Transcription:
Childhood Cancers

Melanie: There's no handbook for your child's health, but we do have a podcast featuring world-class clinical and research physicians covering everything from your child's allergies to zinc levels. Welcome to Kids Health Cast by Weill Cornell Medicine. I'm Melanie Cole. And today, we're talking about childhood cancer with my guest, Dr. Alexander Chou. He's an Assistant Professor of Pediatrics at Weill Cornell Medicine and an attending physician at New York Presbyterian Weill Cornell Medical Center.

Dr. Chou, it's a pleasure to have you with us. You know, this is a topic that is usually talked about whispered. It is one of the scariest things any parent can ever hear. Tell us a little bit about how common this is and what are the most common cancers that you would see in a child.

Dr Alexander Chou: Thanks for having me on the podcast. It's nice to talk with you. So, childhood cancer is actually not that common. It's actually a rare phenomenon. There are about 15,000 new cases each year of kids cancer of any kind. If you consider, you know, something like breast cancer, which has over 250,000 cases each year, childhood cancer is actually a rare type of disease.

But with that said, I still think that's too many. The most common kinds of cancers that we see in kids are things like leukemias or cancers of the blood, lymphomas or cancers of the lymph nodes and things like brain tumors. Those are the most common types of cancers that we see in children.

Melanie: Is there any way? I mean, certainly there's inherited trait. We know about BRCA gene for women and ovarian and breast cancer. And so we have risk factors, Dr. Chou, things we know that can contribute to these cancers. But in kids, is this more of like a random thing or is there an inherited trait?

Dr Alexander Chou: That's a really good question. For the most part, we don't know why these cancers happen. Research over the last few years actually have shown that there's a very small percentage of patients where it can be inherited. And some of these syndromes or conditions we know about predispose you to developing cancer. So, families or patients who have things like Li-Fraumeni syndrome or Beckwith-Wiedemann syndrome. Those are syndromes that we know about that have a higher risk of developing certain types of cancers. Usually, it's sporadic or we don't really know what causes childhood cancers.

Melanie: Well, I mean, I think that for parents, we just want to know everything, right? We want to know anything that could come at our kids because that's just all we care about, is keeping them safe. If a child is diagnosed with cancer, do you usually recommend that the parents have any other children tested? Is there anything in genetics that you recommend parents to, you know, you say, "Okay. Well, you have a couple of other kids and let's check them as well"?

Dr Alexander Chou: Not usually, but it really depends on the type of cancer that we see as well as the patient's own family history. So there's a strong family history of other people in the family for second-degree relatives that have developed cancers at a young age. Then those types of families you would say, "Listen, it may be a good idea for you to have your family tested, because there are certain types of genes that can be passed down and then those certain genes then predispose you to developing cancers.

Melanie: What's exciting in this world and in your field right now, doctor, when you have to tell parents this horrible news? What can you give them hope about as far as the treatment options that are out there and what you are able to do for them at Weill Cornell Medicine?

Dr Alexander Chou: I think that is definitely is scary when I have to tell a patient that their child has cancer. I think though right now, there's a ton of hope. You know, we've made advances, not just in the last -- you know, we look back 50 years, certainly we've made advances, but even in the last five years, we've made advances in the way we understand these types of cancers.

We now are able to tell certain genes and these tumors or these different kinds of cancers. And we now have medications that will target specifically this type of cancer and its genes. And so that's the kinds of side effects that we commonly associate treatments of cancer with, like nausea, vomiting, hair loss. Some of those things can be lessened because we have a very specific type of treatment for a specific type of cancer.

So at Weill Cornell Medicine, we're able to look deeply into a patient's cancers, genes, and look at what is specific this particular tumor. And sometimes we're able to use medications that target specifically only the cancer cells and not the healthy normal cells of the child.

