Overview of Pediatric Cancers

Although pediatric malignancies account for only 1% of all cancers diagnosed in the United States each year, cancer is the leading cause of death by disease in children aged 1–19 years. It is estimated that 15,780 children and adolescents are diagnosed with cancer annually in the United States. The incidence of childhood cancers varies according to age and sex. Overall, leukemia is the most common childhood cancer followed by brain tumors, while in infancy, neuroblastoma, Wilms tumor, and retinoblastoma predominate. Most pediatric cancers have no known cause or risk factors. Only 10% of cases can be linked to familial or genetic factors. The survival rates of pediatric malignancies have improved significantly in the past 50 years, from less than 40% to 80%. The main contributors to survival are early diagnosis and the major discoveries of new chemotherapeutic agents. The field of surgical oncology has undergone major advances in the last few decades, focusing on improving prognosis and minimizing late effects. However, many children who survive cancer suffer from long-term sequelae, including neurocognitive disabilities, organ toxicities, and secondary cancers. Therefore the development of innovative and less damaging therapies is crucial for pediatric malignancies. The mainstay treatment for pediatric solid tumors (neural or nonneural) is chemotherapy for overall reduction in tumor burden, along with a modality of local control. Local control is achieved by surgical resection, radiation therapy, or both. In this chapter we will discuss common childhood cancers, perioperative care, and the role of pediatric critical care.KeywordsCancer predisposition; chemotherapy; childhood cancer; CNS tumors; leukemia; pediatric cancer; preoperative care; radiotherapy.