Can Kids Get Lung Cancer?

It’s important to know that lung cancer is very rare in kids. Overall, other childhood cancers, like leukemia and lymphoma, are more common.

A 2020 study looked into reported lung cancers in the Australian Childhood Cancer registry between the years 1983 and 2015. Within this broad timeframe of over 30 years, researchers only identified 53 kids that met the study criteria.

Since lung cancer is so uncommon in kids, information about it is limited compared to what is known about lung cancer in adults.

This can make discussing how often lung cancer happens in kids, what it’s like, and its outlook challenging. Nonetheless, we have you covered.

We tend to refer to lung cancer as one thing. However, there are actually many different types of lung cancer.

Studies on the topic are ongoing. Research from 2015 found that some lung cancers that have been diagnosed in children include:

• Carcinoid tumors. Carcinoid tumors start in neuroendocrine cells, which are involved in controlling the flow of air and blood in the lungs and can affect the growth of other lung cells. Compared to other types of lung cancer, they tend to occur in younger age groups.
• Primary pulmonary mucoepidermoid carcinoma (MEC). This type of cancer originates in mucus glands but can form in the bronchi, the main airways of the lungs.
• Squamous cell carcinoma (SCC). Squamous cell carcinoma (SCC) is a type of non-small cell lung cancer (NSCLC).
• Adenocarcinoma. Adenocarcinoma is a form of non-small cell lung cancer (NSCLC) which is more commonly seen in adults.
• Bronchoalveolar carcinoma. This is a rare variant form of adenocarcinoma.
• Small cell carcinoma (SCLC). SCLC is rare but fast-growing lung cancer that may return after treatment.

It’s possible for a child to have lung cancer and show no symptoms. This is called being asymptomatic.

Since lung cancer in kids is so rare, when symptoms do appear, they can be easily mistaken for other common lung conditions that affect kids. A few examples are asthma or respiratory infections.

So how do you know what to look for? The symptoms below, particularly when they’re persistent or keep returning, could be signs of lung cancer in a child:

• a cough that doesn’t go away
• chest pain that worsens when coughing or taking deep breaths
• wheezing or hoarseness
• fatigue
• reduced appetite
• unexplained weight loss
• more frequent respiratory infections, such as pneumonia or bronchitis
• coughing up blood
• trouble breathing

In general, cancer happens due to genetic changes in DNA within our cells. These changes cause cells to grow and divide out of control, which leads to the formation of a tumor.

Genetic changes that lead to cancer may be inherited from our parents, which means they’re present from birth. This isn’t the only way these genetic changes can occur, though.

Genetic changes can also happen over time due to errors that naturally occur when our cells divide. Exposure to harmful substances around us can also play a role.

The exact causes of genetic changes in childhood cancers are still poorly understood. For example, the National Cancer Institute notes that only 6 to 8 percent of childhood cancers happen due to inherited genetic changes.

This means that other factors are important for the development of childhood cancers, like lung cancers. The American Cancer Society says that the causes of DNA changes in most childhood cancers remain unknown.

The diagnosis of lung cancer in kids can be challenging. Not only is it rare, but it can also have symptoms that resemble other more common childhood conditions, like asthma.

If your child is having symptoms such as a persistent cough, wheezing, or fatigue, their pediatrician will start by examining their medical history. They’ll also want to know when your child’s symptoms began and whether anything helps alleviate them.

They’ll also ask if your child has a personal or family history of certain medical conditions. Be sure to list anything that comes to mind.

After that, they’ll perform a physical exam. During this time, they’ll check over your child’s body to get an idea of their general health, including listening to their breathing and heartbeat.

Several other tests can help a pediatrician determine the cause of your child’s symptoms. Some of these tests include:

• Blood tests. Blood tests, like a basic metabolic panel and a complete blood count, can help give a doctor a better idea of your child’s overall health.
• Imaging. A chest x-ray can help a doctor to better understand what’s going on in the lungs. Sometimes, more specialized imaging techniques may be used, such as:
  • computed tomography (CT) scan
  • positron emission tomography (PET) scan
  • magnetic resonance imaging (MRI)
• Bronchoscopy. A bronchoscopy uses a thin tube with a camera on the end, called a bronchoscope, to check your child’s airways for abnormal areas. A biopsy may also be collected during this procedure.
• Thoracoscopy. A thoracoscopy is a surgical procedure that uses a thin tube with a camera on the end to allow a doctor to check the tissues of your child’s chest for abnormal areas. A biopsy can be collected during this time as well.
• Biopsy. If a mass or suspicious area is detected in the lungs, your child’s doctor will want to collect a biopsy. This is a tissue sample that can be analyzed in a laboratory to check for the presence of cancer cells.

