Children's Cancers: Open Discussion with ZoAnn Dreyer

WebMD Live Events Transcript

Do you have a child recently diagnosed with cancer? ZoAnn Dreyer, MD, Medical Director of the Texas Children's Cancer Center Ambulatory Service, will be on hand to field any questions you may have regarding children and cancer.

Event Date: 06/02/2000.

The opinions expressed by Dr. Dreyer are hers and hers alone. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Good evening all and welcome to WebMD Live! Our guest this evening is ZoAnn Dreyer, MD. Dr. Dreyer is medical director of the Texas Children's Cancer Center Ambulatory Service and Long-Term Survivor Program. Welcome, Dr. Dreyer.

Dr. Dreyer: Hello to anyone that's chatting. I'm happy to answer any general questions about pediatric patients, children with cancer of all ages. For pediatric care doctors, that includes kids up to 20 years old.

Moderator: How prevalent is cancer in children?

Dr. Dreyer: Cancer is not common in children, although it's the second most common cause of death, second to accidents. The incidence rate of kids under 15 is 14 per 100,000 in the U.S. It's pretty rare, certainly, compared to adult cancer.

Moderator: What are the most common types of childhood cancer?

Dr. Dreyer: The most common two things in children are acute lymphoid leukemia (ALL), of which there are probably three cases per 100,000, and brain or central nervous system tumors.

Moderator: What are the survival rates for those most common types?

Dr. Dreyer: The general survival rates for kids with ALL are probably about 65% to 70%, meaning that 65% to 70% of all children with ALL will be cured. Some groups of children with less aggressive disease, younger children, for example, have cure rates as high as nearly 90%. For central nervous system or brain tumors, the cure rates are closer to 50% to 60% overall, with certain groups doing better than others.

Moderator: Have there been any major advancements in cancer treatment for children?

Dr. Dreyer: Huge advances in the last two decades. For example, in 1965 only about 5% of children with ALL were cured. The advances have mainly come from giving better combinations of stronger medicines, and better understanding the particular type of cancer, so that you can actually tailor the treatment for the child, in a sense. There have also been a lot of advances in the direction of the therapies we use, such as how we deliver radiation therapy, and what sort of studies we can do on tumor cells to identify how they will do with different types of chemo (chemotherapy) drugs.

beetneck_WebMD: Are there a lot of clinical trials involving children?

Dr. Dreyer: About 85% of all children in the US with cancer are treated at major children's cancer centers. And most of those will be treated on what we call clinical trials. And clinical trials in pediatric cancer means that we're using therapy designed specifically for a type of disease that's based on the answers to research questions that have been asked in the past, so that children treated today on clinical trials benefit from the information gained from children treated before them. And in that way, we can offer them what is thought to be the very best therapy at the time they are diagnosed.

hankhankhank_WebMD: I have heard a lot of news about new cancer treatments in general. Do these also apply to children or does the article need to state this?

Dr. Dreyer: That's a terrific question. There are new drugs constantly undergoing trial or research specifically aimed at adult cancers. There are oftentimes fewer drugs available for testing in children's cancer, in one sense because there are many more adult cancer patients than children. Along the same lines, drugs that work in adult cancers may not necessarily work for children. So our therapies are quite specific for children, and not the same as an adult with a similar disease. Our cancer center at Texas Children's is actually one of the major centers in the country that works on new cancer drugs for children and that has a variety of investigational drugs available for children who have had recurrence of their disease, and drugs that are oftentimes not available at other centers, or perhaps just a few other centers.

wabe_grb_WebMD: My eight-year-old niece has been diagnosed with adult leukemia. How is that possible?

Dr. Dreyer: There are some types of chronic leukemias that are much more common in adults and quite rare in children, although most of us would not refer to that as an adult cancer. We would simply say it's a rare form of cancer in children.