A substantial percentage of the cancers which occur in children are found in the 1 to 5 age group. This is sometimes surprising to those who think of cancer as a disease of older people. However in the United States cancer has become the second leading cause of death in children between the ages of 1 to 14, and the leading cause of death in this group, if one excludes accidents.

Cancers in children are not the same as those which occur in adults. Other than leukemia, the common sites are the intracranial cavity, eye and orbit, the bones, the skin and soft somatic tissues, and in the retroperitoneal area, Wilms' tumors and adrenal neuroblastomas. It is thought that many of these childhood tumors have a genetic basis, although definite proof of this is lacking.

Tumors in children are insidious in their onset and are often difficult to diagnose. For this reason frequent and complete examinations of apparently well children are essential if tumors are to be discovered early. Unfortunately many benign tumors offer a serious prognosis because even though they are not cancerous they may grow rapidly and impinge upon vital structures and ultimately threaten the child's survival. It is therefore essential that all growths or all atypical clinical syndromes be investigated and that the possibility of cancer be considered.

The incidence of tumors in children varies with the age group. Many tumors, such as the Wilms' tumor, are found by a mother who is bathing her child. An alert nurse also has opportunities to note symptoms or to discuss those which the mother may have noticed. It cannot be emphasized too strongly that medical evaluation should be secured whenever any suspicious symptoms occur since delay often makes the difference between death and survival.

Unfortunately the leukemia in children is of the acute type, and comprises1/3 to1/2 of all childhood cancers. Although a large number of drugs is available to prolong life for these children we still do not effect a cure by our present method of treatment. The treatment for leukemia and the nursing care specifically related to drug therapy is discussed in the section on leukemia.

Many people take a very pessimistic attitude toward any form of cancer in children and assume that the outcome is always fatal. This is far from true, as the case records of hospital centers who treat children can attest. However, as previously stated, it is most important that diagnosis be obtained early if the child is to be saved.

There are certain tumors which are fairly common among children. The description, symptoms, and the usual treatment for each is outlined in the following paragraphs.