What you should know about childhood cancer and sickle cell disease

Stuart Cramer, DO

Pediatric Hematology Oncology

Cancer in children is rare. However, it is still the leading cause of death by disease past infancy in the United States. More than 40,000 children undergo treatment for cancer each year. Stuart Cramer, DO, answered some questions about childhood cancer and sickle cell disease.

What is cancer?

Cancer is when cells undergo a change that causes them to divide uncontrollably, have the capacity to spread throughout the body and invade normal tissues. When normal tissues are invaded, they do not work as they should. For example, leukemia cells crowd out normal blood cells being made in the bone marrow like weeds crowd out flowers in a garden.

What causes cancer in kids?

Unfortunately, that is not an easy question to answer. The more common causes of cancer in adults – such as smoking and longtime exposure to environmental toxins – do not usually apply to young children. In some cases, cancer is caused by an inherited mutation passed from parent to child. Having a genetic condition, such as Down Syndrome, can increase risk of cancer during childhood.

What are the most common types of childhood cancer?

The most common types of childhood cancer include leukemia, lymphoma and malignant brain tumors. Osteosarcoma (bone cancer) is more common in adolescents.

How can cancer be detected?

It’s not always easy to catch cancer right away because its symptoms can be confused with other more common conditions. Some signs to look out for include:

• Fever without an infection
• Frequent vomiting
• Headaches accompanied with vomiting, especially in the morning
• Loss of energy, paleness
• Lumps or unusual swelling
• Persistent pain in an area of the body
• Sudden weight loss

How is cancer treated?

In the battle against cancer, many treatment options exist, including surgery, chemotherapy, radiation and bone marrow transplants. Researchers are now using information gained about the biology of cancer cells to help in designing drugs that target cancer cells with less effects on normal cells. This is the future of more effective and less toxic drugs.

Because of major treatment advances in recent decades, nearly 90% of children now survive five years or more. This is a huge increase since the mid-1970s when the five-year survival rate was about 50%.

Learn more about how parents can help during and after their child’s treatment on this podcast.

What is sickle cell disease?

Sickle cell disease (SCD) is an inherited red blood cell disorder. People suffering from this disease have abnormal hemoglobin, a protein in the red blood cells that carries oxygen throughout the body. The abnormal sickle hemoglobin forms stiff rods within the red cell, creating a sickle shape. The sickle-shaped cells have difficulty traveling through small blood vessels, obstructing blood flow to that part of the body and causing pain. A normal red blood cell lives for about 120 days, but a sickle cell lives only 10–20 days.

Most children with SCD experience pain periodically, whereas adolescents and adults may suffer from chronic, ongoing pain.

What are the signs and symptoms of sickle cell disease?

Often, signs and symptoms don’t appear until an infant is at least four months old. Some symptoms to watch out for include:

• Delayed growth
• Anemia
• Periodic pain
• Hand-foot syndrome (pain, redness and swelling on the palms of the hands and/or the soles of the feet)
• Frequent infections
• Vision problems

Is there a cure for sickle cell disease?

There is no universal cure for sickle cell disease. Because children with sickle cell disease are at an increased risk of infection and other health problems, early diagnosis with newborn screening is important. For advice on living with sickle cell disease, listen to this podcast.