Comparing the Mechanism of Action and

Treatments in Common Child and Adult Cancers

Widener University

Rebecca Keppler, Student Nurse

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1 University Place, Chester PA 19013

908-656-4724
rlkeppler@mail.widener.edu
AB S TR AC T
PURPOSE
The purpose of this research article is to compare common types of child and
adult cancers. The cancers researched are Leukemia, Neuroblastoma,
Melanoma, and Breast Cancer. This article examines the different mechanism of
action and treatments for these types of cancer.
METHODS
Information was gathered from American Cancer Society, WebMD, and the
Skin Cancer Foundation for this research article. Specific reasons why these
cancers might be affecting each age group were looked at as well as how these
cancers affected specific cells and organs.
RESULTS
The common types of cancers that are found in children are Leukemia and
Neuroblastoma, and the common types of cancers that are found in adults are
Melanoma and Breast Cancer. The mechanisms of action for each type of cancer
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are different and it is important to have an early diagnosis of these cancers and
to start treatments soon after diagnosis.
CONCLUSION
Cancer is not specific to one age group; it can affect anyone at any age. It is
important to be able to identify the different signs and symptoms of different types
of cancers, and to know what types of cancers are most common among different
ages groups.
INTRODUCTION
Cancer cannot be defined by one name, one set of symptoms, or one
outcome. It comes in many types and affects everyone differently. Mechanisms of
growth for Leukemia, Neuroblastoma, Melanoma, and Breast Cancers can range
from somewhat familiar to extremely different. These cancers are shown to affect
different races, sexes, organs, as well as different age groups. Since these
cancers are shown to affect everyone differently it is vital that they be treated
differently as well.
Selections of treatments are vital because of the typical side effects.
Children are shown to respond better to chemotherapy treatments than adults.
Although children respond better to chemotherapy, chemotherapy can cause
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long-term side effects, which could be harmful for the children receiving them.
Therefore, are the differences in childhood and adult cancers related to the
choice of different treatment options? Exploring this research involved the
following objectives:

To identify main cancers in children

To identify main cancers in adults
To look at the mechanisms of growth in cancer cells

METHODS
For this research study, I looked at different types of cancer to determine
the most at-risk age group. I also looked at specific reasons why they might be
affecting that age group; for example, when the child/adult developed the cancer,
where did it originate, and how did it affect the cells of the body?
This article looked at information from American Cancer Society,
WebMD, and the Skin Cancer Foundation. These sources provided pertinent
information for this subject.

RESULTS
Common Types of Child Cancers
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Cancers that are found in children differ from those in adults. Common
cancers that are found in children are Leukemia and Neuroblastoma. Each of
these cancers has a different effect on the body and is found in a different
location. See Figure 1 for survival rates and fatalities for Leukemia.

Leukemia:
Leukemia has four different types: Acute Myeloid Leukemia, Acute
Lymphoblastic Leukemia, Chronic Myeloid Leukemia, and Chromic Lymphatic
Leukemia. The most common is Acute Myeloid Leukemia (AML). AML is a cancer
of the white blood cells; it causes the bone marrow to produce large numbers of
abnormal white blood cells. These WBCs crowd normal healthy cells, resulting in
production of common symptoms of leukemia.
Symptoms of Leukemia depend on the type. Common symptoms are:

A new lump or swollen gland in the neck, under the arm, or in

the groin
Frequent nosebleeds, bleeding from the gums or rectum, more

frequent bruising, or very heavy menstrual bleeding

Frequent fevers
Night sweats
Bone pain
Unexplained appetite loss or recent weight loss
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Feeling tired without a reason

Swelling and pain on the left side of the body

(Leukemia-Topic Overview)
Leukemia cannot be prevented, but there is some ways to decrease the
risk. Avoiding exposure to high levels of radiation, and conditions were the body
can make abnormal chromosomes can decrease the change of getting leukemia.

Neuroblastoma:
Neuroblastoma starts in early forms of nerve cells, and it is found in a
developing embryo or fetus. This tumor cancer can start anywhere in the body
but is usually in the abdomen, or in the adrenal gland. Neuroblastoma can spread
to the lymph nodes, liver, bones, and bone marrow (About Neuroblastoma). See
figure 2 for survival rates and fatalities for Neuroblastoma.
Neuroblastoma is commonly found more in males then females (About
Neuroblastoma). The average age of a child diagnosed with Neuroblastoma is
about 18 months of age but the condition is occasionally seen in teenagers or
even young adults, (About Neuroblastoma).
Signs and symptoms of Neuroblastoma vary, depending on the site of the
tumor is located and its degree of spreading. If the tumor is located in the
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abdomen, common symptoms could be bellyaches, weight loss, or a descended

abdomen. Some children may not show any symptoms other than general aches
and pains (About Neuroblastoma).
Diagnosis of Neuroblastoma involves several tests: 1231-MIBG, CT or
MRI scans, bone marrow aspirate and biopsy, PET (positron emission
tomography) scan, urine VMA/HVA test, and tissue biopsy (About
Neuroblastoma). These tests will show the growth of abnormal cells in the organs
as well as in the cells themselves under a microscope.

