Surviving childhood cancer

A lot of progress has been made in treating childhood cancers in recent decades, and many of these cancers can now be cured. Still, the progress in some cancers has been greater than in others.

Five-year survival rates

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. Doctors use five-year rates as a standard way of discussing and comparing the prognosis (outlook for recovery) for different cancers. Of course, many children live much longer than 5 years, and many are cured. Keep in mind that 5-year survival rates are based on patients who were diagnosed and treated more than 5 years ago. Improvements in treatment often result in a better outlook for patients diagnosed more recently.

The 5-year survival rates for the most recent time period (2002-2008) for the more common childhood cancers are:

• Leukemias: 84%
• Brain and other nervous system tumors: 71%
• Wilms tumors (kidney cancers): 89%
• Hodgkin lymphomas: 96%
• Non-Hodgkin lymphomas: 86%
• Rhabdomyosarcomas: 68%
• Neuroblastomas: 75%
• Osteosarcomas (bone cancers): 71%

Survival rates are often based on previous outcomes of large numbers of children who had the disease, but they are at best rough estimates and cannot predict what will happen in any particular child’s case. The type of cancer is important in estimating a child’s outlook. But many other factors may also be important, such as the child’s age, the location and extent of the tumor, the treatment received, and how well the cancer responds to treatment. If your child has cancer, your child’s doctor can tell you how well the numbers above may apply, as he or she is familiar with the aspects of your child’s situation.

Long-term outcomes

Because of major advances in treatment, more children treated for cancer are now surviving into adulthood. Doctors have learned that the treatment may affect children’s health later in life, so watching for health effects as they get older has become more of a concern in recent years.

Treating childhood cancer requires a very specialized approach, and so does the care and follow-up after treatment. The earlier any problems can be recognized, the more likely it is they can be treated effectively.

Childhood cancer survivors are at risk, to some degree, for several possible late effects of their cancer treatment. This risk depends on a number of factors, such as the type of cancer, the specific cancer treatments they received, doses of cancer treatment, and their age when receiving the treatment. Late effects of cancer treatment can include:

• Heart or lung problems (due to certain chemotherapy drugs or radiation therapy)
• Slowed or decreased growth and development (in the bones or overall)
• Changes in sexual development and ability to have children
• Learning problems
• Development of second cancers later in life

To help increase awareness of late effects and improve follow-up care of childhood cancer survivors throughout their lives, the Children’s Oncology Group (COG) has developed long-term follow-up guidelines for survivors of childhood cancers. These guidelines can help you know what to watch for, what type of screening tests should be done to look for problems, and how late effects can be treated.

It is very important to discuss possible long-term complications with your child’s health care team, and to make sure there is a plan to watch for these problems and treat them, if needed.

To learn more, ask your child’s doctors about the COG survivor guidelines. You can also download them for free at the COG Web site: www.survivorshipguidelines.org. The guidelines are written for health care professionals. Patient versions of some of the guidelines are available (as “Health Links”) on the site as well, but we urge you to review them with a doctor.

For more about some of the possible long-term effects of treatment, see the document, Children Diagnosed With Cancer: Late Effects of Cancer Treatment.