General Information About Childhood Cancers and Pediatric Oncology

Pediatric cancers are rare tumors, and it is estimated that their incidence is about 2000 new cases per year in children under 18.

The malignant tumors observed in children are often very different from those suffered by adults, which requires specific management in a good environment.

The Pediatric Oncology Unit takes care of children with cancer.

What is the purpose of pediatric oncology?

The main challenge of medical management in pediatric oncology is to propose a therapeutic trajectory in line with what we know about the child, taken as a whole, and what we know about the tumor that inhabits him and defines him as “sick.” Cancer can decrease in size and be defeated or resist treatments and expand. Cancer, through different symptoms, generates external effects on the child’s body. This must therefore be grasped, understood, and localized in a constant dialogue with the child’s daily evolution of the “general state” (somatic, psychological, etc.).

What does a pediatric oncologist do?

In Pediatric Oncology, a pediatric oncologist is a doctor specializing in caring for children with cancer. Cancer can be in any place or system, including the blood (leukemia), the brain, or the body. In Pediatric Oncology, they care for children and young people with their families at all treatment stages, from diagnosis to long-term follow-up or palliative care, and often maintain support for many years.

Who does a pediatric oncologist working with?

In Pediatric Oncology, pediatric oncologists work closely with hematologists, surgeons, radiation oncologists, radiologists, pathologists, endocrinologists, and other oncologists, nationally and internationally, to ensure that therapies are appropriate and effective. They work locally with psychologists, social workers, and teachers to support patients and their families, ensuring that the burden of treatment is contained and that the long-term effects of treatment are minimized.

What does the pediatric oncologist do?

Pediatric oncologists are interested in many aspects of cancer care and work as part of a multidisciplinary medical team to offer children and adolescents the best possible cancer treatment. The pediatric oncologist can:

Screen children and adolescents at risk of cancer

Diagnose children and adolescents with cancer

Explain the diagnosis and the stage of cancer (a description of where the tumor is located, if or where it has spread, and if it affects other parts of the body)

Discuss all treatment options and provide a recommendation for the best treatment

Provide therapy to treat cancer (e.g., surgery, chemotherapy, radiation therapy)

Provide follow-up care after effective cancer treatment

Help maintain quality of life by managing cancer-related pain as well as other symptoms or side effects of treatment

Most commonly treated diseases in pediatric oncology

Pediatric oncology takes care of the following diseases (non-exhaustive list) :

  • Leukemia
  • A cancerous disease affects cells in the bone marrow that produce an abnormally high amount of white blood cells.
  • Lymphomas
  • Cancer of the lymphatic system causes an unchecked proliferation of lymphoid cells.
  • Tumors of the central nervous system
  • Tumors of the brain, cerebellum, or spinal cord.
  • Neuroblastoma
  • Tumors of the sympathetic autonomic nervous system.
  • Retinoblastoma
  • Tumor of the eye that originates in the cells of the retina
  • Nephro and hepatoblastoma
  • Tumors develop from the kidney or liver.
  • Sarcomes : Connective tissue tumors that can affect bones or soft tissues (muscles, adipose tissues) of variable localization
  • Germ tumors: Tumors whose origin is often found in the ovaries and testicles, sometimes the brain.

Most frequent examinations in Pediatric Oncology

 It is necessary to carry out various examinations to diagnose and monitor the disease’s course. The most frequent are :

  • Ray in Pediatric Oncology

X-rays allow us to “photograph” areas of the body. This quick and utterly painless examination uses low doses of radiation. The child must remain motionless during the examination.

  • Scanner (CT-Scan) in Pediatric Oncology

Equipped with an X-ray tube, this device makes it possible to obtain an image in the form of sections of the body part to be examined. The machine slowly rotates around the child. Even if it is bulky and impressive, and the examination table narrow and uncomfortable, the scanner is painless. It usually lasts 15-20 minutes. The child must remain motionless throughout the procedure.

  • Ultrasound imaging (ultrasonography) in Pediatric Oncology

Ultrasound imaging is a method that makes it possible to obtain images of the human body through high-frequency sound waves. The images obtained are demonstrated in real-time. This process does not involve any irradiation.

  • MRI in Pediatric Oncology

MRI is a combination of magnetic and radio waves. This examination allows it to obtain images of the organs’ anatomy and function. The images can be reconstructed in 3D. The MRI machine looks like a small tunnel. For this examination, the child is installed on his back on a berth that will be slipped into the device. Since the machine is very noisy, the child will have earplugs or even headphones on his ears with music.

The MRI is not painful but can be pretty sad because of the noise. It lasts 45-60 minutes. One of the parents can accompany the child in certain situations. The examination will be performed under general anesthesia on a small child or child who cannot stay still. This is usually necessary before 8-10 years of age.

  • PET/CT-SCAN in Pediatric Oncology

The PET/CT Scan (PET=positron emission tomography) makes it possible to obtain two examinations simultaneously: the PET examination studies the biological activity of the organs, while the CT examination studies the anatomy and morphology of the organs. The objective of this examination is to detect abnormal metabolic activities. The exam lasts between 2 and 3 hours. Radioactive glucose in small quantities is injected into a vein (via a catheter). The radiation dose is low and poses no danger to the child.

The injected product then circulates in the body via the blood. It is then necessary to wait an hour for the product to settle in the organs and tissues to highlight the biological activity. The actual examination takes place in a scanner to produce the images for about 10-20 minutes.

The most frequent treatments

Once the diagnosis has been made, several treatments can be considered by the medical team. Here are the treatments most frequently performed :

  • Chemotherapy

It is the combination of several drug treatments administered orally, intravenously, or even intrathecally (via a lumbar puncture) and aims to act against cancer cells. These are treatments that, regardless of their modes of administration, penetrate the bloodstream to reach and destroy the cancer cells where they are located, that is to say, also at a distance from the tumor. Chemotherapies are often combined with other therapeutic modalities, such as surgery or radiotherapy.

The frequency, intervals, doses, and duration of administration of drugs are determined as part of the treatment plan, depending on their effectiveness and tolerability. Depending on the type of chemotherapy, various side effects may occur. This is because chemotherapy also affects healthy cells. The occurrence of side effects is very variable, depending on the person.

Some of these treatments are administered during hospitalization for a few days, others on an outpatient basis. Your child will also be seen regularly in a polyclinic check-up to evaluate the effectiveness and tolerance of the various treatments.

  • Surgery

It consists of removing the tumor by operation with an adequate margin of tissue around it. It can be the only treatment carried out or be associated with radiotherapy or chemotherapy. In consultation with our unit, the operation is performed by a surgeon from the Pediatric Surgery Department for children and adolescents.

  • Radiation

Radiation therapy is a treatment that consists of exposing the cancer cells of a tumor to rays to destroy them. This therapy is often used in addition to chemotherapy and surgery. The beams are not painful but can cause side effects, sometimes several weeks after radiation therapy.

Radiotherapy can be carried out on an outpatient basis, that is to say, without hospitalization, because the sessions are short-lived, and the side effects are less than during chemotherapy.