Although significant advancements in the diagnosis and treatment of pediatric cancer have been made over the past several decades, cancer remains the number one cause of death from disease in children in the United States today. More than 12,500 children and young adults are diagnosed with cancer each year in the United States, and the numbers are rising. With the publication of this plan, Colorado is now one of only four states to develop a comprehensive plan to address this devastating disease as it applies to the pediatric and young adult population.
A comprehensive cancer plan tailored to pediatric cancer is critical due to the unique factors and characteristics of pediatric cancer that differ from cancer that affects older Coloradans. The critical and distinguishing factors to be considered include, but are not limited to, the following:
A greater emphasis on research and treatment advancement is needed. The quality of life, late-effects and survivorship issues facing this population are extensive and demand serious attention. Pediatric cancer impacts parents and siblings in a way that is different than adult cancer patients and families . The following plan lays out sixteen objectives to improve the state of childhood cancer in Colorado.
Top five cancer types diagnosed in the pediatric, adolescent and young adult population are:
|0-4 Years||5-9 Years||10-14 Years||15-19 Years||20-22 Years|
|#1||Acute Lymphoblastic Lymphoma||Brain||Brain||Lymphoma||Melanoma|
|#2||Brain||Acute Lymphoblastic Lymphoma||Acute Lymphoblastic Lymphoma||Melanoma||Lymphoma|
|#3||Urinary/Endocrine||Bone & Joint||Bone & Joint||Brain||Male Genital|
|#4||Eye & Orbit/Soft Tissue||Lymphoma||Lymphoma||Male Genital||Endocrine|
|#5||Liver||Endocrine/Lymphoma||Non-Hodgkin's Lymphoma||Bone & Joint||Brain|
PEDIATRIC TASK FORCE
In 2007, the Colorado Kids Cancer Association was asked to empanel as the Pediatric Task Force of the Colorado Cancer Coalition and to identify the distinct and specific needs of the Pediatric Cancer Community. These needs are outlined below – the first pediatric chapter included in the Colorado State Cancer Plan.
Whereas cancer prevention programs in older populations encourage preventative care and annual screenings for early detection, most infants and young children are already seen for routine well visits by medical professionals for the first several years of their lives and then annually throughout childhood. Education of the medical community regarding symptoms and the early detection of childhood cancer at the scheduled routine visits is critical to early diagnosis. Education of parents and access to care, particularly in rural areas, is also critical to all children to aid in the early detection and treatment of pediatric cancer.
Due to the various types of pediatric cancer and corresponding treatment protocols, it is critical that treatment options incorporate access of care, centralized databases and communication between pediatric cancer care centers.
Pediatric cancer research is chronically underfunded. Incorporated into every area of need for children diagnosed with cancer is the need to continue to support and fund the best and brightest minds searching for causes of pediatric cancers as well as those developing new treatment agents that will be the most effective and least toxic.
Survivorship issues facing the pediatric, adolescent and young adult populations are of particular concern, especially since the classification of survivors is so broad and emphasizes the gamut of developmental, social and economic issues facing all children. Addressing survivorship issues is of particular importance for this population because time spent in survivorship generally exceeds the amount of time they are in treatment. The possibility of "late effects occurrences" and chronic health issues spans their lifetime.
END OF LIFE SERVICES
End of life care and services are critical for the pediatric cancer community. Currently, these services are insufficient to address the specific needs of the pediatric cancer community for dealing with end of life issues for a child. Traditionally, end of life care is viewed with aging populations, not children. Therefore, the lack of services available in the pediatric cancer community needs to be brought to the attention of entities providing these services.
Coloradans have been instrumental in bringing childhood cancer to the attention of Washington D.C. and the general public. In 2008, Colorado Sen. Wayne Allard and then New York Sen. Hillary Rodham Clinton successfully co-sponsored the first ever designated National Childhood Cancer Awareness Day, September 13, 2008. Colorado Sen. Mark Udall continued the awareness campaign by successfully sponsoring the 2009 Resolution for the second National Childhood Cancer Awareness Day. The Colorado Kids Cancer Association will ensure the awareness of childhood cancer continues to increase. We believe the more information and education made available to the general public and health care professionals, the more likely open, educated discussions can occur regarding childhood cancer, which impacts so many of our children in Colorado and the United States.
Advocacy for childhood cancer is an area that is growing in importance. There is a critical need to exert public policy influence on behalf of our children, those who are in treatment and those who are long term survivors.
While few lifestyle risk factors have been identified for childhood cancers, there are certain areas that warrant very serious conversation. Pediatric cancers tend to be cancers of genetics, and therefore routine cancer screening is not something that can be universally applied to detect or prevent childhood cancer. However, education of the primary care physician population as to the signs and symptoms of more regularly diagnosed types of childhood cancer can go a long way toward early detection, increasing the rate of survivorship.
Certain cancers are related to infectious agents, such as hepatitis B virus (HBV), human papillomavirus (HPV), human immunodeficiency virus (HIV), Helicobacter pylori (H.pylori), and others, and can be prevented through behavioral changes, vaccines, or antibiotics. Recent breakthroughs in understanding HPV have led to an approved vaccine to prevent the spread of this disease.