Book contents
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
40 - Management of cancer in children
Published online by Cambridge University Press: 05 November 2015
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
Summary
Introduction
This chapter aims to provide the reader with an introduction to the management of children with cancer. Contemporary reviews and resources will be referred to as appropriate. Radiotherapy is an important component of the treatment for many childhood tumours and this may involve advanced techniques including brachytherapy or protons, sometimes requiring referral to another centre or even abroad. Many different healthcare professionals are involved in the delivery of care, coordinated in the UK by specialised multidisciplinary teams (MDTs) at one of 19 principal treatment centres, often in collaboration with shared care units closer to home.
Paediatric cancer is uncommon. Of the 280,000 patients diagnosed with cancer in England in 2012, only 1303 were children (0.5%). The incidence of some childhood cancers has increased marginally over the last 40 years, but death rates have declined dramatically for all non-CNS childhood cancers. With cure rates now over 70%, the prevalence of paediatric cancer survivors in the population is increasing rapidly, posing challenges for the management of cancer survivorship and the late effects of treatment. The incidence of cancer between the ages of 10 and 65 is well modelled by a 10% increase per annum, which equates to a 10-fold increase every 25 years. Given the relative rarity of paediatric cancer, it is still unusual to encounter an adult survivor of paediatric malignancy, but will become more common.
An important challenge in treatment is to minimise toxicity while maximising the chance of cure, leading to a risk-based stratification of treatment intensity, including for radiotherapy. As a result, most paediatric cancer is delivered using nationally or internationally agreed protocols. Radiotherapy has significant late toxicity as it reduces the natural growth seen in childhood, and, because of the long life expectancy of survivors, it may cause radiotherapy-induced second malignancies.
The radiotherapy pathway
Giving radiotherapy to children is complex and requires a team of clinical oncologists, therapeutic radiographers, mould room staff and play specialists, together with nurses, anaesthetic staff, physicists, dosimetrists, and psychologists or psychotherapists.
Play therapy
Play therapy is important in preparing children for radiotherapy. If the trust and cooperation of a younger child can be gained, treatment may not require a general anaesthetic.
- Type
- Chapter
- Information
- Practical Clinical Oncology , pp. 538 - 550Publisher: Cambridge University PressPrint publication year: 2015