By Jamie Lober
Maria Fareri Children’s Hospital is a special place that has been treating kids in the area for over 30 years. “If you look back when our division first started, the outcomes for kids with pediatric cancers in general were not as optimistic as they are today,” said Jessica Hochberg, M.D., assistant professor of pediatrics in the hospital’s pediatric hematology/oncology and stem cell transplant division.
Especially in the last 20 years, there has been incredible progress in the doctors’ ability to treat the kids. “With newer agents and approaches, we are turning the table to curing the majority of pediatric cancers in a way that is not devastating to the rest of their health and they are growing up to be healthy, happy, productive adults with families and careers,” said Hochberg. Kids tolerate therapies well with few exceptions and get back to school and other activities in time, she added.
“The best example is pediatric leukemia because back in the 1950s and 60s that disease was uniformly fatal and there was not much we could do; now, with newer agents and combinations of medicines today, we are curing over 90 percent and we can do it without radiation or high dose chemotherapy,” said Hochberg.
The doctors describe these kids as heroes and are glad to offer them a team of assistants in the fight including nurses, social workers and clinical coordinators. Kids come back doing well after they are done with treatments and are sometimes proclaimed as cured. It is rewarding for the doctors to watch them grow healthy and transition into adults. Every child tackles a different quest.
“The most common cancers in pediatrics are the leukemias, in particular acute lymphoblastic leukemia, closely followed by various brain tumors for which there is also a lot of progress made in surgical techniques, radiation techniques and chemotherapy combinations,” said Hochberg.
The statistics may alarm you. “Childhood cancer occurs regularly, randomly and spares no ethic group, socioeconomic class or geographic region,” said Gillian Kocher, public relations director for Alex’s Lemonade Stand Foundation for Childhood Cancer. Families rely on the politicians to keep research funded and on the scientists to continue the good work they are doing. “Worldwide, an estimated 263,000 new cases of cancer affect children under the age of 20 each year,” said Kocher.
It’s a small number of kids who get cancer compared to adults but pediatric oncology centers have been able to collaborate nationally and internationally to find clinical trials and share information, expertise and treatment strategies. “This way we can identify best combinations of treatments and the treatment becomes uniform throughout the country at the different centers,” said Hochberg. Some kids’ tumors are more resistant than others but there has been a big development of supporting research that looks at the specific biology of tumors and determines what made the tumor cell become a cancer cell. It is used to identify new targets and drugs to use.
There is a lot being investigated such as biological differences that can vary even among the same disease patient to patient. With two patients with the same disease and biology, one may do well and another will not. “There is still a great deal we have to learn about why that is but I always tell families that there was nothing they did to cause it and there is nothing they can do to prevent it,” said Hochberg.
The most dramatic trend is the number of cancer survivors doctors are seeing as they get better treatments. “An interesting direction the field is going in is how to deal with the later effects of chemotherapy or radiation treatment in childhood as an adult,” said Hochberg. New treatment options tend to have less toxicity on the healthy tissues in the body. “Exciting developments that we are actively researching and participating in here are looking at cellular and antibody therapies and manipulating the immune system to better fight off the cancer,” she added.
The community is supportive of patients and has done blood drives and fundraising to help with medical costs. They are also interested in the new findings. “There are a lot of cellular treatments where we can take immune cells from the patient or sometimes from a donor and manipulate those to become cancer-fighting cells and give those back to the patient after we have manipulated them in various ways,” said Hochberg. This has been well-tolerated.
The “Take Home” Message
Doctors want the take home message to be that although they realize childhood cancer is scary, they do plan to cure kids. “We want to be as open as possible while at the same time always giving them hope and reassurance that we will get them through this,” said Hochberg.
Often the fear of what the treatment will be is usually worse than the treatment itself. When patients have a great response to therapies, doctors see relief and fear subsides.
Doctors highlight that pediatric oncology is such a different field today than it used to be. “The biggest misconception is that obviously this is a devastating disease that you would never want your child to go through but I think people need to know that from the time they were kids compared to now it is so different and really is a field full of hope and good much more than the sadness that comes along with it,” said Hochberg. Families are encouraged to get involved and spread the word about research efforts.
Jamie Lober, President of Talk Health with Jamie, is a nationally known speaker and writer with a passion for providing information on health topics A-Z. She can be reached at firstname.lastname@example.org.
Resources for Families
Maria Fareri Children’s Hospital, department of pediatric oncology, westchestermedicalcenter.com/mfch
Alex’s Lemonade Stand Foundation alexslemonadestand.org
Leukemia and Lymphoma Society lls.org
American Cancer Society cancer.org