How Childhood Cancers Differ From Adult Cancers

We sometimes look at children and only see smaller versions of ourselves. But when we look deeper, we know that children have different needs, wants, likes, dislikes, and outlooks. Medical issues also vary greatly from their adult counterparts. Pediatric oncologists and other doctors who work with children are well aware of these differences. Childhood cancers are very different as well.

Differences Between Childhood and Adult Cancers

Childhood cancers differ from adult cancers in many ways.

Prevalence

Childhood cancers are much less common than cancers in adults. Cancers in children and adolescents account for a small percentage of all cancers that are diagnosed.

Risk Factors and Causes

Many cancers that affect adults are related to lifestyle risk factors, such as tobacco or alcohol use, poor diet, or sedentary lifestyle. On the other hand, the causes of most childhood cancers are not known, though they are most likely genetic.

Types of Cancers

Childhood cancers tend to occur at different sites from those common in adults. Among the most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancer. Each of these cancers also occurs in adults, but adult cancers are more likely to strike the lung, colon, breast, prostate, and pancreas. There are some childhood cancers that almost never occur in adults, and some cancers that affect adults, but virtually never occur in children. There are cancers that, while more common at one age than another, can affect both adults and children. Although they may even be treated differently.

Treatment Facility

Most adults who are diagnosed with cancer are treated in their local community by their primary care physicians and cancer specialists. Children’s cancers are much more rare than those of adults, so specialists in many smaller communities may not have continuing experience with the management of these diseases. For this reason, children usually are best treated by teams of doctors who specialize in the diagnosis, treatment, and management of childhood cancers. Such teams are much more likely to be found in children’s hospitals, university medical centers, and cancer centers.

Prognosis

Over the past 20 years, there has been an increase in the number of children diagnosed with cancer. But, according to the National Cancer Institute, the death rate has decreased and the 5-year survival rate has increased. In general, childhood cancers have a better prognosis.

Common Childhood Cancers

The most common childhood cancers are leukemias, lymphomas, brain tumors, and bone cancers.

Leukemias

Leukemia is a cancer of the white blood cells. It affects bone marrow, causing it to produce large numbers of abnormal white blood cells. These white blood cells crowd normal, healthy blood cells out of the bone marrow and blood, leading to the common symptoms, such as pale skin, bleeding, bruising, and serious infection.

Young children are most likely to have a type of leukemia called acute lymphoblastic leukemia (ALL) .

Lymphoma

Lymphomas are cancers of the lymphatic system and lymph nodes, part of the body’s immune system that helps fight infection. Lymphomas occur when lymphocytes, a type of white blood cell, become malignant and multiply out of control. The abnormal cells crowd out healthy cells and create tumors that may occur in the lymphatic system and lymph nodes or in other organs, such as the liver or spleen. Lymphomas are divided into 2 categories, non-Hodgkin lymphoma and Hodgkin lymphoma, which differ to some extent in their treatment and prognosis.

Non-Hodgkin lymphoma is more common in very young children, while Hodgkin lymphoma is more common in adolescents.

Brain Tumors

Tumors of the brain and spinal cord comprise the most common types of solid tumors in children. Not all brain tumors are cancers, but even the non-malignant ones may affect one or several of the functions controlled by the brain, including memory and learning, the senses, and emotions. Tumors may also affect body movement and may lead to seizures or other complex symptoms. Most brain tumors in children start in the lower parts of the brain. Tumors located there affect balance and coordination.

The incidence of brain tumors peaks between the ages of 5-10. Brain tumors occur somewhat more often in boys than girls.

Bone Cancer

Bone cancer is commonly found in the long bones of the legs or arms typically around the knees. Bone cancer in children most likely occurs during adolescent growth spurts. Osteosarcoma, a type of bone cancer, occurs more often in boys than girls. While this cancer is very rare, bone pain is common and children who have unexplained persistent pain in a bone or joint should generally have an x-ray to make sure there is no cancer.

There are many other uncommon childhood cancers that cancer specialists are called upon to diagnose and treat. The diagnosis of cancer can be a trying time for a child and family. Fortunately, with today's advances in medicine, effective therapies exist for many of these cancers.

RESOURCES:

American Cancer Society
https://www.cancer.org

National Cancer Institute
https://www.cancer.gov

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca

Canadian Cancer Society
http://www.cancer.ca

REFERENCES:

Acute lymphoblastic leukemia/lymphoma (ALL). EBSCO DynaMed Plus website. Available at:Acute lymphoblastic leukemia/lymphoma (ALL). Updated October 13, 2017. Accessed November 9, 2017.

Cancer in children and adolescents. National Cancer Institute website. Available at: https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet. Updated August 24, 2017. Accessed November 9, 2017.

Cancers that develop in children. American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html. Updated August 22, 2016. Accessed November 9, 2017.

Childhood cancer: Osteosarcoma. Nemours Kid's Health website. Available at: http://kidshealth.org/en/parents/cancer-osteosarcoma.html. Updated January 2017. Accessed November 9, 2017.

Diffuse intrinsic pontine glioma. St. Jude Children's Research Hospital website. Available at:https://www.stjude.org/disease/diffuse-intrinsic-pontine-glioma.html?vgnextoid=b86c061585f70110VgnVCM1000001e0215acRCRD. Accessed November 9, 2017.

General information about childhood brain and spinal cord tumors. National Cancer Institute website. Available at: https://www.cancer.gov/types/brain/patient/child-brain-treatment-pdq. Updated September 17, 2015. November 9, 2017.

Risk factors and causes of childhood cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-in-children/risk-factors-and-causes.html. Updated August 22, 2016. Accessed November 9, 2017.

What are the differences between cancers in adults and children? American Cancer Society website. Available at: https://www.cancer.org/cancer/cancer-in-children/differences-adults-children.html. Updated August 22, 2016. Accessed November 9, 2017.

Last reviewed November 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP