Monday, July 29th, 2013
The number of children diagnosed with melanoma, the most serious form of skin cancer, is rising about 2 percent each year, and the disease is escaping the notice of many pediatricians who do not expect to see it in their young patients, according to a new study published in the journal Pediatrics. More from ABC News:
Melanoma makes up 5 percent of skin cancer diagnosis but a majority of skin cancer deaths.
In 2013, the American Cancer Society estimated, 76,690 new melanomas will be diagnosed and 9,480 people are expected to die from the disease.
Children make up a tiny fraction of these cases, but a study recently published in the journal Pediatrics found that cases of pediatric melanoma are increasing. Between 1973 and 2009, the study found, cases of pediatric skin cancer rose, on average, 2 percent each year.
Melanoma is also the second most common form of cancer for adolescents and young adults between 15 and 29 years old, according to a 2007 study from the National Cancer Foundation.
Unfortunately, pediatric melanoma can be very difficult to diagnose because the warning signs are often very different than those for adult melanoma. In addition, experts say, testing biopsies in a pathology lab can be inconclusive and occasionally these cancers are only definitively diagnosed after they’ve grown or spread.
A major factor in surviving a cancer diagnosis is early detection, but the early signs of pediatric melanoma often masquerade as inconsequential skin problems….
….Dr. Ashfaq Marghoob, director of Memorial Sloan-Kettering’s regional skin cancer clinic in Hauppauge, N.Y., and spokesman for the Skin Cancer Foundation, said melanoma presents very differently in children versus adults.
“You’re asking these doctors to look for zebras,” said Marghoob. “If you usually see horses you’re not looking for zebras. Their mind is not in tune with looking for these melanomas. The morphology of melanoma in kids is different from adults.”
A 2011 study presented at the Pediatric Dermatology Annual Meeting found that 60 percent of children between the ages of 0 and 10 in the study with melanoma did not meet the common melanoma-detection criteria. The criteria is broken down by the “ABCDE warning signs,” which stands for Asymmetry, Border irregularity, Color variation and Diameter over six millimeters, and Evolution of the lesion.
For children between the ages of 10 and 20, approximately 40 percent did not strictly meet the ABCDE criteria.
Instead, many children in the study had tumors that were symmetrical and amelanosis (lacking pigment). The differences were so significant that the study’s authors proposed creating alternative ABCD criteria for pediatric patients, where A is for amelanosis, B for bumps or bleeding, C for uniform Color, and D for various Diameters or de novo (or new) Development.
Image: Dermatologist examining child, via Shutterstock
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Wednesday, July 17th, 2013
Women who had cancer as girls are often concerned that they will experience diminished or lost fertility, but a new study conducted by researchers from the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center offers hopeful news–though it took female cancer survivors longer to get pregnant than sisters who had not had cancer, two-thirds of the cancer survivors did eventually become pregnant. More from Reuters:
“The main message counters what some people have thought, which is if you had cancer you won’t be able to get pregnant or have children,” said Dr. Lisa Diller, the study’s senior author, from the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center.
Historically, childhood cancer survivors have been counseled that they may be unable to get pregnant because cancer-fighting chemotherapy and radiation can damage their ovaries.
For the new study, Diller and her colleagues used data from questionnaires in an ongoing study of 3,531 cancer survivors and 1,366 of their sisters between the ages of 18 and 39 years old.
The survivors were all diagnosed before age 21 with cancer at one of 26 medical centers in the U.S. or Canada from 1970 through 1986. The women had all been cancer free for at least five years.
Compared to their sisters, cancer survivors were more likely to be clinically infertile, which means they had been trying unsuccessfully to get pregnant for more than a year.
Thirteen percent of survivors were clinically infertile, compared to 10 percent of their sisters.
Still, 64 percent of the 455 clinically infertile survivors eventually got pregnant.
That pregnancy rate is similar to what has been observed in clinically infertile women without a history of cancer, Richard Anderson, a professor of clinical reproductive science at the University of Edinburgh in the UK, writes in an editorial accompanying the new study in the journal Lancet Oncology….
….But Dr. Mitchell Rosen, director of the University of California, San Francisco Fertility Preservation Center, cautions that the new study cannot predict how childhood cancer survivors’ fertility will change as they get into their late 30s or their 40s.
Rosen, who wasn’t involved in the new study, told Reuters Health that getting pregnant gets harder about 10 years before women go through menopause and childhood cancer survivors tend to go through early menopause.
That means childhood cancer survivors’ fertility problems may be amplified in their late thirties and early forties, compared to women without a history of cancer.
Image: Pregnant woman, via Shutterstock
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Tuesday, December 11th, 2012
The family of 7-year-old Emma Whitehead are rejoicing after an experimental cancer treatment helped the girl beat leukemia that was threatening to take her life after two post-chemotherapy relapses. More from The New York Times:
“Desperate to save her, her parents sought an experimental treatment at the Children’s Hospital of Philadelphia, one that had never before been tried in a child, or in anyone with the type of leukemia Emma had. The experiment, in April, used a disabled form of the virus that causes AIDS to reprogram Emma’s immune system genetically to kill cancer cells.
The treatment very nearly killed her. But she emerged from it cancer-free, and about seven months later is still in complete remission. She is the first child and one of the first humans ever in whom new techniques have achieved a long-sought goal — giving a patient’s own immune system the lasting ability to fight cancer.
Emma had been ill with acute lymphoblastic leukemia since 2010, when she was 5, said her parents, Kari and Tom. She is their only child.
She is among just a dozen patients with advanced leukemia to have received the experimental treatment, which was developed at the University of Pennsylvania. Similar approaches are also being tried at other centers, including the National Cancer Institute and Memorial Sloan-Kettering Cancer Center in New York.
“Our goal is to have a cure, but we can’t say that word,” said Dr. Carl June, who leads the research team at the University of Pennsylvania. He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.”
Image: Laboratory technician, via Shutterstock
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Thursday, November 29th, 2012
The story of Mykayla Comstock, a 7-year-old Oregon girl who is undergoing treatment for leukemia, is at the center of a national debate on what age is appropriate to offer medical marijuana as a way to ease the symptoms of cancer treatments. The Oregonian newspaper reports on Comstock’s situation, which is unique in that her parents are divorced and do not agree on the use of cannabis in capsule form:
The Oregon Medical Marijuana Program serves 52 children who have a qualifying medical condition, parental consent and a doctor’s approval. Like adults, most cite pain as a qualifying condition, though many list multiple health problems, including seizures, nausea and cancer.
Allowing adults to consume medical marijuana is gaining acceptance nationwide. But Mykayla’s story underscores the complex issues that arise when states empower parents to administer the controversial drug to children.
Oregon’s law, approved by voters 14 years ago, requires no monitoring of a child’s medical marijuana use by a pediatrician. The law instead invests authority in parents to decide the dosage, frequency and manner of a child’s marijuana consumption.
The state imposes no standards for quality, safety or potency in the production of marijuana.
Little is known about how the drug interacts with the developing body, leading pediatricians say. A recent international study found sustained cannabis use among teens can cause long-term damage to intellect, memory and attention.
Many doctors worry about introducing a child to marijuana when they say other drugs can treat pain and nausea more effectively.
Mykayla’s father, who is divorced from the girl’s mother, was so disturbed by his daughter’s marijuana use that he contacted child welfare officials, police and her oncologist. Jesse Comstock said his concerns were prompted by a visit with Mykayla in August.
“She was stoned out of her mind,” said Comstock, 26. “All she wanted to do was lay on the bed and play video games.”
But Mykayla’s mother and her boyfriend, Erin Purchase and Brandon Krenzler, see the drug as a harmless antidote to leukemia’s host of horrors. The couple, regular cannabis users raised in Pendleton, said Mykayla relies almost exclusively on pot to treat pain, nausea, vomiting, depression and sleep problems associated with her cancer treatment.
Mykayla, who favors a knit cupcake cap to cover her fuzz of strawberry-colored hair, said marijuana makes her feel better.
It helps me eat and sleep,” she said, nestled against her mother on a couch. “The chemotherapy makes you feel like you want to stay up all night long.”
Marijuana, she said, “makes me feel funny, happy.”
“She’s like she was before,” her mother said. “She’s a normal kid.”
Image: Marijuana capsules, via Shutterstock
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Thursday, September 27th, 2012
Avalanna Routh, a six-year-old Massachusetts girl who was diagnosed in 2006 with a rare form of brain cancer, has died, Boston news station Fox 25 is reporting. Last year, Routh got to meet her idol, Justin Bieber, in an inspiring event arranged by The Jimmy Fund. From Fox:
Avalanna’s family gathered last year for a play wedding between Routh and Bieber at the Jimmy Fund Clinic, and then traveled with her to New York City in February to meet Bieber, who had learned of the girl’s love for him. In June, Bieber brought Avalanna on stage at the Apollo Theater.
Wednesday afternoon Bieber tweeted: “just got the worst news ever. one of the greatest spirits i have ever known is gone. please pray for her family and for her,” and then, “RIP Avalanna. i love you.”
Bieber was “just a dream,” Avalanna’s mother, Aileen Routh told the Globe after the February visit.
“We were Bieber fans before, but there is now a whole new respect for this kid that did such a great job with her and was just so graceful in doing it,” she said.
Image: Justin Bieber, via s_bukley / Shutterstock.com
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