The treatment of cancer in children can include chemotherapy (the use of medical drugs to kill cancer cells), radiation (the use of radiant energy to kill cancer cells), and surgery (to remove cancerous cells or tumors). The type of treatment needed depends on the type and severity of cancer and the child's age.
For children with leukemia or lymphoma, surgery generally plays a minor role. This is because leukemia and lymphoma involve the circulatory system and lymphatics, two systems that are located all throughout the body, making it difficult to treat by operating on one specific area. In children with osteosarcoma and other solid tumors that haven't spread to other parts of the body, however, surgery can often effectively remove cancer when used in combination with chemotherapy and/or radiation.
Children with certain types of cancer may receive bone marrow transplants. Bone marrow is a spongy tissue inside certain bones of the body that produces blood cells. If a child has a type of cancer that affects the function of blood cells, a bone marrow transplant (in conjunction with chemotherapy to kill the defective cells) may allow new, healthy cells to grow. Bone marrow transplant is also sometimes used to treat cancer that does not involve blood cells because it allows doctors to use higher doses of chemotherapy than would otherwise be tolerated.
Chemotherapy is medication which is used as a complementary tool to eliminate remaining cancer cells in the body. A child or teen with cancer is usually given the chemotherapy drugs intravenously (through a vein) or orally (by mouth). The drugs enter the bloodstream and work to kill cancer in parts of the body to which the cancer has spread.
The duration of chemotherapy treatment and type of drugs that are used depend on the type of cancer the child has and his or her response to the drugs. Every child's treatment differs, so a child may receive daily, weekly, or monthly chemotherapy treatments. The child's doctor may also recommend cycles of treatment, which allow the child's body to rest between periods of chemotherapy treatment.
Many of the medications used in chemotherapy also carry the risk of both short-term and long-term problems. Short-term side effects include nausea, vomiting, hair loss, fatigue, anemia, abnormal bleeding, and increased risk of infection due to destruction of the bone marrow, as well as kidney damage and menstrual irregularities. Some drugs carry a risk of bladder inflammation and bleeding into the urine, hearing loss, and liver damage. Others may cause heart and skin problems.
Your doctor will use precautions as well as other medications to counteract as many of the side effects as possible.
Radiation is one of the most common treatments for cancer. When a child receives radiation therapy, he or she is treated with a stream of high-energy particles or waves that destroy or damage cancer cells. Many types of childhood cancer are treated with radiation, in conjunction with chemotherapy or surgery.
Radiation has many potential side effects (such as increased risk of future malignancy and infertility), which you should discuss with your child's doctor. The primary goal when treating children with cancer is to cure them; this takes priority over all other aspects of care. However, there are many medications and therapies that can make children more comfortable while undergoing treatment for cancer.
A way of giving intravenous chemotherapy is through a long plastic line called a 'central line'Hickman line. These are called central lines because they end up in a central blood vessel in your chest, close to your heart. Central lines usually enter your body in the centre of your chest. Then they run up, under your skin, to a large vein by your collarbone. The only bit you can see is the length of line that hangs out of the small hole in your chest.
A central line Hickman line in place
Another way of recieving treatment is through a Portacath. A Portocath is a small chamber or reservoir that sits under your skin at the end of your central line. You can feel it, but unless you are very thin you cannot usually see it. When you need treatment, your nurse puts a needle into the chamber and gives you injections or attaches a drip. This stays in place for as long as you need treatment. Then your nurse will remove it until your next treatment.
The main advantage of a Portacath is that you can't see it on the outside of your body. You don't have to have a tube coming out of your chest as you do with a central line. But others prefer a central line because they don't like having a needle put in each time they need treatment. If you prefer, you can have the area over the portacath numbed with a local anaesthetic cream before the needle goes in.