Cancer in children is aggressive but more treatable: Everything you need to know about pediatric oncology

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Pediatric oncology is a distinct field of medicine that requires special treatment methods tailored to the specifics of a growing organism. Tumors in children often arise from immature cells that divide rapidly. This accelerates the progression of the disease, and the underdeveloped immune system is not always able to suppress the malignant process, leading to rapid progression and metastasis. At the same time, the high biological activity of childhood tumors makes them more responsive to treatment, which increases the chances of achieving remission.

Causes of Tumor Development in Children

One key feature is that malignant tumors in children are not caused by external factors (such as smoking or environmental pollution) as in adults. The cause of most tumors is genetic, mutations, and abnormalities in cell division during embryonic development.

Genetic Factors

According to the American Cancer Society (ACS), about 5-10% of cases are hereditary. This means that newborns can inherit gene defects that contribute to the development of malignant tumors. For example, children with Li-Fraumeni syndrome have a much higher risk of developing tumors (including breast cancer, sarcomas, and brain tumors). This condition is linked to a mutation in the TP53 gene, which plays a key role in controlling the cell cycle and suppressing tumor cells.

There is also a significant risk of cancer in children with Down syndrome, where the likelihood of acute leukemia is 10-20 times higher compared to children without the syndrome.

Note: Leukemia accounts for about 30% of all cancer cases in children in the U.S.

Expert Advice: Genetic testing performed during pregnancy planning plays an important role in preventing hereditary diseases in children, including in the context of oncology. Analyzing gene mutations in parents helps identify potential risks for inherited abnormalities that may predispose to cancer after birth.
In the case of IVF, preimplantation genetic testing (PGT) is conducted on the embryo before its transfer to the uterus. This helps avoid the transmission of genetic defects that may lead to cancer in children.

Embryonal Tumors

Tumours in children are often embryonal and develop from cells that should have become part of mature tissues but have not gone through the whole process of differentiation. These tumors grow rapidly and are prone to aggressive metastasis. Examples include:

Neuroblastoma – arise from cells of the sympathetic nervous system, often seen in children under two years old.
Wilms’ tumor – a malignant kidney tumor typically diagnosed in children under five years old.
Hepatoblastoma – a liver tumor mostly observed in early childhood.

According to the National Cancer Institute (NCI), embryonal tumors make up about 60% of all childhood cancers. They are characterized by rapid growth but most often respond well to treatment, making them more predictable compared to tumors in adults.

Errors in Cell Division

In children, cells divide much faster than in adults due to the active growth of the organism. The intense pace of this process increases the risk of random mutations. For example, during division, genetic material may be incorrectly distributed, leading to the formation of cancer cells.

Expert Advice: After the birth of a child, it is important to regularly visit a pediatrician and undergo scheduled check-ups to detect any potential health deviations. Tumors, despite their aggressiveness, are most treatable when detected early. Parents should be especially careful if there has been a history of cancer in the family, as a genetic predisposition may increase the risk of malignancy.

Differences Between Pediatric and Adult Oncology

The most common types of cancer in children are:

Leukemias – up to 30% of all cases, with acute lymphoblastic leukemia (ALL) making up 75% of these cases.
Central nervous system tumors – about 20%.
Soft tissue and bone sarcomas – 15%.
Nephroblastoma, retinoblastoma – tumors that are unique to childhood.

To understand how doctors determine the treatment strategy in pediatric oncology, it is important to consider the key differences between tumors in children and adults. These differences involve biological features of the tumors, their characteristics, and their response to treatment.

Types of Malignant Tumors

The main types of tumors in children and adults differ. In children, embryonal tumors (neuroblastoma, retinoblastoma, and Wilms’ tumor) dominate, while in adults, epithelial tumors (lung, breast, and colorectal cancers) are more common.

The American Society of Clinical Oncology (ASCO) reports that among children under 14, approximately 60% of all cancer cases are embryonal tumors, while such tumors are much less common in adults.

Tumor Growth Characteristics

Pediatric tumors generally have higher proliferative activity (the ability to divide), leading to rapid growth. However, despite this, tumors in children often metastasize less aggressively than those in adults. According to the National Cancer Institute, tumors like neuroblastomas and Wilms’ tumors grow rapidly, but they are also more responsive to treatment, thanks to their high sensitivity to chemotherapy and radiation therapy. In contrast, adult tumors are typically more resistant to treatment and require more complex and prolonged therapy regimens.

Prognosis and Survival Rates

The prognosis for children with cancer is generally more favorable than for adults. Survival rates have increased in recent decades, with survival rates for children with cancer in developed countries rising to 80-85%, depending on the type of tumor. In comparison, the survival rate for adults is about 60-70%. This is because many childhood tumors, especially embryonal ones, are highly sensitive to treatment and respond quickly to chemotherapy.

Rehabilitation of Children in Remission

After cancer treatment, children undergo an important rehabilitation phase aimed at restoring impaired body functions and preventing long-term consequences.

Weakness: Chemotherapy and radiation therapy often lead to muscle weakness, joint pain, and limited mobility. Physical therapy and special exercises are prescribed to strengthen muscles and restore mobility.
Cardiovascular Problems: High blood pressure, arrhythmia, and other disorders may occur after treatment, especially after radiation to the chest area. Rehabilitation includes cardiological monitoring and specialized programs to improve heart function.
Hormonal Disorders: Treatment may disrupt the function of endocrine glands, affecting growth, reproductive function, and other developmental aspects. Regular endocrinological monitoring and supportive therapy are required to normalize hormonal levels.
Immune System Suppression: Chemotherapy can weaken the immune system, increasing the risk of infections. A balanced diet, vitamin therapy and medication support are important to maintain immunity.

Hospitality Medservice assists families at every stage. Your coordinator will help choose a clinic, and after achieving remission, will select a resort with programs for the recovery of children after cancer treatment.

Features of Treating Young Patients

In next-generation oncology centers, the focus is on gentle treatment principles. Pediatric tumors, especially those of embryonal origin, typically show high sensitivity to conservative treatment methods (chemotherapy, immunotherapy, and radiation therapy). This allows effective targeting of the tumor, including distant metastases. For example, in cases of leukemia and lymphoma, which represent a significant portion of pediatric cancer cases, drug therapy is often the only measure capable of defeating the disease.

Additionally, conservative methods help avoid severe organ dysfunction. Children are in a period of active growth and development, so any lost tissue or organ can critically affect their future life.

When Surgery is Necessary

In some cases, surgery is indispensable. This applies to tumors like Wilms’ tumor or osteosarcoma, where surgical removal remains a key stage in therapy. However, even in such cases, surgery is often performed after a course of chemotherapy to reduce the tumor size and minimize the volume of tissue to be removed.

Expert Advice: Hospitality Medservice works with leading medical centers where treatment is developed based on molecular tumor analysis and the child’s unique characteristics. This approach allows the use of targeted drugs that specifically affect malignant cells, reducing the risk of side effects. Radiation therapy uses innovative equipment, such as proton accelerators, which irradiate the tumour with high precision without damaging healthy tissue. These technologies reduce the number of sessions and make treatment more gentle. Choosing a clinic with such capabilities provides the child with the best chances for recovery and maintaining quality of life.

Hospitality Medservice is your trusted partner in finding the best clinic worldwide. On our website, we represent only reputable medical institutions with advanced facilities and the latest treatment protocols. Explore clinics, get to know the doctors, compare treatment costs, and reach out to us for assistance with organizing:

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Reviewed by: Marianna Sharipova, MD, Medical Director of HMS, 20 years of experience in medical tourism.
Author: Anna Kukarkina, MD