Cancer in Children

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Treating Cancer in Children TOPICS

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 at least 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 (2003-2009) for the more common childhood cancers are:

  • Acute lymphocytic leukemias: 90%
  • Acute myelogenous leukemias: 64%
  • Brain and other central nervous system tumors: 75%
  • Wilms tumors: 90%
  • Hodgkin lymphomas: 97%
  • Non-Hodgkin lymphomas: 85%
  • Rhabdomyosarcomas: 64%
  • Neuroblastomas: 79%
  • Retinoblastomas: 99%
  • Osteosarcomas: 71%
  • Ewing sarcomas: 72%

Survival rates are 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 child’s case. The type of cancer is important in estimating a child’s outlook. But many other factors can also be important, such as the child’s age, the exact type of cancer, 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 is your best source of information on this topic, as he or she is familiar with your child’s situation.

Long-term outcomes

During and after cancer treatment, the main concerns for most families are the short- and long-term effects of the cancer and its treatment, and concerns about the cancer still being present or coming back.

It is certainly normal for families to want to put the cancer and its treatment behind them and to get back to a life that doesn’t revolve around the cancer. But it’s important to realize that close follow-up care is a central part of this process that offers children the best chance for recovery and long-term survival.

Once treatment is finished, the health care team will set up a follow-up schedule. For many years after treatment, it is very important that children have regular follow-up exams with the cancer care team. As time goes by, the risk of the cancer coming back goes down, and doctor visits might be needed less often. But they are still important because some side effects of treatment might not show up until years later.

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. It’s important to discuss what these possible effects might be with your child’s medical team. The risks depend on a number of factors, such as the type of cancer, the specific cancer treatments used, doses of cancer treatment, and the child’s age at the time of treatment. Some of the more common late effects of cancer treatment include:

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

To help raise 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 website: 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 our document, Children Diagnosed With Cancer: Late Effects of Cancer Treatment.


Last Medical Review: 09/05/2013
Last Revised: 01/31/2014