Common Types of Adult Cancers

Some cancers that are found in adults at different frequencies from those
commonly found in children. Although childhood and adult cancers can arise from
mutated DNA, adult cancers are more likely due to lifestyle habit or
environmental factor. Common cancers found in adults are Melanoma and Breast
Cancer.

Melanoma:
Melanoma is the most dangerous form of skin cancer. Melanoma affects

melanin cells, basal cells, and squamous cells by impairing their DNA. This
cancer most often results from ultraviolet radiation from sunrays and tanning
beds, or from genetic defects (Melanoma). Melanoma presents itself as moles.
The majority of Melanomas are black or brown, but they can also be skin-colored,
pink, red, purple, blue or white, (Melanoma). Melanoma kills an estimated 9,710
people in the US annually, (Melanoma). If not treated, melanoma can spread to
other parts of the body, where it can become hard to treat and quickly fatal.
Prevention of skin cancer includes avoiding prolonged exposure to UV
light and using a lotion with a high SPF. Another way to prevent skin cancer is to
go to the dermatologist annually to have a skin check and to report any changes
in moles. Catching skin cancer early is the best way to prevent it from becoming
fatal (Melanoma). See figure 3 for survival rates and fatalities for Melanoma.

Breast Cancer:
Breast cancer can affect both men and women. It is an uncontrollable
growth of breast cells, resulting from mutation or abnormal changes in genes
responsible for cell growth. The use of screening mammograms has reduced the
number of cases of breast cancer (Breast Cancer). The most common symptom

of breast cancer is a new lump or mass that is painless, and hard, with irregular
edges (Breast Cancer). Other possible symptoms include:

Swelling of all or part of a breast (even if no lump is felt)

Skin irritation or dimpling
Breast or nipple pain
Nipple retraction (turning inward)
Redness, scaliness, or thickening of the nipple or breast skin
Nipple discharge (other than breast milk)

(Breast Cancer)
Breast cancer is separated into several types based on how the cancer
cells look under the microscope. A patient may have more than one type of
breast cancer as well. The different types of breast cancer are ductal carcinoma
situ, invasive (or infiltrating) ductal carcinoma, and invasive (or infiltrating) lobular
carcinoma. Less common types of breast cancer are inflammatory breast cancer,
Paget disease of the nipple, Phyllodes tumor, and angiosarcoma (Breast
Cancer). Although these are less common types of cancer it is still important that
they are recognized and treated just as vigorously as more common types of
breast cancers. See figure 4 for survival rates and fatalities for breast cancer.

Mechanism of Growth of Cancer Cells

The mechanisms of growth of cancer cells are shown to be different in
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children and adults. Children more commonly get cancer from a mutation of their
normal cells DNA. Although, the most common way to develop an adult cancer
is from lifestyle decisions and environmental factors, adults can also get cancer
from mutated normal cells DNA.
Every cancer has a different mechanism of growth, and different cancers
can start in different locations of the body. It is important to know where in the
body cancers are likely to develop because the sooner they are caught, the better
the prognosis is for the patient.

DISCUSSION

When diagnosing cancers that are common in children, it is important that

they are found early. Many cancers in children do not have preventative factors;
this makes it almost impossible to prevent their cancer. This is why it is important
to find the abnormalities and catch these cancers early.
In adults, prevention and early detection are important. Steps can be taken
to prevent some of the types of cancers that the adult population face. The most
common factors that can lead to cancer are cigarette smoking, environmental
factors, and obesity.
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Different Cancer Treatments:

Every type of cancer is treated differently. It is important to have the
correct kind of treatment for a patient because these treatments have severe side
effects. This is very important in children with cancer because their bodies are
more fragile. Treatment should be specific to the child because every child is
different and their bodies can handle different degrees of treatments.

Child Cancers:
Treatment of Leukemia should be started once diagnosis is confirmed.
This is important because, the longer the cancer is untreated, the more mutated
cells arise. Treatment depends on type of Leukemia, age of the patient, and
general health of the patient. For all types of leukemia, three stages of treatment
are usedinduction therapy, consolidation therapy, and maintenance therapy.
Induction therapy kills leukemia cells in the blood and bone marrow to induce
remission. Treatments include chemotherapy and corticosteroids. Induction
usually lasts 4 weeks and is done in a hospital, (Leukemia-Topic Overview). The

