How Worried Should Parents Be About Pediatric Cancer?

A pediatric cancer doctor addresses concerns about childhood cancers.

Gary Kupfer, MD discusses pediatric cancer

Gary Kupfer, MD, talks to parents about what doctors look for as signs of pediatric cancers, which are rare. "Although the prognosis for children diagnosed with cancer is good, childhood cancers can take both parents and pediatricians off guard because it’s so unexpected," says Dr. Kupfer.

Credit: Robert A. Lisak

With parenthood comes worry. We worry that our children might be bullied, struggle with depression, or somehow encounter harm. And we also we worry when our children are sick, especially if they aren’t getting better.  

If you are a parent who worries about cancer, you should know that “childhood cancer is rare,” says Gary Kupfer, MD, a pediatric hematologist and oncologist with Yale Medicine. “While over 1 million Americans get cancer each year, only 1 to 2 percent of them are children,” he says.

Although the prognosis for children diagnosed with cancer is good, childhood cancers can take both parents and pediatricians off guard because they're so unexpected, explains Dr. Kupfer. 

To raise awareness about pediatric cancers and help families recognize and understand the risks, we sat down with Dr. Kupfer, who answers questions parents may have.

What is the most common childhood cancer?

Although we do see children with brain tumors and lymphomas, leukemia in children is the most common type of cancer that we take care of. It shows up in one out of about 50,000 children each year. Early detection is really difficult, unless you're extremely lucky. Typically, a doctor can detect it based on clues, such as kids who aren't feeling well for an extended time, fever, bruising, and their refusal to walk due to bone pain, a result of leukemia, which causes the bone marrow to expand outward against the surrounding bone.

What we try to focus on is helping pediatricians understand what they should be looking for so those kids who need special medical attention receive it more quickly.

What are symptoms of childhood cancer that parents should be aware of?

There are few specific signs and symptoms that parents can point to. However, new and concerning signs—such as bruising, pale appearance, and pain—should certainly trigger a trip to the pediatrician. It is really not the parents’ job to diagnose or screen for cancer. Share any health concerns you have with your pediatrician, who can talk to specialists to evaluate the need for a further workup, if needed.

What can parents do to decrease the risk of their child getting cancer?

Much of childhood cancer is the result of chance—for example, genetic changes that occur due to random events during times of rapid growth, which is a natural part of normal childhood growth and development.

One exception to this rule is that specific genetic disorders are associated with susceptibility to cancer. We encourage parents to talk with their pediatrician about any family history of such disorders and to share information about young relatives with cancer diagnoses—it can bring awareness that children in the family might require close attention and screening.

What do you say to parents when their child is diagnosed with cancer?

We have to have very honest conversations about what they're going to be going through. I can't necessarily reassure them that they will not be facing something difficult or stressful or with potential for death. What I try to reassure them about, though, is that we have very good therapies. In most cases, the outcomes are good. Every step of the way we—the doctors, nurses, child-life specialists, and social workers—are going to be with them. It's an entire team that includes the parents; they need to be a big and very important part of that team. 

The other piece of that puzzle is that we aren’t detached; we establish a bond. Establishing that emotional connection with families and patients is extremely important because we're not just giving their child penicillin for strep throat. We're with them on a long journey to cure their child. That's not a journey for the faint of heart.

So, we are with them from beginning to end, wherever that end goes, and we try to make sure they know that from the beginning, that we're not going to desert them. We're going to take the best care that we can of their child. 

What should parents know about childhood cancers?

We’ve come a long way in curing childhood cancers. Before the 1950s, the most common type of childhood leukemia was uniformly fatal. Now we achieve an overall survival rate of 90 percent. That’s nothing short of a modern medical miracle.    

So much hope exists in the cure of childhood cancers that research is now focusing on minimizing long-term side effects of therapy in diseases that have nearly a 100 percent long-term cure, such as acute lymphocytic leukemia, Hodgkin’s lymphoma, and Wilms tumor.

Challenges remain. But pediatric oncology as a field and as a group of dedicated medical professionals will not rest until all afflicted children, both at home and abroad, are cured and are able to go on to live happy, healthy, and productive lives.

To learn more about Yale Medicine's Pediatric Hematology & Oncology Program, click here.