By Michelle Li
Published 11:04 EST, Mon September, 20th, 2021
Pediatric cancers refer to cancers that affect children under the age of 18 years old, while adult cancers are those that occur in people over 18. However, age is not the only difference between pediatric and adult cancers. There are a number of other key differences in the onset, progression, and treatment between the two that need to be taken into consideration.
Onset and Development of Pediatric and Adult Cancers
The most significant difference between pediatric and adult cancers is that it is more common for adults to be diagnosed with cancer compared to children. According to the American Cancer Society, approximately 10,500 new cancer cases in children (ages 0-14) and 5,090 cases in adolescents (ages 15-19) will be diagnosed in the United States in 2021; this amounts to a total of 15,590 estimated new pediatric cancer cases (“Cancer Facts & Figures”). An expected 1.9 million new cancer cases are expected to be diagnosed in the United States 2021 (“Cancer Facts & Figures”). Only a small fraction of those cases are pediatric patients with cancer while the vast majority are adult cases. While this can be partially attributed to the differences in population percentages, the causes of pediatric and adult cancers also provide a partial explanation. According to the World Cancer Research Fund, at least 18% of diagnosed cancer cases in the United States are connected to body fatness, lack of exercise, alcohol consumption, or lack of nutrition in diet (“Diet and Physical Activity: What’s the Cancer Connection?”). As all four are lifestyle or environmental factors, adults are more likely to have been exposed to these factors over longer periods of time, contributing to the higher diagnoses of cancer in adults. Pediatric cancers are usually unrelated to these lifestyle choices, as children have most likely not been exposed to certain factors due to their age (specifically in the case of alcohol or tobacco) or have been exposed for shorter periods of time (Vahey).
Additionally, the connection to lifestyle or environmental factors may also partially explain the difference in common types of cancers for children and adults. The most common pediatric cancers are leukemia, brain and central nervous system cancers, lymphoma, bone cancer, and neuroblastoma, among others (Watson). Common cancers for adults, on the other hand, include lung, breast, colon, kidney cancer, etc (“Cancer Statistics”). As children are less exposed to the lifestyle and environmental factors found to be related to cancer diagnoses, they are also less likely to have cancers related to those factors; for instance, children who have not been exposed to cigarette smoke are less likely to develop lung cancer. The opposite is true for adults who may make the choice to smoke tobacco products and, as a result, become more exposed to cigarette smoke and experience higher rates of lung cancer. Interestingly, the common types of adult cancers begin in specific organs, while the common pediatric cancers don’t occur in the same pattern (Vahey).
Progression: How Pediatric and Adult Cancers Act
In terms of progression of pediatric and adult cancers, pediatric cancers are often more aggressive and progress faster than adult cancers (Vahey). Pediatric cancers are also more likely to have moved to other organs by the time of diagnosis. This may also be partially attributed to the lack of useful screening tests for pediatric cancers; a number of screening tests are available for adult cancers, which may result in earlier detection for adults and diagnoses before the cancer has spread to other parts of the body (Vahey).
Another difference between pediatric and adult cancers lies in their prognosis. In general, children have a better prognosis compared to adults, as two-thirds of pediatric cancer cases are cured (Vahey). However, survival rates vary greatly depending on the type of cancer.
Treatment also differs between pediatric and adult cancer patients. Children’s bodies react differently and experience different risks than adults, and this is still true for cancer treatments. Besides the different considerations based on age, treatment also varies based on the type of cancer, the affected tissues, and the spread of the cancer. Since pediatric cancers spread faster and have often moved to other parts of the body by the time of diagnoses, surgery is not as likely to cure a pediatric cancer patient (Vahey). However, children’s bodies respond more positively to chemotherapy. This may be explained by the fact that chemotherapy is effective against fast-growing cancers — which pediatric cancers tend to be (“Treating Children with Cancer”). Additionally, children’s bodies may also recover better compared to adults after high doses of chemotherapy, which would allow for more intense treatments with higher chances of effectively treating the cancer. The possibility of more short and long term effects is still present, though (“Treating Children with Cancer”). In contrast, children’s bodies do not respond better to radiation therapy. In fact, children experience more serious side effects than adults who have undergone radiation therapy (“Treating Children with Cancer”). Different factors must be considered when treating pediatric patients with cancer than when treating adults. In addition to the different options for treatment for certain cancers, healthcare professionals must also consider how a pediatric patient will respond to a treatment, even if it has proven to be effective in adults with cancer.
Pediatric and adult cancers vary greatly in their onset, progression, and treatment. The difference in patient ages translates to different common cancers by age group, different developments in progression, and different treatments. Ultimately, the fact that pediatric cancers diverge so much from adult cancers speaks to the importance of considering the differences between pediatric and adult patients in healthcare settings for not only cancer but other conditions as well.
Michelle Li, Youth Medical Journal 2021
“Cancer Facts & Figures 2021.” National Cancer Society, http://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2021.html. Accessed 28 July 2021.
“Cancer Statistics.” National Cancer Institute, http://www.cancer.gov/about-cancer/understanding/statistics. Accessed 29 July 2021.
“Diet and Physical Activity: What’s the Cancer Connection?” American Cancer Society, http://www.cancer.org/cancer/cancer-causes/diet-physical-activity/diet-and-physical-activity.html. Accessed 28 July 2021.
“Treating Children with Cancer.” National Cancer Society, http://www.cancer.org/cancer/cancer-in-children/how-are-childhood-cancers-treated.html. Accessed 26 July 2021.
Vahey, Marianne, and Cameron Howell. “Childhood Cancers.” The Gale Encyclopedia of Cancer: A Guide to Cancer and Its Treatments, edited by Deirdre S. Hiam, 5th ed., vol. 1, Gale, 2021, pp. 517-27. Gale Health and Wellness, link.gale.com/apps/doc/CX8067200154/HWRC?u=mlin_m_newtnsh&sid=bookmark-HWRC&xid=ea00a342. Accessed 28 July 2021.
Watson, Stephanie. “Pediatric Cancer.” The Gale Encyclopedia of Cancer: A Guide to Cancer and Its Treatments, edited by Deirdre S. Hiam, 5th ed., vol. 3, Gale, 2021, pp. 1622-27. Gale Health and Wellness, link.gale.com/apps/doc/CX8067200495/HWRC?u=mlin_m_newtnsh&sid=bookmark-HWRC&xid=5600b57e. Accessed 28 July 2021.