Although it’s much less common than in adults, kids can get cancer. Researchers estimate that
If your child has been diagnosed with cancer, it can feel daunting to start exploring their treatment options. One type of treatment that may come up is chemotherapy.
When chemotherapy is recommended as a treatment option, a flood of thoughts and images probably comes to mind. It can be scary, but we’re here to help you out.
We’ll walk you through the basics of chemotherapy for kids, how it works, and the side effects that may happen. We’ll also list questions to ask your child’s care team so you can make treatment decisions with all the facts at your fingertips.
Chemotherapy is one of the potential treatment options for childhood cancer. Let’s call it “chemo” for short.
Right off the bat, it’s important to know that chemo may not be necessary for your child’s cancer. Whether it’s recommended will depend on several things, such as:
- the specific type of cancer your child has
- where the cancer is located in the body
- the extent, or stage, of the cancer
- your child’s age and overall health
Chemo is a type of systemic treatment. This means that it works throughout the entire body, as opposed to just one area.
Chemo drugs work by disrupting the cell cycle, which controls the growth and division of cells in the body. Because chemo works best on cells that are growing and dividing rapidly, it can kill cancer cells or slow their growth.
It’s also possible that chemo may be used alongside other treatment options. For example, chemo may be recommended before or after your child has surgery to remove a tumor.
This is because chemo can help shrink a tumor before surgery or get rid of cancer cells that may remain after surgery. Chemo used to help shrink a tumor before surgery is called neoadjuvant chemotherapy, and chemo used to help kill cancer cells left after surgery is called adjuvant chemotherapy.
Chemo for your child: Questions to ask
- Why is chemo being recommended for my child’s cancer?
- Are there other treatments that are used for this type of cancer? If so, how effective are they? Are they more or less effective than chemo?
- Will chemo be used alongside any other types of treatment? If so, which ones?
While we often use chemotherapy as a general term, there are actually several types of chemo drugs. These drugs are grouped based on factors like their chemical structure and how exactly they work against cancer cells.
The types of chemo drugs that can be used to treat cancer in kids may include:
- Alkylating agents. Alkylating agents work by damaging DNA, which can prevent a cell from growing and dividing. Examples of alkylating agents that may be used in kids are:
- Antimetabolites. Antimetabolites interfere with the components that make up DNA. Because of this interference, a cell cannot grow and divide. Antimetabolites that may be used for childhood cancers are:
- mercaptopurine (6MP)
- cytarabine (ara-C)
- Antitumor antibiotics. Antitumor antibiotics interfere with enzymes involved in copying DNA. Because copying DNA is needed for a cell to divide, the affected cell cannot do so. Daunorubicin and doxorubicin are antitumor antibiotics that may be used in kids.
- Plant alkaloids. Plant alkaloids can work by interfering with the copying of DNA or by preventing the process that enables cells to split into two new cells. Plant alkaloids that can be used to treat childhood cancers are:
Some types of chemo drugs are more effective against certain types of cancer than others. Because of this, the type of chemo drug that’s used for your child will depend on the specific type of cancer they have.
Additionally, your child’s treatment plan will probably include multiple chemo drugs. This is totally normal.
Because the different types of chemo drugs work in different ways, they can team up to fight cancer. Using multiple chemo drugs may also lower the risk of cancer becoming resistant to a specific chemo drug.
Chemo drugs for children: Questions to ask
- What chemo drugs will be a part of my child’s treatment?
- Generally speaking, how do these drugs work against cancer?
- Are there other types of chemo drugs that may be used for this type of cancer?
- Why do you recommend this drug combination over others?
As we noted earlier, chemo drugs target cells that are growing and dividing rapidly. Because of this, in addition to affecting cancer cells, it’s also possible for them to impact healthy cells that grow quickly, such as those in the:
- hair follicles
- mouth and digestive tract
- bone marrow
When healthy cells in these areas are damaged or killed, it can lead to side effects. Some common side effects associated with chemo are:
- hair loss
- reduced appetite
- mouth sores
- low blood counts that can cause:
- anemia, which can lead to symptoms like extreme tiredness and shortness of breath
- frequent infections
- easy bruising or bleeding
These types of side effects generally go away after your child’s chemo has ended. It’s also important to know that side effects can be different depending on things like:
- the type of chemo drug used
- the dosage of chemo that’s used
- the location of the cancer being treated
- your child’s age and overall health
Chemo side effects: Questions to ask
- What side effects can I expect for my child with this type of chemo?