Melanie: Wow. That's pretty cool. Really the technology today and these advancements in these types of cancer, it's amazing what you can do. Now, off from the treatments for just a minute, Dr. Chou, when adults go through cancer, obviously we're looking for our support systems, maybe someone goes to chemo with us. We've got all of these things that we do as adults. But with kids, boy, there's a lot, their social life, their school. How do you help families with all of that? Because it's such a scary time for the parents and they're trying to be supportive for their children, but sometimes the whole family needs a little help.

Dr Alexander Chou: That's a really important point. I think that, you know, whenever we take care of a patient, a child with cancer, we take care of not only them, but their whole entire family. And I think that whenever a child is diagnosed with cancer, they need their whole team with them. And that team includes not only just the doctors and the nurses and the nurse practitioners or physician assistants, yes, they're all involved, but I think more importantly, they need their family and their friends, and I try to make sure that they are as engaged as possible.

So what does that mean? That means I don't believe in isolating kids when they're diagnosed or getting treatment. I think that as many friends and family, people in their faith communities, people just in their communities that could help them, they need to enlist them and not be shy about that, because they're going to need help. Yes, we provide, we have wonderful social workers and psychologists, all these other people that will come around them. But I think, at the end of the day, we need even more people that's engaged in their communities to give them the help that they need, because I don't think isolating these kids particularly in a bubble is a good idea.

So what that also means, there are time periods when I think it's appropriate for kids to go back to school or certainly have their friends visit. You know, everyone needs to be very careful, especially in the era of COVID in terms of symptoms and things. But I think that there are ways that we can make it safe for kids not to be isolated.

Melanie: What a great point that they can expand by their faith-based organizations, their community, even the school can get involved. Can you expand a little bit, Dr. Chou, on the multidisciplinary care? You just touched on it a little about some of the people that work with you for this very important time and really scary crucial time for parents and for the children with cancer, about all the different people that are involved and help them go through this at Weill Cornell Medicine.

Dr Alexander Chou: There's just so many. The obvious ones are people like the doctors and the nurses, the nurse practitioners, the physician assistants. But, just as important are the social workers, the psychologists, the physical therapists, occupational therapists, the other pediatric subspecialists that we have at Weill Cornell Medicine, infectious disease people or the GI people, the cardiology people, they all are part of the whole network of people that will come around a child and their family when they're treated here at Weill Cornell Medicine.

Melanie: So it's a real multidisciplinary approach and such a caring, compassionate, supported care that you're doing there at Weill Cornell medicine. And before we wrap up, what would you like parents to know? What do you think the most important message about childhood cancer is for these families? Give them some hope and encouragement about the expertise and that compassionate care they're getting from your team.

Dr Alexander Chou: I want them to understand that cancer is not only treatable, but curable in a large number of patients. And survival, long-term survival, so talking about kids who are diagnosed young, but they're going off to college and getting married. Survival is higher than ever, so there's a lot of hope with today's medicine. So I want them know that even though it's scary, there's a whole team that'll walk this whole journey with them, with the goal of curing their child with cancer so that they could go to high school, college, get married, all of those things.

And here at Weill Cornell Medicine, I really want patients and their parents to know that we have the latest technologies and a dedicated team of experts who can help patients and their families going through this journey of cancer with compassion and holistic care,

Melanie: And thank you so much, Dr. Chou, for joining us today. It really is so important, that support community, multidisciplinary approach for these families. It can be such a scary time.

Thank you so much for joining us today. And Weill Cornell Medicine continues to see our patients in person as well as through video visits. And you can be confident of the safety of your appointments at Weill Cornell Medicine. That concludes today's episode of Kids Health Cast. We'd like to invite our audience to download, subscribe, rate, and review Kids Health Cast on Apple Podcasts, Spotify and Google Podcast. For more health tips, go to weillcornell.org and search podcasts. And don't forget to check out our Back To Health. I'm Melanie Cole.

Rehabilitation medicine can help patients with a wide array of disorders and diseases, including cancer. If cancer cares of interest, listen to CancerCast, Weill Cornell Medicine's dedicated oncology podcast, featuring leaders in the field and patient stories. CancerCast highlights dynamic discussions about the exciting developments in oncology.

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