By Bill Thomas | August 5th
For a parent, watching your child grow from a tender newborn into a fully developed human being with their own little personality is unlike anything else. It’s amazing how fast it all happens; one day you’re carrying them in your arms, the next you’re measuring their height against the wall, wondering how long it will be before they grow taller than you.
Transformation is a natural part of childhood. That’s as true biologically as it is emotionally, with a child’s muscles and bones growing and developing right alongside their character. But childhood isn’t just transformational. It’s also precious. Fragile. Delicate.
No one understands that quite like the parent of a child who has been diagnosed with bone or soft tissue cancer. And there are a lot of them. It’s an unfortunate fact of pediatric cancer that around 1,800 children and young adults are diagnosed with some form of sarcoma each and every year. Of those children, only around 60% are likely to survive their diagnosis longer than five years.
Everyone here at Pediatric Cancer Research Foundation knows how precious, how fragile, how delicate childhood can be. Our vision is to make it possible for all children facing childhood cancers to overcome their disease and achieve their full potential so they can realize happy, healthy, productive futures.
Making that vision a reality means improving outcomes for pediatric cancer patients by powering research, supporting survivorship and mental health, and ensuring equitable care. It also means increasing awareness and sharing helpful information about pediatric cancers. With that in mind, here’s some important information you should know about childhood sarcomas…
What are the Most Common Types of Sarcomas in Children?
More than 70 subtypes of sarcomas are currently known, including liposarcomas (which develop in the body’s fat cells), fibrosarcomas (which develop in the fibrous soft tissue of tend. However, the three most commonly occurring types of bone and soft tissue cancers in children and young adults are Ewing sarcoma, osteosarcoma, and rhabdomyosarcoma.
Ewing Sarcoma
Ewing sarcoma takes its name from Dr. James Ewing, a Cornell University pathologist who discovered the disease in the early 1920s. Rare and highly malignant, Ewing sarcomas most often develop in bone but can occur in nearby soft tissue as well. Likewise, while Ewing sarcomas are mainly found in the vertebrae, chest, and pelvis, they can appear in other parts of the body, such as the arms, legs, and head.
It is estimated that 200-250 children and young adults are diagnosed with Ewing sarcoma annually and accounts for around 1% of all cases of childhood cancer. About a quarter of all patients diagnosed with Ewing sarcoma have already undergone metastasis at the time of diagnosis, with tumors typically spreading to other bones, bone marrow, or the lungs.
Osteosarcoma
Osteosarcoma is the most common malignant bone cancer found in children and young adults. It accounts for around 2% of all childhood cancers, affecting approximately 400-500 pediatric patients annually. It is usually found in the “long bones” of the arms and legs, and especially common in and around the knee.
Childhood osteosarcoma development typically begins with osteoblasts, the cells that form new bones and grow and heal existing bones. As a result, osteosarcoma is more likely to occur during an adolescent growth spurt. Cure rates for osteosarcoma are highly dependent on the location of the tumor and whether it has metastasized or not. In instances where osteosarcoma has spread to the lungs, the cure rate drops from 60% to around 30%.
Rhabdomyosarcoma
Around 350-400 pediatric rhabdomyosarcoma cases are diagnosed each year, with the disease accounting for 3% of all childhood cancers. It is the most common malignant soft tissue found in children and young adults, with more than half of those diagnosed being under the age of 10. Rhabdomyosarcoma tumors develop in muscle tissues or from the cells that form skeletal muscles.
Challenges of Treating Pediatric Bone and Soft Tissue Cancers
No parent ever wants to believe their child is at risk of being diagnosed with pediatric cancer. Unfortunately, it can happen to anyone. That’s why it’s important to be observant and aware of the symptoms and early warning signs.
Pediatric bone and soft tissue cancers can be especially difficult to diagnose for a few reasons. One of the chief differences between childhood cancers and adult cancers is that childhood cancers tend to be rarer than adult cancers. That’s just as true of sarcomas as any other form of pediatric cancer, which means that sarcomas are sometimes overlooked when a child begins showing symptoms.
Additionally, the symptoms themselves often mimic symptoms of more common and benign childhood ailments. In fact, the most common symptom is very easy to miss: a painless lump or swelling of the soft tissue. Even when sarcoma is considered, determining the specific kind of tumor a patient has can be tricky. There are many, many different types of sarcomas and are extremely difficult to distinguish from one another, requiring extensive testing to properly diagnose.
The rarity of many sarcomas is equaled by the tumors’ aggressiveness. Bone and soft tissue cancers in children tend to grow quickly and can spread to other parts of the body. In instances where sarcomas are metastatic or recurring, survival rates are significantly lower.
This aggressiveness, when combined with sarcomas’ presence in children’s still-developing bone and muscle tissue and their proximity to critical nerves and large blood vessels, may raise concerns over surgical and radiation-based therapy options.
New Developments in Treatments for Childhood Sarcomas
Although there are many challenges in treating pediatric sarcomas, significant progress is being made. In recent years, the shift towards precision medicine and targeted therapy has allowed traditional treatments for sarcoma, such as chemotherapy and radiation therapy, to be utilized more effectively with fewer negative side effects. The development of newer, better immunotherapy treatment options, which utilize the body’s own immune response against cancer cells, also contributes to a growing trend in healthcare towards improving not just patient outcomes, but also quality of life.
Advances in AI and machine learning, meanwhile, are making data collection and information sharing between institutions faster and easier, providing more researchers access to the resources they need to better understand–and subsequently treat–otherwise rare and difficult-to-study pediatric cancers. AI and machine learning tools are also helping to make delicate surgical procedures safer and more precise, while optimizing diagnostics so that oncologists can identify sarcomas and other tumors more quickly and reliably.
Another diagnostic breakthrough has come in the form of liquid biopsies. Unlike traditional biopsies, which are often invasive and greatly limited by tumor location, liquid biopsies only require a simple blood draw. Studies have shown that circulating tumor DNA for several of the most common pediatric cancers can be detected and monitored via liquid biopsy.
One of the researchers on the cutting edge of liquid biopsies is Dr. Brian Crompton at the Dana-Farber Cancer Institute. With funding from Pediatric Cancer Research Foundation, Dr. Crompton is developing a new approach for detecting and profiling Ewing sarcoma using liquid biopsies. Interested in learning more about Dr. Crompton’s research? Expect an exciting update in an upcoming blog post!
In the meantime, if you would like to help us continue powering research projects that target rare cancers with low survival rates and develop more effective, less toxic treatments, please consider becoming a donor. To stay up-to-date with all the latest news shaping the future of pediatric cancer treatment, don’t forget to follow Pediatric Cancer Research Foundation’s Profectus Blog!