Over the past years, significant progress has been made in the fight against childhood cancer. Still, more than 15,000 young Americans under the age of 21 will be diagnosed with cancer this year, and more than 1,800 of them will not survive.
The childhoods of these girls and boys will be cut short and their loved ones will experience the pain and hardship a childhood cancer diagnosis brings. September is Childhood Cancer Awareness Month, which will provide an opportunity for us all to redouble our efforts to eradicate this debilitating disease.
For patients, families, and physicians focused on treating childhood cancer, this journey has been a long one, marked by many small and large victories as well as disappointments. It was only 60 years ago that childhood cancer was a universally fatal disease. Today, some childhood cancers such as acute lymphoblastic leukemia and certain lymphomas have cure rates of more than 85 percent. But, unfortunately, survival rates for other types of childhood cancer remain poor.
Our success has been the result of partnerships among pediatric health-care professionals, researchers, and communities, resulting in a structure of national collaborations that have developed and advanced clinical trials for childhood cancer. Most important, the childhood cancer patients and their families who have participated in these trials who have been largely responsible for the progress made to date.
Despite the dramatic impact of a cancer diagnosis on a child’s life and his or her family, we spend less than 4 percent of all federal cancer research dollars on childhood cancer research. This is a staggering fact, given the incredible return on investment for each childhood cancer survivor who will go on to live a long and productive life in our society.
But in many cases, our ability to cure cancer in these young patients has come at a high cost. Many of the therapies in use today lead to significant acute and long-term physical toxicities, disabilities and psychosocial hardship. Nevertheless, the future is bright as we have entered a new era of scientific and technological advancement that promises to eradicate death from childhood cancer. It is not difficult to envision a future in which no child will die from childhood cancer because, as a result of cutting-edge research, they can be cured or their cancer can be successfully managed as a chronic disease.
Sylvester Comprehensive Cancer Center’s pediatric oncology clinic – alex’s place – and Holtz Children’s Hospital are working together to provide care to children with cancer in our community and to improve outcomes through cutting-edge research. Until recently, the only weapons we had against most forms of childhood cancer were chemotherapy and radiation therapy. Although effective in killing many cancer cells, these treatments lack specificity.
A better understanding of the genetics of childhood cancer now allows us to identify cancer cells not necessarily by the way they look under a microscope but by their genetic and molecular make-up. An example of the value of this approach is acute lymphoblastic leukemia (ALL). In the treatment of ALL, we now rely on the genetics of the leukemia cells to make the diagnosis and determine which treatment will be most effective. In many instances, we are discovering new cancer subtypes through our understanding of their molecular genetics and, most important, uncovering what we call “targetable lesions.” They are genetic abnormalities in cancer cells that we can selectively target with novel, more-precise drugs.
Another cornerstone of childhood cancer therapy in the past was the widespread use of bone-marrow transplantation to treat high-risk leukemia and other difficult-to-treat childhood cancers. Through this approach, we were able to harness the power of the immune system transplanted from the donor to recognize residual cancer cells in the transplant recipient to completely eradicate cancer that had become resistant to chemotherapy.
Today we are able to engineer the immune system of cancer patients in a way that it recognizes and kills the cancer cells in the body, an approach that has proven to be highly effective in early-phase experimental clinical trials conducted at Sylvester. In this context, the ability of our pediatric cancer program to treat childhood cancer with precision medicine has become a reality.
This September, during Childhood Cancer Awareness Month, let’s celebrate the lives of all those members of our community touched by this disease and renew our commitment to the fight against childhood cancer. It will only be through our collective community efforts and increased investment as a nation that we will be able to cure every child diagnosed with cancer.
Julio Barredo, M.D., is the director of Sylvester Comprehensive Cancer Center’s Children’s Cancer Programs at UHealth – the University of Miami Health System. For more information, visit sylvester.org/cancer/pediatric.