What Environmental Factors Are Related to Childhood Tumors? What Surgical Methods Are Available?

What Environmental Factors Are Related to Childhood Tumors? What Surgical Methods Are Available?

 

Source: Sunflower Children's Hospital Author: Sunflower Children's Hospital Editor: Gao ZX Date: 2023-10-08

 

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The following Q&A on childhood tumors is excerpted from "100 Questions and Answers About Childhood Tumors," which includes over 200 questions related to childhood tumors.

 

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1. Why Do Children Get Tumors?

 

Many parents are eager to understand what causes their children to develop tumors. Currently, there is no definitive conclusion regarding the causes of childhood tumors; it is thought to be a result of multiple factors. Only a small portion is attributed to genetic factors. Another possibility is that these mutated genes do not come from the parents but occur during the embryonic development process (before birth). Such tumors are not hereditary.

 

In recent years, we have increasingly focused on the correlation between environmental factors and childhood tumors. Among the viral infections associated with the incidence of childhood tumors, there is a relative consensus on Epstein-Barr virus (EBV), which can lead to certain types of lymphomas, nasopharyngeal carcinoma, and hemophagocytic syndrome in children. Hemophagocytic syndrome can occur in many diseases, especially in children with tumors. If hemophagocytic syndrome is caused by EBV, the mortality rate is relatively high.

 

Radiation exposure is also a well-established cause of tumor formation, such as the nuclear leak incidents in the Soviet Union and Japan. However, this does not mean that taking children for routine CT or MRI scans is dangerous; parents need not worry about the radiation from these medical examinations. Additionally, with the improvement of living conditions, people often fly, and there is radiation exposure during flights, but this type of radiation is not sufficient to be a sole cause of tumors.

 

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2. What Types of Childhood Tumors Are There?

 

Like adult tumors, childhood tumors can be benign or malignant. Fortunately, the majority of childhood tumors are benign, accounting for 75% to 85% of all childhood tumors, with various types of hemangiomas and lymphangiomas being the most common. Benign tumors have a complete fibrous capsule separating them from surrounding normal tissue, and their borders are clear. Benign tumors typically grow slowly, some may accompany a person throughout their life, and some tumors might even gradually shrink. When a child develops a benign tumor, there are generally no obvious symptoms initially; symptoms only appear when the tumor grows to a certain size and begins to press on nearby organs, affecting their normal physiological functions.

 

When it comes to the types of childhood tumors, people might first think of leukemia. The most common malignant tumors (cancers) in children are indeed hematological tumors, including leukemia, lymphoma, and Langerhans cell histiocytosis. The second most common type is central nervous system tumors, including brain tumors and spinal cord tumors. Additionally, there are several malignant solid tumors, such as neuroblastoma, Wilms tumor, hepatoblastoma, soft tissue sarcomas (common types include rhabdomyosarcoma, synovial sarcoma, and primitive neuroectodermal tumors), germ cell tumors, bone tumors, and retinoblastoma.

 

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3. What Should Parents Do First If Their Child Is Diagnosed with a Tumor?

 

For a family, when a child is first diagnosed with a tumor, parents often experience varying degrees of psychological shock. Some parents cope better than others; some recover quickly while others take longer. However, it is advised that parents strengthen their mental resilience during this time, face the situation positively, and try not to express too many negative emotions in front of the child. Meanwhile, they should focus on the following points:

 

1. Accept reality and build confidence. The overall cure rate for childhood tumors is better than that for adult tumors, and most childhood tumors are treatable. Parents must trust the hospital, cooperate with doctors, and maintain confidence in the treatment process.

 

2. Choose a suitable hospital. Parents should take their child to the most authoritative children's hospital, oncology hospital, or pediatric unit of a comprehensive hospital in their area. Once a hospital is chosen, trust in the hospital team is crucial, as is believing in oneself and the child. During treatment, it’s important to stick to the treatment plan and avoid losing resolve.

 

3. Mobilize the entire family and make plans. It is recommended to hold a family meeting to organize the family's manpower, finances, and energy. The family should embrace the belief that the child’s illness is treatable. The child’s illness is merely a challenge in their life journey that can be overcome. As the child improves and grows, parents will gain experience and confidence in treatment. Even families facing financial difficulties should not abandon their child’s treatment due to poverty; parents can seek help from new rural cooperative medical schemes, urban resident health insurance, government social security funds, charitable foundations, and social assistance.

