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An early start on tackling childhood cancers

The most vulnerable cancer patients are drawing the attention they deserve.

A fresh emphasis on childhood cancer could help patients such as Bradley Lowery, pictured here with England striker Jermain Defoe. Credit: Shaun Botterill/Getty

When the England football team’s mascot stepped onto the Wembley pitch before a World Cup qualifying match on Saturday, he winced and covered his ears. The roar was deafening as the crowd in London welcomed five-year-old Bradley Lowery — a fan with terminal cancer.

Over the past few months, Bradley has picked up countless fans of his own around the world. His family has raised hundreds of thousands of pounds to fund experimental treatment of his illness. The outpouring is understandable: there is no heartache like a sick child, and no greater gift than the chance to help one.

Others with the disease may also get more attention in future — from researchers, funders and the public. On the same day as Bradley’s big moment, the charity Children with Cancer UK in London announced it will give £1.5 million (US$1.9 million) towards the goal of sequencing the tumour DNA of every child with cancer in the United Kingdom. It is a worthwhile effort that could boost research — paediatric cancers are rare, and every effort should be taken to collect data when possible.

The harsh truth is that little can be done clinically with that information. The burgeoning wave of precision medicine still lags in childhood and adolescent cancers, and they are often overlooked because they are so uncommon. It is difficult to find the samples and funding for this type of research, and scientists who endeavour to do so often find themselves justifying their work by pointing out the relevance of their findings to more common, adult cancers.

As we highlight in a News Feature this week, there are positive signs of change. The US Cancer Moonshot Initiative, for one, has chosen paediatric cancers as one of its ten areas of focus — a move that some researchers hope is a sign that the plight of children with cancer is getting wider recognition.

Children could also benefit from a new focus on survivorship. The American Association for Cancer Research (AACR) meeting in Washington DC this weekend will hold sessions dedicated to understanding the long-term effects of cancer treatment. This was also listed as a focus in the Moonshot Initiative, and is an area of research that could have a particular impact on survivors of childhood cancers.

The high cure rates of some childhood cancers can be misleading: by the time these survivors reach the age of 45, 80% of them will have severe or life-threatening conditions as a result of the treatments they have received. Programmes such as the St. Jude Children’s Research Hospital Childhood Cancer Survivor Study, based in Memphis, Tennessee, are an important step to understanding these effects.

It is difficult to call for more money in a time of tremendous financial uncertainty — particularly in the United States, where President Donald Trump has called for an 18% funding cut to the National Institutes of Health. This will hang over the AACR meeting.

But in the face of that disquiet, it is crucial to nurture the steps that researchers and funders have taken to recognize cancers in children, adolescents and young adults. Even though paediatric cancer is rarer than adult cancer, it is important to get the message out that focusing on the disease in children yields huge dividends in terms of the years of life that can be won.

Related links

Related links

Related links in Nature Research

Trump faces backlash on health-agency cuts 2017-Mar-17

US child-health study rises from ashes of high-profile failure 2017-Feb-07

US Cancer Moonshot must strike a balance between research and prevention 2016-Nov-22

Cancer experts unveil wishlist for US government ‘moonshot’ 2016-Sep-07

Related external links

US National Cancer Institute: Childhood cancer

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An early start on tackling childhood cancers. Nature 543, 590 (2017). https://doi.org/10.1038/543590a

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