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it takes a soldier a DIPG/childhood cancer foundation

Types of Childhood Cancer

Types of Childhood Cancer

 

Childhood cancer is the number one cause of death by disease in children today more then Asthma, Diabetes, Cystic Fibrosis, and AIDS combined. Statistically, 12,500 children are diagnosed each year. Approximately, 46 children every school day, that averages out to two classrooms. 7 families say goodbye to their child for that last time everyday. The average age for diagnosis's is 8. Some occur within the first two years of life. 

Childhood cancer is also extremely under funded, and only receives less the 3% in national funding to be shared amongst all types of childhood cancer.

Childhood cancer is broken down into 12 major types, Leukemia/Lymphoma or blood cancers are most common in children and CNS/Brain Tumors are the most common solid mass tumor.

There are many sub-types for each type. Although, some may have a great prognosis, many do not. Statistic's, state that there is an 80% five year survival rate for childhood cancer. That may be true for some but not many. Many do not survive over 2 years since diagnosis. I hope that with this information, more people will become aware, of the fact that there are many forms of childhood cancer and not just one or two that you most commonly hear about. Also, please note in the links referenced below, the numbers of children diagnosed each year very, and in most cases are about 5 years old. I wish there was a more up to date accounting of exactly how many children are diagnosed each year, or lose their battle each year.

Also, many adult cancers can and do effect children as well. However, there are many forms of cancer that are found exclusively in children. Most forms of childhood cancers unlike their adult counterparts, have no known cause, therefore, no cure and in some cases no treatments. There are no risk factors involved with childhood cancer other then being a child.  

What many do not realize that even if a child is “cured” they may suffer years of long term side-effects from the treatments they received in order to get that cure. As well, as being at a higher risk of getting another form of cancer, as a child or later in life. Since childhood cancer, is not researched at the same rate as many adult cancers, the treatment for children is more then likely going to be the same as an adult’s but in a lower dose. Children are not little adults. In many cases no new treatments have come to light for children in more then 30 years.

If you as an adult, have suffered from cancer, or watched a loved one suffer and can remember what you/they went through with treatments, just imagine if you can, that same effect twofold in a child. I will emphasize more on brain tumors in children then any other form since that is what my daughter Aimee had, and I am more versed in that area. Although, doing my research I am finding that many forms of childhood cancer can’t be found. I am not sure if that’s due to the fact they are considered very rare and not researched enough or studied enough for the experts to provide valid information about them. The worst part about childhood cancer is many of the symptoms mimic other childhood illness therefore are not being diagnosed until in some cases the cancer has reached other organs and/or is at stage IV.

I know much of the information provided here will be over-whelming, so please forgive me. I am also sure that I missed many forms of childhood cancer, but did provide links that can offer more information.

 Leukemia/Lymphoma (blood/bone marrow)

Acute Lymphoblastic Leukemia (ALL)

Acute Myeloid Leukemia (AML)

Acute Promyelocytic Leukemia (APL)

Juvenile Myelomonocytic Leukemia (JMML)

Chronic Myelogenous Leukemia (CML)

Chronic Lymphocytic Leukemia (CLL)

Hairy Cell Leukemia, (slow growing form of CLL)

Non-Hodgkins Lymphoma (NHL)

     another name Burkitt’s Lymphoma or Wills Tumor

     (can involve either B-cells or T-cells)

Hodgkins Lymphoma (HL)

Myeloma (blood plasma)

Walderstrom Macroglobulinemia

For more information about Leukemia, please visit the links below provided by the leukemia/lymphoma society.

 

Central Nervous System (CNS) (Brain/Spinal Cord) depending on the location depends on the cells involved in these types of tumors. Also, depending the locations, many can not be surgically removed or even biopsied. The Central Nervous System, is made up of the brain and the spinal cord. The peripheral nervous system (PNS) is made of nerves.

 

 http://www.glioma.ws/ 

 

Four major parts of the brain are: Cerebrum, Cerebellum, Limbic System, and the Brain Stem

The brain is then divided into 3 main parts: the forebrain, midbrain, and hindbrain. Brain tumors can be benign (not cancer) or malignant (cancer).

Forebrain: consists of the cerebrum, thalamus, and hypothalamus (part of the limbic system).

Midbrain: consists of the tectum and tegmentum.

Hindbrain: is made of the cerebellum, pons and medulla.

