Key Points for This Section

The goal of supportive care is to improve the quality of life for young cancer patients and their families. Cancer in children is different from cancer in adults. Children of different ages need different treatment and support. A child's circle of family and friends may be larger than it usually is for adults. Most decisions about care will be made by the child's parents or guardians.

Note: Information about physical adjustment to treatment, problems with physical and cognitive development, and life after cancer treatment will be added to this summary in the future.

The goal of supportive care is to improve the quality of life for young cancer patients and their families.

Most children with cancer can be cured. However, cancer treatment for young patients can cause unwanted side effects and other problems during and after treatment. Early treatment of cancer symptoms and the side effects of therapy helps patients feel better, stay stronger, and cope with life after cancer. Supportive care improves the patient's physical, psychological, social, and spiritual quality of life.

Supportive care is given to children of all ages, including infants, children, adolescents, and young adults.

Cancer in children is different from cancer in adults.

Cancer in children and young adults is different from cancer that develops later in life. Childhood cancers usually do not act like adult cancers and are not treated the same way:

• Treatment

  In general, treatments for childhood cancer use higher doses of chemotherapy and radiation than is used for adults. These treatments may also be given over a shorter amount of time than in adults. This is because children can receive more intense treatment (higher doses given over a shorter time) than adults can, before serious side effects occur.




• Side effects

  Some of the unwanted side effects of cancer treatments cause more harm to children than they do to adults. This is because children's bodies are still growing and developing, so cancer and its treatment are more likely to affect developing organs.

  Side effects of chemotherapy and radiation therapy may happen right away or weeks or years after treatment. Cancer treatment may also affect a child's growth or cause a second cancer to form. Problems that appear weeks or years after treatment are called late effects. Because of possible late effects, childhood cancer survivors need life-long follow-up. (See the PDQ summary on Late Effects of Treatment for Childhood Cancer ¹ for more information).




• Supportive care

  The types of supportive care given to children may be different from those used for adults. For example, certain medicines used to control symptoms in adults may not be safe for children.

Children of different ages need different treatment and support.

The treatments and supportive care will be different for different age groups and will change as the child grows and develops. For some cancers, the prognosis (chance of recovery) and risk of late effects depend partly on the age of the child at the time of diagnosis or treatment. See CureSearch ² for more information about treatment and support for different age groups.

A child's circle of family and friends may be larger than it usually is for adults.

Even with a diagnosis of cancer, the child will still be going to school, spending time with friends and family, and enjoying many activities that were a part of life before cancer. The child's circle of family and friends may be large. In addition to parents, brothers, and sisters, many others may be closely involved in the child's everyday life. This includes grandparents, aunts, uncles, cousins, teachers, schoolmates, and friends. Everyone in a child's circle of family and friends are affected by the child's cancer diagnosis and treatment, and possible side effects of treatment.

Most decisions about care will be made by the child's parents or guardians.

Children under the age of 18 don't have the legal right to make their own decisions about treatment. Their parents or guardians legally make these decisions for them. Decisions about treatment may be difficult because of this. There are ethical concerns about informed consent (the process of giving information about possible treatments and their risks and benefits, before treatment decisions are made). In the treatment of children, parents are informed and decide whether to give permission for the treatment. Whenever possible, it is best that the child be involved and agrees with decisions about treatment.

Glossary Terms

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

Treatment with drugs that kill cancer cells.

To adjust to new situations and overcome problems.

To heal or restore health; a treatment to restore health.

The process of identifying a disease, such as cancer, from its signs and symptoms.

The amount of medicine taken, or radiation given, at one time.

Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.

A process in which a person is given important facts about a medical procedure or treatment, a clinical trial, or genetic testing before deciding whether or not to participate. It also includes informing the patient when there is new information that may affect his or her decision to continue. Informed consent includes information about the possible risks, benefits, and limits of the procedure, treatment, trial, or genetic testing.

Side effects of cancer treatment that appear months or years after treatment has ended. Late effects include physical and mental problems and second cancers.

Refers to the practices and procedures used for the prevention, treatment, or relief of symptoms of a diseases or abnormal conditions. This term may also refer to a legal drug used for the same purpose.

A part of the body that performs a specific function. For example, the heart is an organ.

PDQ is an online database developed and maintained by the National Cancer Institute. Designed to make the most current, credible, and accurate cancer information available to health professionals and the public, PDQ contains peer-reviewed summaries on cancer treatment, screening, prevention, genetics, complementary and alternative medicine, and supportive care; a registry of cancer clinical trials from around the world; and directories of physicians, professionals who provide genetics services, and organizations that provide cancer care. Most of this information, and more specific information about PDQ, can be found on the NCI's Web site at http://www.cancer.gov/cancertopics/pdq. Also called Physician Data Query.

The likely outcome or course of a disease; the chance of recovery or recurrence.

Having to do with how the mind works and how thoughts and feelings affect behavior.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Refers to a new primary cancer in a person with a history of cancer.

A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.

Having to do with deep, often religious, feelings and beliefs, including a person’s sense of peace, purpose, connection to others, and beliefs about the meaning of life.

Care given to improve the quality of life of patients who have a serious or life-threatening disease. The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, palliative care, and symptom management.

One who remains alive and continues to function during and after overcoming a serious hardship or life-threatening disease. In cancer, a person is considered to be a survivor from the time of diagnosis until the end of life.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment.