Treatments my child may require

The treatment of childhood cancer usually involves a combination of surgery, chemotherapy and often radiotherapy dependent on the age of the child, the type of cancer and its location.

Rarer tumour types may have treatment tailored to the child’s situation as there may not be a standardised tumour protocol available. In these circumstances, the treatment offered may be part of a trial to give your child the most up-to-date treatment.

Your doctor and members of the care team will discuss the options for treatment with you in-depth.

Surgery

For children with solid tumours, surgery is often the first step of treatment if the tumour is small or in a relatively accessible location. If the tumour is too large to remove, usually, chemotherapy will have been given first to try and shrink it.

Dependent on the size and location of the tumour, the surgeon may be able to remove all or part of the tumour. Samples of lymph nodes around the tumour are often taken as well to look for any signs of tumour spread.

Chemotherapy

Chemotherapy is a group of different drugs that affects the way cancer cells grow and reproduce. As a result, they work to shrink tumours and fight the cancer cells. Although good at fighting cancer cells, chemotherapy drugs cannot tell the difference between normal healthy cells and cancer cells. As a result, healthy cells are damaged too resulting in side effects.

Chemotherapy is often the first step of treatment for children with leukaemia and sometimes also for children with solid tumours (if their tumour is in a difficult location or is too large to remove surgically immediately). Chemotherapy is usually given in cycles, and the more intense regimes are given as an inpatient.

Autologous stem cell transplants

Some children require a stem cell transplant as part of their treatment. This is where some healthy cells are removed from your child before he or she receives very high dose chemotherapy and or radiotherapy. Following this, the child is given back their healthy stem cells to enable them to build up their immune system again.

Allogeneic stem cell transplants

Some children require a stem cell transplant from a donor as part of their treatment. The child would first require very high dose chemotherapy and or radiotherapy. Following this, your child is given back stem cells from a pre-matched donor to enable them to build up their immune system again.

Radiotherapy

Children with certain tumour types may receive radiation therapy as a part of their treatment. It is generally avoided in children under two years of age if possible due to side effects of radiation in a rapidly growing child. Occasionally, for some children under this age, the benefits of radiation may outweigh the risks, so this is decided on a child-by-child basis.

If your child requires radiotherapy, they will usually receive conventional radiotherapy. In some situations, children may require proton radiotherapy (very precise doses of radiotherapy which can be delivered with much greater accuracy), especially if the tumour affects the head or neck.

Supportive care

Treatment for childhood cancer can result in a number of side effects. Please be assured that your child’s healthcare team will work to keep them as comfortable and as symptom-free as possible during treatment. This is called supportive care. It includes treatment for infections, pain relief and treatments to reduce side effects such as sickness.

In many regions as a matter of routine, children with cancer are referred to the local children’s hospice team to help with supportive care (symptom management) whilst on active treatment.

Supportive care enables your child to feel as comfortable as possible whilst undergoing treatment. This is an area many centres are working hard to improve.

What will happen next?

These links will take you through some of the possible investigations and procedures your child may need and then some of the treatments they may receive.