The exact treatment for a child with lung cancer can depend on many factors, such as:

• the type of lung cancer
• the extent or stage of the cancer
• how well your child’s lungs are working
• the presence of certain genetic changes
• your child’s age and overall health
• shared decision making between you and your child’s care team

Potential treatment options that may be recommended include:

• Surgery. Surgery to remove a tumor is one of the main treatment options for lung cancer, particularly if the tumor hasn’t spread outside of the lungs. Before surgery, chemotherapy may be used to help shrink the tumor.
• Chemotherapy. If surgery isn’t an option, chemotherapy may be recommended. Chemotherapy drugs can kill cancer cells or slow their growth. They’re typically given by mouth or via an IV.
• Radiation therapy. Radiation therapy is another option if surgery isn’t recommended. It uses high-energy radiation to destroy cancer cells.
• Targeted therapy. Targeted therapy drugs target specific markers on or inside cancer cells. They may be used for NSCLC with certain genetic changes.

Being presented with a list of potential treatment options can be a lot to take in. It may be helpful to take notes during these appointments or even record some of the appointments to watch later.

Never hesitate to ask questions when they come up. When making decisions about your child’s treatment, it’s important to have all the facts that you can. Remember, your child’s care team is there to help.

One important aspect of treatment that we haven’t mentioned yet is clinical trials. Prior to being used more widely, newer, innovative cancer treatments must first be tested in clinical trials to see if they’re both safe and effective.

Since many childhood cancers, especially lung cancer, are rare, many kids get treatment by participating in a clinical trial. As you learn about your child’s treatment options, be sure to ask about clinical trials that your child may be eligible for.

The main risk factors for lung cancer in adults are related to lifestyle and environmental factors that can lead to harmful genetic changes. Things like smoking and long-term exposure to secondhand smoke probably come to mind.

However, these things typically take many years to impact a person’s cancer risk. That’s why most people develop lung cancer at a later age as opposed to earlier.

So, what puts kids at risk of lung cancer? Similar to our discussion on the causes of lung cancer in kids, the exact answer is still unclear. There are a few things we do know, though.

According to the American Cancer Society, previous radiation exposure may contribute to harmful genetic changes in childhood cancer. However, they note that most gene changes likely occur naturally and don’t have any outside causes.

We also know of some specific genetic changes that are associated with certain types of lung cancer in kids:

• Anaplastic lymphoma kinase (ALK) gene. Some kids with NSCLC have an alteration in the ALK gene. It’s believed that this change can contribute to the growth and spread of cancer cells.
• DICER1. Kids with pleuropulmonary blastoma often have a change in DICER1, a gene important for controlling the expression of other genes. As such, changes in DICER1 can lead to abnormal gene expression that could cause uncontrolled growth and development of cells.

There are several things that can influence the outlook for a child that has lung cancer. These include:

• the specific type of lung cancer
• how quickly the cancer is growing
• whether or not the cancer has spread to the lymph nodes or other parts of the body
• the presence of certain types of genetic changes
• how your child has responded to treatment
• your child’s age and overall health

A small amount of research has been done on the outlook for lung cancers in kids. Let’s see what some of it says.

A 2015 study included 211 children that were diagnosed between the years 1998 and 2011. Researchers found that children with MEC or carcinoid tumors had better overall survival compared to children with other types of lung cancer.

Research from 2020 included 53 children diagnosed with lung cancer between 1983 and 2015. Within this group, the 5-year survival rate was estimated to be 74 percent.

Reading about cancer outlook can be difficult. However, remember that these statistics are based on the experiences of many kids with lung cancer over a broad span of time. As such, they don’t reflect individual situations or recent advances in treatment.

While lung cancer can happen in kids, it’s very rare. When it does occur, its causes are unclear. Some types of lung cancer, such as NSCLC and pleuropulmonary blastoma, may be associated with certain genetic changes.

Since symptoms can be similar to more common childhood lung conditions, lung cancer can be difficult to diagnose in kids. Once a diagnosis is made, treatment can involve surgery, chemotherapy, or radiation therapy.

The outlook for lung cancer in kids can depend on factors like the type of lung cancer, its stage, and your child’s age and overall health. Your child’s care team can help give you a better idea of your child’s individual outlook.