Childhood cancers: the importance of precise diagnosis

As with adult cancer, there are few warning signs of a tumor before it reaches a certain size. Childhood cancers develop very quickly. The diagnosis must therefore be made as soon as possible in order for a coordinated and appropriate therapeutic decision to be made.

How to make a quick and precise diagnosis of childhood cancers ?

This diagnosis is made based on a microscopic examination of a tumor sample and imaging exams. Now, in addition, a genetic analysis and search for tumor biomarkers in the blood and/or urine are often performed, providing specific information concerning the risk of development.

Once the diagnosis has been determined, the treatment is decided upon during a multi-disciplinary consultation meeting among the various specialists, including pediatric oncologists, radiotherapists, surgeons and pediatric psychologists. The major concern, aside from recovery, is to limit the after-effects of treatment and maintain the body’s functions as far as possible. Chemotherapy is therefore often used as a first line of treatment to reduce the size of the tumor. Conservative surgery may then be offered, aiming to preserve the organ and the surrounding tissue to the extent possible.

Chemotherapy is in fact the only treatment able to destroy the cancer cells at several points in the body. It is therefore recommended to treat cancers that affect several sites in the body (such as leukemia), which develop and harm certain blood cells, or lymphomas, which affect the white blood cells or lymphocytes. It is also used to treat tumors that already show metastasis at the time of diagnosis.

Radiotherapy remains the first line of treatment when the tumor is not accessible for surgery, which is the case with certain brain tumors. Proton therapy is often chosen over classic radiotherapy. This ultra-precise form of radiotherapy can irradiate tumors located deep inside the body and close to sensitive organs, such as the optic nerve or certain parts of the brain. It limits the side effects usually associated with radiotherapy and which limit its use, such as slowed growth or increased risk of secondary cancer.

The proton therapy center at Institut Curie’s Orsay site was entirely renovated in 2010 and is one of only two centers in France that offers proton therapy to children.