These high doses can kill more cancer cells, but they can also damage too many healthy blood cells.

A stem cell transplant helps a child recover from this damage by giving them new, healthy stem cells that will mature into healthy red and white blood cells.

There are two main types of stem cell transplants: allogeneic, which uses stem cells from a donor, and autologous, which uses a child’s own stem cells, collected before they get the high-dose chemo or other treatment.

Clinical trials for childhood cancer

Most children with cancer are treated at specialized children’s cancer centers where they will have access to the most up-to-date treatment available through clinical trials (studies of promising new therapies). Children’s cancer centers often have many clinical trials going on at any one time, and in fact, most children treated at these centers take part in a clinical trial as part of their treatment. Learn more about finding a pediatric cancer center and clinical trial.