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second stage of treatment is consolidation therapy. Consolidation therapy kills

any leukemia cells that are present.
If the cells that are killed regrow, they could cause relapse. Treatments
include more chemotherapy and possibly stem cell transplant. Consolidation
treatment lasts several months and does not require staying overnight at the
hospital. The last step of therapy is maintenance therapy. This step prevents any
remaining leukemia cells from growing. Lower doses of chemotherapy are used.
Chemotherapy is given with pills and once-a-month intravenous treatment.
Maintenance is often continued for up to 3 years, but during this time, most
people are able to go back to being as active as they were before beginning
treatment, (Leukemia-Topic Overview).
Treatment for Neuroblastoma is determined by whether the cancer is low,
intermediate, or high risk. Low-risk occurs if the child is younger than one year of
age at diagnose, or has a small easily removed tumor. Intermediate-risk of
disease is if the child had a large tumor that has not spread. This child will
probably be treated with surgery and four to eight months of chemotherapy, with
no radiation treatments (About Neuroblastoma). High-risk disease children make
up half of Neuroblastoma patients. This is because the tumor has spread to other

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parts of the body or because the tests show high-risk features (About
Neuroblastoma). Treatment for high-risk children includes five months of
chemotherapy, surgery, radiation therapy, self stem cell rescue followed by highdose chemotherapy, and immunotherapy and biological therapy combined
(About Neuroblastoma). Unfortunately, high-risk Neuroblastoma still has a very
high rate of non-responsiveness, or recurring/ relapsing during or after treatment
(About Neuroblastoma).

Adult Cancers:
Treating Melanoma starts by removing the cancer. The standard method
of doing this is by surgical excision (cutting it out), (Melanoma). Most of these
surgeries can be done in an outpatient facility under local anesthesia. Sutures
where the mole is removed remain in place for one to two weeks before removal.
Excision is used to treat all kinds of skin cancer. If the cancer has spread to other
parts of the body, more treatments would have to be used (Melanoma). These
treatments can include chemotherapy, immunotherapy, targeted therapies, and
checkpoint blockage therapy. It is very important that this cancer is caught early,
and that treatment is started soon after.

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Treatment of breast cancer depends on the cancer type and how much it
has spread. Main types of treatment include surgery, radiation therapy,
chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy
(Breast Cancer). Most women who have breast cancer have some type of
surgery, often to remove a tumor or mass. Two types of surgery are done breastconserving surgery or mastectomy. In either surgery, the breast can be
reconstructed or it can be done at a later date.
Cancer is not specific to one age group. Cancer can affect anyone at any
age, but it is the different types of cancers that are specific to a certain age
group. It is important to be able to identify the different signs and symptoms of
different types of cancers and to know what types of cancers are most common
among different ages. Knowing the signs, symptoms, and mechanisms of action
will allow for the most promising outcome.

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References

1. Leukemia-Topic Overview. WebMD. 2012. Retrieved October 30, 2014.

http://www.webmd.com/cancer/tc/leukemia-topic-overview.

2. About Neuroblastoma. Kids Health from Nemours. 2011. Retrieved October

30, 2014.
http://www.cancer.org/cancer/neuroblastoma/detailedguide/neuroblastomawhat-is-neuroblastoma

3. Melanoma. Skin Cancer Foundation. New York, New York: Skin Cancer
Foundation. 2014. October 30, 2014. http://www.skincancer.org/skin-cancerinformation/melanoma

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4. Breast Cancer. The American Cancer Society. 2014. Retrieved October 30,
2014. http://www.cancer.org/cancer/breastcancer/

5. Cancer Facts & Figures 2014. American Cancer Society. Atlanta: American
Cancer Society; 2014. Received October 30, 2014.
http://www.cancer.org/acs/groups/content/@research/documents/webcontent/
acspc-042151.pdf

Figure 1

Number of Children Diagnosed with Leukemia vs. Fatalities in 2014

60000
50000

Number of Patients with Leukemia

40000

Number of Children
Diagnosed

30000

Number of Fatalities

20000
10000
0
Leukemia

(Cancer Facts & Figures 2014)

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Figure 2

Number of Children Diagnosed with Neuroblastoma vs. Fatalities in 2014

800

Number of Patients with Neuroblastoma

600

Number of Children
Diagnosed

400

Number of Fatalities

200
0
Neuroblastoma

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(Cancer Facts & Figures 2014)

Number of Adults Diagnosed with Melanoma vs. Fatalities in 2014

80000
70000
60000

Number of Patients with Melanoma

50000

Number of Adults
Diagnosed

40000

Number of Fatalities

30000
20000
10000
0
Melanoma

Figure 3
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(Cancer Facts & Figures 2014)

Figure 4

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Number of Adults Diagnosed with

Breast Cancer vs. Fatalities in 2014

250000
200000

Number of Adults
Diagnosed

150000

Number of Fatalities

Number of Patients with Breast Cancer

100000
50000
0
Breast Cancer

(Cancer Facts & Figures 2014)

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