- How can I make my child more comfortable when they’re not feeling well?
- How long will side effects last?
- When should I contact my child’s care team about side effects?
Chemo is given in cycles. One cycle includes a period of chemo treatment followed by a period of rest. The rest period allows your child’s body to recover from the effects of chemo before another cycle begins.
Many times, chemo is given directly into the bloodstream using an IV. If your child is getting chemo in this way, it’s likely that a thin, flexible tube called a catheter will be temporarily inserted into a vein in their body.
This catheter, sometimes called a port, lets your child’s healthcare team give your child chemo and other medications without having to insert a needle every time. It can also be used to collect blood samples that can indicate how your child is responding to their treatment.
The catheter will remain in your child’s body until they are done with their chemo treatments.
In addition to an IV, chemo can be given in other ways, such as:
- taken by mouth as a pill, capsule, or liquid
- injected into a muscle or another area of the body
- applied to the skin
Chemo treatment plan: Questions to ask
- How many cycles will be in my child’s chemo treatment?
- How long will they receive treatment? How long will their resting period be?
- Where will the treatment sessions take place? Will they be inpatient or outpatient?
- What will happen during a treatment session?
- In what form will my child receive chemo?
- If my child is receiving chemo via an IV, what type of catheter will be used? What’s involved in placing it?
- Are there any precautions that I should take while caring for my child while they’re actively receiving treatment?
- How can I get detailed records of the treatment my child receives, including the specific chemo drugs used and the doses that were given?
- What support resources are available for my child and their loved ones during treatment?
- Which days of each cycle will my child feel the best? Which days will they feel the worst? Will this change with each cycle?
The outlook for a child who’s treated with chemo can depend on many factors, such as:
- the specific type of cancer they have
- the stage of the cancer
- how your child’s cancer responds to chemo
- what other types of treatment are used, if any
- your child’s age and overall health
The treatment of childhood cancers has vastly improved in recent years. The American Cancer Society (ACS) estimates that, due to these advances,
However, while chemo for childhood cancer absolutely saves lives, it’s also possible for it to have effects that happen months or even years after treatment. These are called late effects and can include but aren’t limited to:
- heart damage, which can lead to problems like arrhythmias and heart failure
- hearing loss
- problems with attention, memory, or problem-solving
- growth and developmental delays
- decreased fertility
- developing second types of cancer, which may include solid tumors or blood cancers like myelodysplastic syndromes and acute myeloid leukemia
Nevertheless, the life expectancy of survivors of childhood cancer is expected to continue to improve. A
Due to treatment advances, the gap in life expectancy compared with the general population was estimated to lessen from 25 percent to 14 percent for people diagnosed in more recent years.
The greatest improvements in estimated life expectancy were predicted to be in those who received chemo alone, as opposed to radiation therapy alone or both chemo and radiation therapy.
Chemo outlook: Questions to ask
- What’s the overall goal of my child’s treatment? Will it cure their cancer?
- If my child’s cancer doesn’t respond to chemo, what are the next steps?
- What do you believe my child’s individual outlook is?
- What types of late effects are possible with this type of chemo?
- What types of specialists can help manage late effects, should they occur?
Chemo is often part of the treatment plan for many common childhood cancers. It uses drugs that target rapidly dividing cells, killing them or slowing their growth.
While chemo is lifesaving for many kids, it’s also associated with short- and long-term side effects. As you’re making treatment decisions, your child’s care team will discuss the benefits and risks of each potential treatment option with you.
If chemo is recommended for your child, be sure to ask any questions you have. It’s totally normal to feel overwhelmed during this time, so it may help to write your questions down as they occur. That way, you can make sure to ask them later.