 

4. Communicate fully with doctors and obtain disease-related information through formal channels. The more parents understand about tumor treatment, the easier it will be to comprehend doctors' actions and cooperate with treatment. Parental cooperation with treatment has a notably positive impact on treatment outcomes, as tumors are chronic, long-term diseases that require ongoing management and follow-up even after treatment.

 

5. When dealing with the child, do not completely hide the illness, especially from school-aged children and teenagers. Parents should guide them to understand the disease correctly, help them build confidence, and tell them that with cooperation in treatment, they can overcome the illness. After recovery, they should return to school and society, as they have a long and beautiful life ahead. At the same time, parents should provide them an education just like healthy children, without blindly indulging them due to their illness, as this can negatively affect their physical and mental health.

 

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4. What Negative Emotions Might Parents Face If Their Child Develops a Tumor?

 

As parents and caregivers, it is easy to overlook one’s own needs. However, only by taking care of themselves can parents better care for their children and provide them with a positive role model. Here are some suggestions:

 

1. Talk more with friends, family, healthcare professionals, and other parents of sick children. Be open about your feelings; joining parent support groups can also be beneficial. Such exchanges not only help in coping with various emotions but can also provide practical advice and support to help families navigate difficult times.

 

2. Try various stress relief methods, such as walking, conversing, or reading, to find what works best for you. It is important to note that when overwhelmed by certain emotions (like anger), it is easy to vent through arguments or violence, but these actions do not solve problems and may exacerbate negative feelings. Parents should explore safe ways to relieve stress and find what suits them best.

 

3. Seek support and help from friends and family. They can assist with everyday tasks, such as buying necessities, cooking, cleaning, or picking up and dropping off children from school.

 

4. When talking with friends and family, try to discuss topics beyond the child's illness to avoid amplifying negative emotions and to stabilize feelings.

 

5. When discussing the illness with the child, listen closely to their feelings and thoughts.

 

6. Share the responsibilities that come with the child’s illness with a spouse and other family members. Take turns caring for the child in the hospital and collaborate on other aspects of life. This mutual support among family members can provide emotional backing, help ease tensions, and reduce conflicts.

 

7. Consider using websites, microblogs, and social media to communicate with more people.

 

8. If psychological issues significantly affect daily life, seek professional psychological counseling.

 

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5. What Are the Common Surgical Methods for Childhood Tumors?

 

1. Diagnostic Surgery  

   (1) Fine Needle Aspiration Biopsy: This includes fine needle aspiration biopsy and core needle biopsy. Fine needle aspiration is valuable for cytological examinations and assessing tumor malignancy; core needle biopsy is significant for determining tumor pathology.  

   (2) Open Surgical Biopsy: This involves traditional surgical removal of part or all of the tumor for pathological examination to clarify the diagnosis.  

   (3) Endoscopic Biopsy: This refers to obtaining tumor specimens through instruments such as endoscopes or gastroscopes for pathological examination.

 

2. Therapeutic Surgery  

   (1) Curative Surgery: Aimed at completely removing the tumor, this is key in treating solid tumors.  

   (2) Palliative Surgery: Used for advanced malignant tumors, this surgery removes part of the tumor to alleviate symptoms, reduce pain, and extend life.

 

3. Preventive Surgery  

This involves corresponding excisions for diseases with potential malignant tendencies and precancerous lesions to prevent the occurrence of malignant tumors.

 

4. Reconstructive and Rehabilitation Surgery  

To improve the quality of life for tumor patients and enhance long-term survival rates, reconstructive surgery may be considered. This involves repairing and reconstructing tissue after tumor removal to enhance the child’s appearance and function, commonly applied in head and neck tumors, breast tumors, joint and bone tumors, and soft tissue tumors.

 

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What Do Complete Resection, Nearly Complete Resection, and Partial Resection Mean?

 

Complete resection refers to the total removal of the tumor, with no visible tumor lesions remaining; nearly complete resection generally indicates that over 90% of the tumor has been removed; partial resection typically means that less than 90% of the tumor volume has been excised. Some studies may have slightly different definitions regarding the extent of resection, so specific resection degrees and scopes should be confirmed through detailed discussions with the doctor.