Often the midbrain, pons, and medulla are referred to together as the brainstem.

 http://www.neurophysiology.ws/brainstem.htm

Lobes, within the cerebral cortex: Frontal, Parietal, Occipital, and the Temporal.

Astrocytomas (can occur anywhere within the brain/CNS)

(glial-cells: the star-shaped brain cells called astrocytes)

Low grade astrocytomas:

Pilocytic astrocytoma (such as pilomyxoid astrocytoma, pleomorphic xanthoastrocytoma, and subependymal giant cell astrocytoma)

Diffuse astrocytoma (such as gemistocytic astrocytoma, protoplasmic astrocytoma, and fibrillary astrocytoma)

Oligodendroglial tumor (such as oligodendroglioma)

Mixed glioma (such as oligoastrocytoma)

 

High grade astroctyomas:

Anaplastic astrocytoma

Glioblastoma multiforme

Anaplastic oligodendroglioma

Anaplastic oligoastrocytoma

 

Brainstem Gliomas (the brainstem is divided into 3 main sections)

(Glioma’s are the term for the cells involved. (glial cells))

The brain stem controls basic functions, including blood pressure, heart beat, and breathing (respiration). It is the bottom-most portion of the brain, connecting the cerebral hemispheres with the spinal cord. Several structures are part of the brain stem:

 

PONS (PONTINE)

Pons Reticular Formation: The pons or pontine is the center section of the brainstem.

DPG (diffused pontine glioma)

DIPG (diffused intrinsic pontine glioma)

These tumors can be like Astrocytoma or Glioblastomas depending on the grade. In most cases especially, DIPG biopsies are rarely preformed due to location. At time of DX the prognosis is usually no more then 18 months. During which time children can suffer greatly. In many cases the children become paralyzed, unable to move. Although, in some cases their mind is fully functional. They are fully aware of what is going on. In many cases the only form of treatment is radiation, which gives them what we commonly call the "honeymoon period". Steroids (dexamethasone)

 http://www.chemocare.com/bio/dexamethasone.asp

are the other most common treatment, however the side effects are high and many children can gain close to 100 pounds during their journey, which then makes there ability to walk, breathe, that much more difficult. Steroids, are used specifically to decrease swelling (edema), associated with tumors of the spine and brain, as well as nausea and vomiting associated with some chemotherapy drugs. However, with DIPG, chemotherapy drugs are unable to break through the blood brain barrier, the brains way to protect itself from harm. DIPG most commonly effects children between 5-9. It seems now that many outside that age bracket, from birth to 17 are becoming effected.

 

MIDBRAIN The midbrain is the short portion of the brain stem between the pons and the cerebral hemispheres. The midbrain is a relay center for sight and hearing.

 

MEDULLA

Medulloblastoma (the most common form of brain

                                tumor in children)

Primitive Neuroectodermal Tumors (PNET)

Meningiomas: grow from the meninges.

Schwannomas: are benign tumors that begin in

Schwann cells

Craniopharyngiomas: develop in the region of the pituitary gland near the hypothalamus. The growth of abnormal cells in the tissues of the brain. Germ cell tumors: arise from primitive (developing) sex cells, or germ cells. Also, extracranial germ cellPineal region tumors: occur in or around the pineal gland, a tiny organ near the center of the brain. (also called the pituitary gland)Atypical Teratoid/Rhabdoid Tumor (AT/RT) occurs in the brain but can effect other areas of the Central Nervous System.

 

CNS embryonal tumors

Ependymoblastoma

Ependymoma

Medulloblastoma (some fall into this category)Medulloepithelioma

Pineoblastoma

Pineal parenchymal tumors of intermediate differentiation

Supratentorial primitive neuroectodermal tumor (SPNET)

Atypical Teratoid/Rhabdoid Tumors (AT/RT)

Neuroblastoma forms in your nerve tissue. It usually begins in the adrenal glands, which sit atop your kidneys. It may also begin in your neck, chest or spinal cord.

Adrenocortical Carcinoma

Bladder Cancer

Bone Cancers

Osteosarcoma

Ewing Sarcoma

Malignant Fibrous Histiocytoma

ChondrosarcomaBreast (yes children can & do get breast cancer)Bronchial

Carcinoid Cancers or Abdominal Cancers 

 

 

These are also considered rare in children, but it does happen more often then we think.

