There are several types of cancer that are common in children. Leukemia, a cancer of the blood cells, accounts for about one-third of all childhood cancers. The most common type is Acute Lymphocytic Leukemia (ALL). It usually occurs between 2 and 8 and is sometimes referred to as "childhood leukemia".

Brain and spinal cord tumors are the second most common type of childhood cancer. In children, they can occur anytime between birth and 15.

Lymphoma is a cancer of the lymph tissue. One form, Non-Hodgkin Lymphoma, is the third most common type of childhood cancer. Another form, Hodgkin Lymphoma, is less common and is more likely to be diagnosed in older children and young adults.

Osteosarcoma is the most common type of bone cancer in children. It usually forms in the thighbone, upper arm bone or lower leg bone (tibia). Another type of bone cancer, Ewing's sarcoma, most commonly occurs in the hipbones, thighbone, upper arm bone and ribs.

Rhabdomyosarcoma is the most common type of soft tissue tumor in children. It is most commonly found in the muscles in the head and neck, kidneys, bladder, arms, legs or trunk. Rhabdomyosarcoma typically is diagnosed in children 2 to 6.

Neuroblastoma is a cancer of the nerve cells that usually starts in the abdomen. It's most common in babies and very young children.

Retinoblastoma is a rare form of cancer that affects the retina of the eye. It's most commonly diagnosed in children younger than 5. The cancer usually only affects one eye, but can occur in both eyes. Retinoblastoma accounts for 5 percent of all cases of childhood blindness.

Late Effects of Childhood Cancer Researchers have made some great strides in the diagnosis and treatment of childhood cancers. Today, 79 percent of children with cancer survive for at least five years after diagnosis. About 75 percent of children will survive ten years or more (specific survival rates depend upon the type of cancer).

Children who survive their cancer may have no signs of the original disease. However, the treatments used to kill the cancer cells can have some serious long-term effects, including the risk of a second cancer. Radiation therapy can damage organs or surrounding tissue. Radiation directed at the brain may cause learning and memory problems and growth problems. Girls who receive chest radiation are at higher risk for breast cancer later in life. Chest radiation can also damage the heart, lungs and thyroid. Abdominal radiation can damage the digestive tract, kidneys, bladder, sperm production (in males) and ovary function (in females).

Chemotherapy, or treatment with anti-cancer drugs, can affect many areas of the body because the drugs must pass through the body's digestive tract or circulatory system to reach the tumor. (In some cases, doctors can administer high doses of the drugs directly at the site of the tumor.) Girls who have received chemotherapy are at higher risk for ovarian failure and premature menopause. Some chemotherapy agents are known to cause a loss of bone mass (increasing the risk of osteoporosis later in life) and damage to the lungs, heart and urinary system.

Survival Needs as Adults Because of the increased risk for cancer recurrence, development of a second cancer and effects of radiation and chemotherapy, children who survive their cancer continue to need close follow-up throughout adulthood. The kinds of problems that can appear later in life depend upon the type of cancer, stage at diagnosis and types and length of treatment. However, sometimes children don't have their complete medical history. Parents may be reluctant to tell their children about the cancer to spare the child "painful details". Current medical records may be incomplete. And tracking down old medical records can be a difficult and lengthy process. Thus children may be aware they are a cancer survivor, but may have no knowledge about what types of treatment they received.

Health experts say it's important for parents to keep accurate records when a child is diagnosed with cancer. Even if a parent chooses to "shield" a child from details, the information should be made available so it can be accessed when the child continues his/her medical follow-up as an adult.

At UCLA's Jonsson Cancer Center, cancer survivors are followed with a team of physicians, social workers, vocational education specialists and a Family Nurse Practitioner. The team starts with a review of the patient's medical history and then makes recommendations for long-term monitoring and follow-up. Clients may be advised to seek screening for early complications, like heart problems or breast cancer. A healthy diet and lifestyle is also encouraged. With continued monitoring, doctors can learn more about the late effects of cancer and treatment. In addition, the close follow-up enables health care providers to reduce the risk of some complications or to watch for known complications and intervene promptly when the problems occur. Ideally, the program will help improve both the quality of life and survival rates of those who have endured childhood cancers.

For information on childhood cancer: Candlelighters® Childhood Cancer Foundation, http://www.candlelighters.org (This organization also provides a list Follow-up Clinics for Childhood Cancer Survivors.)
American Cancer Society, http://www.cancer.org, or contact your local chapter
National Cancer Institute, http://www.nci.nih.gov, (800)4-CANCER