Most children with cancer are treated in specialized centers especially designed for pediatric cancers. According to the American Cancer Society (ACS), 94 percent of children in the United States are treated in a cancer center that is a member of the Children’s Oncology Group (COG). These centers are associated with a university and usually with a children’s hospital. In addition, these centers can offer the most up-to-date treatment through participation in clinical trials, or studies of promising new therapies. Many private practice pediatric oncologists are participating members of the COG and can direct therapy as well.

Treatment for children with cancer is primarily planned by a cancer care team. This team includes healthcare professionals who work together to provide a comprehensive treatment plan. The care team may include the following individuals:

• Pediatrician
  
  
• Oncologists (medical, radiation and surgical)
  
  
• Surgeons (including sub-specialists such as urologists and neurosurgeons)
  
  
• Pathologists
  
  
• Hematologist
  
  
• Nurses
  
  
• Therapists (respiratory, physical, occupational and speech)
  
  
• Psychologists and education professionals
  
  
• Dietitians
  

A specific treatment plan will be established by physicians based on the child’s status, including:

• Child’s age, overall health and medical history
• Type and stage of cancer
• Treatment options
• Child’s tolerance for specific medications and procedures
• Prognosis for the course of the disease
• Medical and parental opinion or preferences

Some childhood cancers will be treated similarly to the same cancer in adults and some treatments will vary. Cancer treatments may be used alone or in combination with each other. They include:

• Surgery. Depending on the type of cancer, surgical removal of all or part of the cancerous tissue may be an option.
  
  
• Chemotherapy. These powerful anti-cancer drugs are used to kill cancer cells. The drugs work by interfering with the cancer cells’ ability to reproduce. The type of drugs, the method of administration and the schedule of treatment depend on the cancer. Chemotherapy may be used in combination with radiation therapy and/or surgery. Some chemotherapy may affect normal organs either during treatment or months to years after treatment. Although there are some exceptions, most childhood cancers initially respond well to chemotherapy. Cancers in children tend to grow fast and chemotherapy is particularly effective against rapid-growing cells. 
  
  
• Radiation therapy. This treatment uses high powered x-rays to kill cancer cells. Radiation therapy is used in different ways depending on the type and location of the cancer. Administration is not painful, although it does have some side effects. In children, radiation therapy in large doses can interfere with normal growth and development. In certain cancers, such as Hodgkin’s lymphoma, the dose of radiation is lowered and combined with chemotherapy. In children, radiation may provide a cure for cancer, control the disease or help relieve its symptoms.

During treatment, psychological counseling is essential for children and their families to cope with the emotional difficulties associated with cancer and the treatment. Support groups specific to the cancer are typically available and can be beneficial throughout the treatment period.

Unlike adult cancers, childhood cancers are not associated with lifestyle risk factors, such as smoking or alcohol use. For that reason, there is no real way to prevent cancers in children. If there is a family history of cancer, parents may inform their pediatrician for monitoring of their children. However, most cancers in children do not have a strong genetic link. Survivors of childhood cancer may experience treatment-related side effects several months or years after their cancer.  They are also at greater risk to develop another cancer later in life. Numerous studies have been conducted among childhood cancer survivors. Some of these studies have shown an increased risk of organ malfunction, cognitive impairments, hearing loss (after use of certain chemotherapy drugs) and increased risks of social problems or suicidal behavior as adults. The Children’s Oncology Group has recently released long-term follow-up guidelines for managing survivors of childhood cancer.