Dealing with childhood cancer

It's rare for a child to develop cancer. Only one or two of every 10,000 U.S. kids younger than 15 is diagnosed with cancer each year, according to the U.S. National Cancer Institute. But if one of those children is yours, that's little comfort.

However, new generations of medications and treatment methods have not only improved the survival rate for children with cancer but have allowed far greater numbers to thrive and live long lives.

Here's what you should know if you have a child with cancer:

1. THE PROGNOSIS HAS GREATLY IMPROVED

"When I started in the field about 43 years ago, the survival rate was dismal: About 2 to 5 percent would survive for one year," said Dr. Dominick Sabatino, director of pediatric hematology and oncology at Nassau University Medical Center in East Meadow. "Now, about 71 percent survive for five years."

In fact, he said, many children with cancer will recover and go on to have normal lives. "There are newer drugs and treatments, better ways of handling complications and innovative ways of giving drugs," Sabatino said. "Years ago, I didn't have half the drugs I have today. All I had were a few chemotherapy drugs. Now, there's a whole armamentarium."

2. CLINICAL TRIALS ARE THE NORM

In some fields of medicine, it's unusual for a patient to take part in a clinical trial, or research study, instead of simply getting the standard treatment for a disease. But for kids with cancer, participation in clinical trials is accepted and routine.

About 60 percent of children and adolescents with cancer are enrolled in clinical trials, said Dr. Arlene Redner, associate chief of oncology at the Steven and Alexandra Cohen Children's Medical Center of New York in New Hyde Park. That's in comparison to fewer than 5 percent of adults with cancer who participate in clinical trials.

Typically, a clinical trial assigns some children to undergo standard treatment while others get the standard treatment plus another medication. "No one gets a placebo," Sabatino said.

3. CLINICAL TRIALS HAVE PROS AND CONS

On the one hand, Redner said, "it has been shown that children with cancer who are enrolled in clinical trials have a superior outcome to children who are not." And, she added, knowledge about the specific cancer that's gleaned from the trial could help other kids in the future.

But there's a risk that a child could develop side effects from a medication that's being tested without actually getting any benefits, she said. However, Redner added, "a family who enters a clinical trial can decide at any time to take their child off the trial."

4. THE CHILD'S DOCTORS WILL HANDLE THE DETAILS

Parents or guardians rarely need to bring up the idea of enrolling a child in a clinical trial. "Pediatric oncologists routinely mention clinical trials and if one is open for the (particular) disease," Redner said.

For those seeking more information, the U.S. National Cancer Institute has details about clinical trials for pediatric cancer at bethesdatrials .cancer.gov/pediatric/index.aspx and cancer.gov/clinicaltrials/search, and information on clinical trials generally at bethesdatrials.cancer .gov.

5. NEW TREATMENTS ARE ON THE HORIZON

Currently, research in leukemia allows physicians to adjust treatment based on the types of cancer cells that are present, Redner said. About a third of childhood cancers are leukemias, according to the U.S. National Cancer Institute.

Future treatments will go down to the molecular level and target genes and proteins linked to cancer, she said. The most common medications, she said, will be able to interfere with the growth of tumor cells and battle proteins on the surface of those cells.