Advances in pediatric cancer care have dramatically changed what a cancer diagnosis means for children and their families. Today, most children diagnosed with cancer will survive, shifting the focus beyond curing the disease to ensuring they can live long, healthy lives after treatment.
“Childhood cancer is scary, but most children diagnosed with cancer will be cured,” said Peter Cole, MD, Chief of Pediatric Hematology/Oncology at Rutgers Cancer Institute and RWJBarnabas Health, “In pediatric oncology, we have to focus on the lives of children before, during and after diagnosis and successful treatment.”
For children, successful cancer care cannot be measured by survival alone. Treatment takes place during critical years of physical, cognitive and emotional development, and decisions made throughout treatment can affect health decades later. The goal is to cure the disease while giving each child the best chance of a long, healthy life.
That long-term perspective begins at diagnosis. Accurate diagnosis and staging, multidisciplinary treatment planning and access to clinical trials allow care teams to tailor treatment to each child and their disease.
Additionally, new therapies are expanding options for children with difficult-to-treat cancers. Stem cell transplantation and cellular therapies, including CAR T-cell therapy, are options for some children with high-risk or relapsed cancers. At RWJBarnabas Health, these therapies are provided as part of a pediatric hematology and oncology program that brings research and clinical care together.
Cancer treatment can involve repeated appointments, procedures and time away from school, friends and familiar routines. Creating spaces around children’s developmental and emotional needs can make those experiences less intimidating.
At the Jack & Sheryl Morris Cancer Center, the pediatric space was designed around a Jersey Shore theme and includes arcade games and other child-focused elements. The idea is simple: a place where children receive cancer treatment should still feel designed for children and their families.
Childhood cancer survivors can develop late effects months or even years later as a result of chemotherapy, radiation, surgery or stem cell transplantation. Depending on their disease and treatment, those effects can include cardiovascular problems, endocrine disorders, fertility challenges, secondary cancers, and cognitive or psychosocial concerns. Survivors therefore need long-term, individualized follow-up that considers their previous treatment exposures and evolving health risks.
“Most children diagnosed with cancer will be cured, but we don't abandon them after they complete treatment,” Cole said. “They can still have medical needs after curative therapy, so we continue to monitor for late effects.”
Medical surveillance is only one part of survivorship. Children may need support returning to school, navigating emotional and social changes and adjusting to life after treatment. Parents and caregivers face their own challenges, and siblings can also experience the disruption and stress that comes with a cancer diagnosis.
Programs dedicated to childhood cancer survivorship can help patients and families navigate what comes next. Because some late effects may not emerge until years after treatment, ongoing follow-up is critical.
“Once we form a relationship with our patients, we continue to provide multidisciplinary care through our survivorship clinic,” Cole said. “Even though we're a pediatric program, we don't send them out into the world when they reach 18 or 21. We continue caring for them well into adulthood.”
As more children survive cancer, the definition of successful pediatric cancer care must continue to evolve. Success means providing the care and support children need before, during and after treatment to help them thrive for decades to come.