 

Adrenal Cortex

Stomach (gastric)

Pancreas

Colorectal

Carcinoid Tumors

Gastrointestinal Stromal Tumors

 

Other forms that are considered very rare:

Multiple Endocrine Neoplasia Syndromes (MEN)

(there are 3 forms of MEN- MEN1, MEN2A, MEN2B)

Carney Complex

Skin Cancer

    (Melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma)

ChordomaCervical (yes, young girls can and do get cervical cancer)Colorectal (yes, children do get colon cancer)Esophageal Tumors (throat cancer family)Esthesioneuroblastoma

 

Eye Cancer:

Retinoblastoma Melanoma: A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines. 

Head & Neck Cancer:

Head and neck cancers include cancers of the nose and throat, thyroid tumors, mouth cancer, salivary gland cancer, cancer of the larynx (or voice box), and respiratory tract.

Nasal cavity and Throat called nasopharyngeal (Nasopharyngeal cancer occurs in association with Epstein-Barr Virs (EBV) infectin, which is associated with infectious mononucleosis)

Papillomatosis of the larynx

Heart cancer

Rhabdomyomas (muscle tissue)

Rhabdomyoscarcoma (muscle tissue but can occur anywhere in the body)

Fibromas (fibrous tissue)

Myxomas (are rare usually benign) Other benign tumors include histiocytoid cardiomyopathy tumors, teratomas, hemangiomas, and neurofibromas. Malignant tumors that begin in the heart are rare, but may include malignant teratomas, rhabdomyosarcomas, and chondrosarcomas.

 

Langerhans Cell Histiocytosis (LCH) Can effect different parts of the body. Parents exposed to certain chemicals, or family history can increase the risks of LCH.

Islet cell tumor: A mass of abnormal cells that forms in the endocrine (hormone-producing) tissues of the pancreas. (rare in children)

Hepatocellur (Liver Cancer)

 

Lung Cancer:

Small Cell

Non small Cell

Mesothlioma (although rare, children are at a higher risk then most know. According to some researchers and specialists in the field, since children’s lungs are still developing it puts them at a higher risk then adults. Asbestos can be found in some toys, and older schools or apartment buildings and homes. We have made great strides in cleaning up many of the older schools and other buildings. For more information about lung cancer in children please visit Asbestos.com)

Pleuropulmonary Blastoma usually occurs in the first two years of life, and may also be found in siblings.

 

Nasal (part of head and neck)

Nasal cavity and Throat called nasopharyngeal

Oral Cancer

 

Ovarian Cancer (yes children can and do get this as well)

Renal Cell (kidney cancer)

Scarcoma (soft tissue)

Testicular Cancer (very rare in younger boy’s more common in teens)

Thymomas and Thymic Carcinoma

Carcinoma of the Cervix and Vagina (very rare in most cases now when a young girl is diagnosed with this form of cancer it’s due to exposure from diethylstilbestrol (DES) drug.

 

MOST COMMON SYMPTOMS:

 

Signs of Childhood Cancer

Continued, unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in bones, joints, back, or legs
... Lump or mass, especially in the abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
Constant infections
A whitish color behind the pupil
Nausea which persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes which occur suddenly and persist
Recurrent or persistent fevers of unknown origin

 

COMMON DIPG SYMPTOMS

Constant/Chronic headaches 

Dizziness (sometimes more severe when laying down) 

Hic-ups

Loss of balance

Head tilt

Crossed eyes

Blurred or double vision

Vomiting, with or without nausea   

TERMINOLOGY AND ANATOMY OF DIPG

One must remember that DIPG are brain stem gliomas, but not all brain stem gliomas are DIPG's. (diffuse intrinsic pontine gliomas)

 brainstem   (brnstm)

The part of the vertebrate brain located at the base of the brain and made up of the medulla oblongata, pons, and midbrain. The brainstem controls and regulates vital body functions, including respiration, heart rate, and blood pressure

Brainstem gliomas are tumors that occur in the region of the brain referred to as the brain stem, which is the area between the aqueduct of Sylvius and the fourth ventricle. Although various systems are used to classify these tumors, the authors have divided brainstem gliomas into 3 distinct anatomic locations—diffuse intrinsic pontine,[1] tectal, and cervicomedullary. Intrinsic pontine gliomas carry a grave prognosis. Longer survival is associated with the tectal and cervicomedullary gliomas. Tumors also are characterized on the basis of site of origin, focality, direction and extent of tumor growth, degree of brainstem enlargement, degree of exophytic growth, and presence or absence of cysts, necrosis, hemorrhage, and hydrocephalus.[2]

dif·fuse   (d-fyz)
v. dif·fuseddif·fus·ingdif·fus·es
v.tr.
1. To pour out and cause to spread freely.
2. To spread about or scatter; disseminate.
3. To make less brilliant; soften.
v.intr.
1. To become widely dispersed; spread out.
2. Physics To undergo diffusion.
adj. (d-fys)
1. Widely spread or scattered; not concentrated.
2. Characterized by verbosity; wordy. See Synonyms at wordy.

