While cancer can affect anyone, there are several key differences between pediatric and adult cancers. This can include disease type, causes, mutational profile, and treatment.
“Adult cancers often develop due to lifestyle and environmental factors, whereas childhood cancers typically originate from developing cells that have gone awry,” explains Kimberly Stegmaier, MD, chair of Pediatric Oncology at Dana-Farber and associate chief of Hematology-Oncology at Boston Children’s Hospital. Moreover, data now suggests that around 10% of children with cancer have an inherited predisposition to develop cancer.
Distinct Types and Causes
While childhood cancer is rare, the more common types of cancer that affect pediatric patients include blood cancers – such as leukemia and lymphoma – and tumors of the brain, spinal cord, or bone. Cancer of the lungs, breast, colon, prostate and skin – including melanoma – are more likely to occur in adults. This means that the cells from which cancers originate in children and adults tend to be different.
“Pediatric cancers also typically possess what we call ‘quiet’ or ‘simple’ genomes,” Stegmaier says. “This is in contrast to adult cancers that frequently have ‘complex’ genomes with larger numbers of gene mutations. In pediatric cancers, however, we tend to see a smaller number of key structural abnormalities involving the chromosomes that lead to the production of abnormal, cancer-promoting proteins called fusion oncoproteins. About half of the abnormalities that drive childhood cancer, such as these fusion oncoproteins, are distinct from what physicians observe in adult cancer.”
Similar to adult cancers, pediatric cancers may be treated with chemotherapy, radiation, surgery, or a combination of those approaches. The last decades have seen remarkable advances in the development of targeted drugs for adult patients with cancer, and while there are notable examples of successful application of these therapies to childhood cancers such as CD19-directed therapies for B-cell acute lymphoblastic leukemia – a blood cancer that overproduces immature white blood cells – there are many childhood cancers where progress has yet been made in improving outcomes. Stegmaier says this is because the biology and targets in pediatric cancers are frequently different. Additionally, pediatric targets are often difficult to make drugs against, and childhood cancers are rare. There is no market incentive for biopharmaceutical companies to develop drugs for rare cancers.
“Academic efforts at the Dana-Farber are essential to discovering new therapies for children with cancer because the pharmaceutical industry is not likely to do it,” Stegmaier says.
Treatment at Every Stage of Life
Every patient, regardless of age, benefits from supportive care during and after treatment. Dana-Farber has specialized programs to help pediatric and adult patients cope with their cancer journeys.
With patient and family programs – from the Young Adult Program to various centers geared toward older adults – all patients receive tailored care from a dedicated, multidisciplinary team. A holistic approach ensures that every patient is treated as an individual – physically, socially, and emotionally.
For pediatric patients, providers in the Jimmy Fund Clinic pay special attention to maintaining the joys of childhood through activities and programs like daily arts and crafts, holiday festivities, and trips in and around Greater Boston.
“Celebrations of holidays, as well as daily arts and crafts in clinic create a safe and special place for families,” says Lisa Scherber, director of Patient and Family Programs in the Jimmy Fund clinic. “While in clinic, procedural support is provided by our Child Life Specialists, working in tandem with our nursing team. Events that take place outside of the clinic walls have created a beautiful impact on patients of all ages and their families.”
Learn more about care and treatment for adults and children from Dana-Farber Cancer Institute.