For any parent, having a child with cancer is devastating. For the parents of Carrick Stafford Wood, it was even more so. Carrick was born with cancer, specifically acute myeloid leukemia (or AML). He spent the first six months of his life in the hospital before finally going home on Christmas Day.
We spoke to Lisa Diller, MD, clinical director of Pediatric Oncology at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, about this rare scenario.
Is it unusual for babies to be born with cancer?
It’s unusual, but it can happen. The most common cancer in newborns is neuroblastoma – a rare cancer of the developing nervous system. It can present with a tumor near or around the spine as well as in the abdomen or the adrenal gland. Sometimes we can tell because the baby’s liver is enlarged. Other times, we can tell because the cancer sometimes spreads to skin within the newborn period. Other tumors we see more rarely in children are leukemia (a blood cancer) and a tumor called teratoma that often appears as a mass near the coccyx bone.
Can cancer be detected before birth, and if so can you treat it then?
Cancers can sometimes be seen before birth by ultrasounds that are done to check a baby’s health. The Advanced Fetal Care Center at Boston Children’s Hospital can do more diagnostic studies in utero when necessary, including MRIs and even biopsies. It’s very important to have obstetricians, surgeons, and neonatologists as part of the team that cares for newborns with cancer.
We sometimes suggest that the obstetrician deliver a baby early if we think symptoms might progress and harm the baby. For example, there was a young boy who was in utero, and his mother noticed a couple weeks before his due date that he wasn’t kicking as much. She went to the obstetrician, they did an ultrasound, and they saw a tumor by the spine that was affecting the baby’s ability to move his legs. Within 24 hours he was delivered and immediately sent to Dana-Farber/Boston Children’s to start chemotherapy. He’s doing great now.
How successful is cancer treatment overall for newborns?
Neuroblastomas and teratomas in newborns are usually very treatable, and most children are cured. Infantile leukemia is hard to treat, but again, with aggressive therapy, we are able to cure many of them. We have an infant leukemia expert here in Dr. Lewis Silverman, and we’re always doing new studies to see if we can improve our outcomes.
What about secondary cancers?
As many people know, radiation can cause cancer, but it is also an important treatment choice for cancer patients. In a newborn, we almost never use radiation, because exposing a newborn to radiation could not only result in second cancers later in life, but also the area of the body that you radiate will often not grow appropriately.
When we feel we absolutely have to use radiation to save a child’s life, we’ve learned how to give the absolute minimum amount of radiation in order to cure them while minimizing long-term harm. We’ve learned from survivors how to improve our therapies.