in·trin·sic/inˈtrinzik/

Adjective:
  1. Belonging naturally; essential.
  2. (of a muscle) Contained wholly within the organ on which it acts.
Synonyms:internal - inner - interior - inward - real - substantial

pon·tine   (pntn, -tn)
adj.
1. Of or relating to bridges.
2. Of or relating to a pons, especially the pons Varolii.

Gliomas are classified by cell type, by grade, and by location.

glioma is a type of tumor that starts in the brain or spine. It is called a glioma because it arises from glial cells. The most common site of gliomas is the brain.[1]

So that means that a DIPG is a D=Spread out, scattered, disseminate
                                               I= situated within
                                               P= pontine, pons, (location)
                                              G=glial cells (type) -oma: Suffix meaning a swelling or tumor.

Now the meaning of a DPG somewhat the same as the first minus the I or inside.
      D=Spread out, scattered, disseminate
                                              P=pontine, pons (location)
                                              G=glial cells (type) -oma: Suffix meaning a swelling or tumor.

Just like the first, and second: PG =====P=pontine, pons (location)
                                                               G=glial cells (type) -oma: Suffix meaning a swelling or tumor.

Just and FYI both, a DPG and PG can be removed or shaved to a point. Since a DIPG is INSIDE in most cases it can not. Therefore there is a difference between all three. Which then could and would change the out come of survival and/or treatment. 

Then you can go even more in depth, and determine if it's focal
 Focal tumors are defined as:
  • Involving less than 50% of the afflicted anatomical structure or
  • Less than 2 cm in maximum diameter 
  • Imaging:
    • Well-circumscribed
    • Absence of hypodensity 
    OR Atypical:

    a·typ·i·cal

       [ey-tip-i-kuhl]  Show IPA
    adjective
    not typical; not conforming to the type; irregular; abnormal:atypical behavior; a flower atypical of the species.

    typ·i·cal

       [tip-i-kuhl]  Show IPA
    adjective
    1.
    of the nature of or serving as a type or representativespecimen.
    2.
    conforming to a particular type.
    3.
    Biology. exemplifying most nearly the essentialcharacteristics of a higher group in natural history, andforming the type: the typical genus of a family.
    4.
    characteristic or distinctive: He has the mannerisms typical ofhis class.
    5.
    pertaining to, of the nature of, or serving as a type oremblem; symbolic. 

Difference between Astrocytoma's and Glioblastoma's

 

Astrocytoma:  A tumor that begins in the brain or spinal cord in small, star-shaped cells called astrocytes. The location of the tumor depends on the age of the person. In adults, astrocytomas most often arise in the cerebrum, whereas in children, they may arise in the brain stem, cerebrum, and cerebellum. Slow growing--grading I or II

 

Glioblastoma: A highly malignant, rapidly growing type of braintumor that arises from glial cells in the brain. Early symptoms may include sleepiness, headache, and vomiting. Also called a grade IV astrocytoma. Treatment can involve surgery and radiation treatment.

Rapid growing--grading III or IV

 

 

 

THE ABOVE DEFINATIONS CAME FROM SEVERAL MEDICAL DICTIONARY'S, MOST OF WHICH CAN ALSO BE FOUND ONLINE.

 

Resources

http://statecancerprofiles.cancer.gov/

http://www.cdc.gov/

http://www.nih.gov/ 

http://www.cancer.gov/

http://serendip.brynmawr.edu/bb/kinser/Structure1.html

http://www.neurosurgery.pitt.edu/neuro_oncology/brain/types.html

 

 

 

http://www.leukemia-lymphoma.org

http://www.leukemia-lymphoma.org/attachments/National/br_1285360923.pdf

http://www.leukemia-lymphoma.org/attachments/National/br_1209387080.pdf

 

 

 

 

http://seer.cancer.gov/statistics

 

http://www.soc-neuro-onc.org/en/art/53

http://www.asbestos.com/

 

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