Tackle football practice began this month for Josh Pita. The 8-year-old loves the sport. So much that when he learned in November 2010 he had cancer, he lamented “I can’t play football,” said his mom Laura Pita.
That complaint came after his first question — “Am I going to die?”
The answer was no.
After his diagnosis, Josh had a month of intense chemotherapy and then was in remission from his cancer, acute lymphoblastic leukemia, or ALL, in which the bone marrow overproduces malignant white blood cells.
His experience reflects how new treatments, more research and greater collaboration among doctors have dramatically increased the survival rates for children diagnosed with cancer. In the 1970s, fewer than half of children with cancer would live to see five more years. Now, about 80 percent of children with cancer survive five years or more, depending on the type of cancer, according to the American Cancer Society.
“It’s not easy work, but it is not a mystery,” said Dr. Brian Cauff, the associate medical director of pediatric hematology oncology at Joe DiMaggio Children’s Hospital in Hollywood. “It’s through cooperative groups, enrolling children in clinical trials and learning more about how to treat their cancer,” added Cauff, who treated Josh.
Through collaborative groups, like the Children’s Oncology Group with more than 200 members, doctors have begun to share information and track the effectiveness of new treatments. Cancer in children is rare, making up less than 1 percent of all cancers diagnosed each year, according to the American Cancer Society.
The rarity makes it harder for doctors to conduct studies on their own, especially studies for the even smaller category of hard-to-beat cancers, explained Dr. John Goldberg. He is the director of the pediatric oncology early phase clinical trials program at the University of Miami Sylvester Comprehensive Cancer Center and Holtz Children’s Hospital at UM/Jackson. It is the only program in South Florida that enrolls children with cancer in the earliest phase of new treatments. There are other hospitals that participate in experimental treatments in later phases.
“For a doctor like me, here in South Florida, and I was going to study all kids with ALL and decide what to do, it would be really hard to get 100 patients in a year and see what was working,” Goldberg said. “But if I join with all pediatric oncologists in the country and agree to do a clinical trial as a group we have more statistical power to be able to tell if our treatment is making a difference.”
Leukemia is one of the most common cancers among children. And ALL — the kind of leukemia Josh had — is the most common type of leukemia. About 2,500 kids a year are diagnosed with ALL, Goldberg said. Yet, through groups like the Children’s Oncology Group, doctors have been able to home in on the best treatment.
The protocol Josh followed was laid out by the group. In all, he will complete three and half years of chemotherapy. The first six months are most intense, followed by less intense monthly chemo treatments and oral medicine at night. Because of the collaboration, doctors have been able to determine when it’s most effective and safer to have less treatment. For example, girls with ALL can have just two and half years of chemotherapy, Cauff said. He said research has shown that it’s not helpful for boys to shorten the treatment, but it’s not clear why.