Understanding Pediatric Cancer (Solid Tumors)

It can be scary to learn that your child has cancer. But childhood cancers vary a lot. Learning more about your child’s condition can help your family understand and cope with a cancer diagnosis.

It’s important to know:

  • Cancer is much rarer in children than in adults.
  • The most common childhood cancers are different from the most common adult cancers.
  • Treatment has improved. More than 80% of children with cancer can expect to survive five years or more after treatment.
  • Ongoing monitoring is important. Survivors may have long-term side effects, often later in life.

What is cancer?

Cancer is a disease in which cells divide uncontrollably. These fast-growing cancer cells can form masses of tissue called tumors.

Two side-by-side diagrams, the left illustrating tissue with carcinoma in situ, and the right illustrating tissue with cancer.
Cancer may start out as a group of abnormal cells, called carcinoma in situ (left). As these cells grow and multiply, spreading into tissue, they are called cancer.

Cancer spreads in three ways:

  • A tumor can grow into nearby tissue.
  • As a tumor grows, some cancer cells can enter the bloodstream and spread to other tissues. This can lead to tumors in other parts of the body.
  • Cancer cells can spread through the lymphatic system. This network of tissue and organs helps the immune system rid our bodies of toxins and waste.

What are solid tumors?

Solid tumors are masses of tissue. Tumors that are cancerous are called malignant. These tumors can grow back even after they are removed.

Noncancerous tumors are called benign. When a benign tumor is removed, it usually doesn't grow back.

Tumor sizes

Doctors refer to solid tumors to exclude blood cancers such leukemia and lymphoma.

We care for children with all types of solid-tumor cancers. Conditions we treat include:

  • Bone sarcomas, like Ewing’s sarcoma and osteogenic sarcoma
  • Soft tissue sarcomas, like rhabdomyosarcoma
  • Kidney tumors, like Wilms’ tumor
  • Germ cell tumors of the ovary or testicle
  • Neuroblastomas
  • Brain and spinal cord tumors
  • Other rare childhood cancers

Symptoms

Cancer in children can be difficult to recognize early because the symptoms are similar to those of more common childhood illnesses and injuries. Childhood cancer is also rare, so these symptoms are most likely linked to something that is not cancer.

Still, there are symptoms to watch for and discuss with your child's doctor, especially if the symptoms continue for a while. These include:

  • Rapid, unintended weight loss (more than 10% over several months)
  • Unusual lumps or swelling
  • Inability to bear weight or walk, without a known injury (for example, a toddler who stops walking)
  • Back pain without a known injury
  • Night sweats
  • Fever lasting longer than five days (without other symptoms like runny nose, cough or vomiting)
  • Blood in urine
  • Pain or swelling in arms or legs unrelated to injury
  • Pain that lasts longer than normal after an injury
  • Early onset of puberty

Children get different cancers, and their bodies respond to treatment differently.

About half of all children with cancer have leukemia or brain tumors. Adults are most often diagnosed with breast cancer, lung cancer, prostate cancer and skin cancer.

Cancer in children often grows faster than adult cancers, and can get worse more quickly. Some cancer treatments for adults aren’t safe for children’s growing bodies.

But many childhood cancers are easier to cure. Children can often tolerate higher doses of chemotherapy, for instance, with fewer side effects.

Cancer is much rarer in children than adults. Each year in the U.S., about 11,000 children younger than 15 are diagnosed with cancer, compared with about 1.7 million adults.

The most common cancers in children and young teens are leukemia, brain tumors, and lymphoma. Among older teens, sarcomas of soft tissue and bone are also common.

More than 80% of kids and young teens with cancer today will be cancer-free survivors in five years. For the most common form of childhood cancer (lymphoblastic leukemia), that number is more than 90%. The five-year survival rate is the standard way of measuring cancer outcomes.

In most cases, scientists don't know the cause. Some adult cancers can be linked to lifestyle — such as smoking, sun exposure or diet. But in kids, it is extremely unlikely that you or your child could have done anything to prevent cancer.

A tumor’s stage is a way to measure how much cancer is inside the body. Staging is based on the tumor’s size, location, and whether it has spread. Doctors use staging to choose the best treatment.

Here is the National Cancer Institute’s staging system:

  • Stages I, II and III: Cancer is present. A higher stage means the tumor is bigger and has spread into more nearby tissue.
  • Stage IV: Cancer has spread to other parts of the body.

Children who’ve been treated for cancer need follow-up care and monitoring, most likely for the rest of their lives. That’s because chemotherapy, radiation therapy and other cancer treatments can cause long-term side effects as children become adults.

Childhood cancer survivors also may experience social and emotional issues related to cancer. OHSU has a Life After Cancer program to support kids, teens and young adults. We can answer your questions and help your child manage many of these issues.

Clinical trials

Our team works with researchers at the OHSU Knight Cancer Institute and contributes expertise to the national Children’s Oncology Group. We may offer your child participation in a clinical trial to test better ways to  treat and cure cancer.

Clinical trials are research studies that test promising new medications and approaches, sometimes years before they are widely available.

If a clinical trial might be right for your child, your Doernbecher oncologist will discuss it with you. The choice to participate is your own.

Support and resources

Doernbecher offers many resources for children and families coping with cancer. In addition to your child’s medical team, you’ll find a range of experts who can help your family navigate the physical and emotional effects of cancer treatment. They include:

  • Social workers
  • Child life specialists
  • Palliative care providers

For families

Call 503-346-0640 to:

  • Request an appointment.
  • Seek a second opinion.
  • Ask questions.

Find resources and support.

Locations

Parking is free for patients and their visitors.

Doernbecher Children’s Hospital
700 S.W. Campus Drive
Portland, OR 97239
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