What to Know About Childhood Cancer
- Acute lymphoblastic leukemia (ALL) is caused when the bone marrow creates too many immature white blood cells, which are critical to the immune system since they fight infection.
- Signs of ALL typically include fever as well as unexplained bruising, and the disease is diagnosed through bone marrow and blood tests.
- Acute lymphoblastic leukemia is most common in early childhood, peaking between 2 and 5 years of age.
- CAR T-cell therapy is a treatment method used for relapsed and treatment-resistant acute lymphoblastic leukemia and reengineers immune cells to fight leukemia.
- After a cancer diagnosis, it's important to build a strong support system filled with family and friends, or support groups either online or in-person and mental health professionals if necessary.
"Azel is a fun-loving and outgoing 3-year-old that loves Buzz Lightyear," is how Darnell and Abigail Bryant described their son.
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But concerned doctors had Azel undergo an ultrasound and it was determined the 3-year-old had a form of leukemia, which is a blood cancer.
"They said there's nothing that this could be other than cancer. The way it was explained to us, it just mutated," Abigail said.
Azel was diagnosed with T-Cell lymphoblastic leukemia.
Understanding Leukemia
According to the American Cancer Society, leukemia is a cancer of the early blood-forming cells. There are different types of leukemia that are classified based on how fast it grows and where the cancer originates. Depending on the type of leukemia, doctors will treat it accordingly.
"Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers," the American Cancer Society says.
Azel's diagnosis of T-cell lymphoblastic leukemia is a subtype of acute lymphoblastic leukemia (ALL). There are two subtypes of ALL depending on the type of immune cell or lymphocyte that is involved.
WATCH: What Is Acute Lymphoblastic Leukemia ALL?
In B-cell lymphoblastic leukemia, it begins in immature cells that would normally develop into B-cell lymphocytes.
In T-cell lymphoblastic leukemia, ALL begins in immature cells that would normally develop into T-cell lymphocytes, according to the Leukemia and Lymphoma Society.
Acute lymphoblastic leukemia is a type of cancer of the blood and bone marrow and it most common in early childhood, peaking between 2 and 5 years of age.
Being diagnosed with acute lymphoblastic leukemia (ALL) can be emotionally overwhelming, and patients and their loved ones are sure to have many questions about the disease and how it will affect the child.
Dr. Olalekan Oluwole, a hematologist with Vanderbilt University Medical Center, explained what causes ALL.
"It is often not something that is heritable (passed down)," Dr. Oluwole tells SurvivorNet.
"If there happens to be a pattern in a certain family, many times that may be maybe because they were in the same environment. 'I got exposed to the same thing, right?' So it is not necessarily something that is heritable or like some of the other cancers, some of the other genes that we know about things like breast cancerALL is not like that," Dr. Oluwole explained.
Acute Lymphoblastic Leukemia Symptoms and Risk Factors in Children
Signs of ALL typically include fever as well as unexplained bruising, and the disease is diagnosed through bone marrow and blood tests.
It’s important to note that leukemia symptoms in children may look different from how they appear in adults. The National Cancer Institute describes signs and symptoms of ALL in children may include:
- Fever.
- Easy bruising or bleeding.
- Petechiae (flat, pinpoint, dark-red spots under the skin caused by bleeding).
- Weakness, feeling tired, or looking pale.
- Bone or joint pain.
- Shortness of breath.
- Painless lumps (swollen lymph nodes) in the neck, underarm, stomach, or groin.
- Pain or feeling of fullness below the ribs.
- Loss of appetite.
Acute Lymphoblastic Leukemia Treatment
Treatment options for acute lymphoblastic leukemia, include chemotherapy, radiation therapy, stem cell transplant and targeted therapy.
Similar to adults battling ALL, children’s treatment is divided into phases. The National Cancer Institute describes them as:
Remission induction: The first phase that aims to kill the leukemia cells in the blood and bone marrow putting the leukemia into remission.
Consolidation/intensification: The second phase of treatment begins once the leukemia is in remission and aims to kill any leukemia cells that remain in the body and may cause a relapse.
Maintenance: The third phase of treatment which aims to kill any remaining leukemia cells that may regrow and cause a relapse.
Within each of the phases, cancer warriors fighting the disease can receive:
- Chemotherapy
- Targeted therapy
- Radiation therapy
- Bone marrow or stem cell transplant
- Engineering immune cells to fight leukemia with (CAR)-T cell therapy where the body's germ-fighting T cells are reengineered to fight the cancer and infused back into your body. CAR-T might be an option for children and young adults.
CAR-T cells have the potential to wipe out all of the cancer cells in the body. And they may stick around in the blood stream for months. That's why this treatment can lead to long-term remission for several different kinds of blood cancer.
"You will be seeing many more diseases where CAR-T will become commercially available," Sid Ganguly, MD, Deputy Director of Hematologic Malignancies and Cellular Therapeutics at the University of Kansas Medical Center, told SurvivorNet.
Dr. Ganguly added people who don't fall into the categories for which the FDA has approved CAR T cells may be able to enroll in clinical trials that offer the treatment.
For people going through a stem cell transplant for ALL, there are a few things you can expect to happen. A stem cell transplant wipes out the immune system, leaving a person more vulnerable to infections. As a result, this kind of treatment requires staying away from people and avoiding certain foods that could make you sick.
"You've lost all immunity to any prior vaccinations you've ever had," Dr. Caitlin Costello, a hematologist-Oncologist at UC San Diego Health explained to SurvivorNet.
"So over the course of the next two months, we'll be pretty strict about what you eat, and who you see, and who you are around, and really limit your public exposure, if you will, to your doctors, and nurses, and caregiver team."
Childhood Cancers Compared to Cancers in Adults
The American Cancer Society says 85% of children with cancer now survive five years or more thanks to major treatment advances in recent decades, an increase since the 1970s where the survival rate was 58%.
Childhood cancers are not as likely to be associated with lifestyle or environmental risk factors when compared to cancers in adults. Also "only a small number of childhood cancers are caused by DNA changes passed from parents to their child," according to the American Cancer Society.
Childhood cancers tend to respond better to certain treatments because children's treatments are often more intense, and they tend to have fewer health problems.
Azel's Ongoing Cancer Journey
Azel's parents explained their son is bravely fighting the disease and provides them with the added encouragement needed to support their beloved cancer warrior.
"We went back to the hospital wondering if this was going to be a traumatic experience for Azel, but he was so brave! He wore his Henry Danger costume and was ready to go! I'm so proud of this little boy's resiliency," Abigail described on a special Facebook page dedicated to Azel's cancer journey. The family also created a GoFundMe page to help with expenses, another aspect of coping with a cancer diagnosis.
Darnell and Abigail hopes by sharing Azel's cancer journey, other families bravely fighting are motivated to keep going and never give up. They recommended the book "When a Kid Like Me Fights Cancer," which shares a cancer journey from a child's perspective.
"I wept when I read it with my husband to our son," Abigail said.
"It perfectly explains everything that our family is going through at a level of which our son can understand," she added.
As the Bryants shared, caring for a child diagnosed with cancer can be incredibly stressful on the entire household. That's why after a cancer diagnosis, it's important to build a strong support system filled with family and friends, or support groups either online or in-person and mental health professionals if necessary. The added support not only eases the anxiety of the cancer warrior, the added support helps their loved ones too.
Dr. Shelly Tworoger, a researcher at Moffitt Cancer Center told SurvivorNet that "there's a number of common things cancer patients can experience, such as anxiety, depression, financial toxicity, social isolation and sometimes even PTSD." So helping to ease those feelings is a great way to support your loved one.
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