Key Takeaways
- Pediatric cancer types and causes: Unlike adult cancers tied to lifestyle choices, childhood cancers – most commonly leukemias, brain tumors, neuroblastomas and lymphomas – typically stem from unknown causes or rare genetic changes.
- Diagnosis and warning signs: Symptoms like unexplained fevers, abnormal lumps, severe headaches with morning vomiting and persistent joint pain often mimic common illnesses, requiring thorough evaluations by primary care providers for proper diagnosis.
- Survival rates and outcomes: Advances in treatment have raised the overall five-year survival rate for pediatric cancer in the U.S. to approximately 85%, though prognosis varies significantly depending on the cancer type, stage and individual factors.
- Treatments and targeted therapies: Pediatric cancer care relies on chemotherapy, surgery and radiation, while newer precision medicine options like CAR T-cell therapy and targeted drugs offer customized care for specific tumor profiles.
- Complications and long-term survivorship: Because treatment can cause physical, cognitive and developmental effects, childhood cancer survivors require ongoing follow-up care and a personalized survivorship plan.
Childhood cancer is a full family battle, says Lillie Brown, a 28-year-old pediatric cancer survivor from Missouri.
Brown was diagnosed with osteosarcoma, a type of bone cancer, at 13 years old. At 15, she was declared cancer-free after undergoing 11 months of chemotherapy and is now a mother of two, with another child on the way.
“Parts of cancer will live with me forever,” she says. “The good part of that is realizing what I’ve overcome, the community that surrounded me and knowing I could do hard things. But it’s not just cancer, chemo, remission – there’s more to it than that. A lot of it stays with you.”
Although childhood cancer rates are stabilizing, and cancer research and treatments march forward, it’s common for a childhood cancer diagnosis to put a strain on families both during and after treatment. If the hardship weighs heavily, you aren’t alone.
What Are the Common Types of Childhood Cancer?
The types of cancers kids typically develop differ from those that are most common in adults. The most common types of childhood cancer include:
- Leukemia, which starts in blood-forming tissue like bone marrow. Leukemia is the most common type of childhood cancer, accounting for 1 in 3 cancer diagnoses. The most prevalent type of leukemia is acute lymphoblastic leukemia, or ALL for short.
- Brain tumors. Brain and central nervous system tumors account for about 16% of cancers in kids ages zero to 19, says Dr. Debra Friedman, E. Bronson Ingram Chair in pediatric oncology and division director of pediatric hematology/oncology at Monroe Carell Jr. Children’s Hospital at Vanderbilt in Nashville, Tennessee.
- Neuroblastoma, or cancer of the nerve cells. Neuroblastoma is the most common solid tumor outside of the brain, accounting for 5% of cancers in those ages zero to 19, adds Friedman, who is also the deputy director at Vanderbilt-Ingram Cancer Center. Solid tumors are abnormal masses of cells that don’t contain cysts or liquids.
- Lymphoma, which starts in the infection-fighting lymphatic system. About 12% of childhood cancers are lymphomas.
Some cancers are less common in children, but still much more common in children than adults. These cancers include:
- Wilms’ tumor, a rare type of kidney cancer
- Rhabdomyosarcoma, a soft tissue cancer
- Retinoblastoma, a cancer that starts in the retina of the eye
- Osteosarcoma and Ewing’s sarcoma, both of which are types of bone cancers
Common Childhood Cancer Comparisons
Childhood Cancer Type
Primary Location and Target Cells
Most Common Age Group Affected
5-Year Relative Survival Rate
Acute Lymphoblastic Leukemia (ALL)
Bone marrow and blood
1 to 4 years
90%
Brain and CNS Tumors
Brain tissue and spinal cord
Varies by sub-type
75%
Neuroblastoma
Nerve tissue (adrenal glands)
Under 5 years
80%
Hodgkin and Non-Hodgkin Lymphoma
Lymphatic system
Adolescents (15 to 19 years)
90%
Osteosarcoma
Bone tissue (legs and arms)
Teens (10 to 19 years)
70%
What Causes Cancer in Children?
Unlike in adults, lifestyle factors don’t seem to play a significant role in the development of cancer in children. Kids simply haven’t had enough years for lifestyle choices, such as poor diet or exposure to smoking, to have immediate impact, though these factors can increase cancer risk later in life.
In fact, the cause of most childhood cancers is unknown. About 8% to 10% of childhood cancers are caused by an inherited genetic mutation, according to the National Cancer Institute. Other genetic changes that contribute to cancer may occur spontaneously in cells during a child’s development.
Factors that may cause or increase a child’s risk for cancer include:
- Genetics. Inherited genetic mutations and gene changes may affect how rapidly cells grow, a key for cancer development.
- Medical conditions. For example, Down syndrome can raise a child’s risk of developing cancer.
- Developmental issues in utero. When certain cells don’t mature, cancers like Wilms’ tumor or retinoblastoma can form.
- Exposure to infection in early childhood. For example, exposure to Epstein-Barr virus – the same virus that causes most cases of mononucleosis – can contribute to certain cancers like Hodgkin lymphoma and Burkitt’s lymphoma.
- Radiation exposure, like from X-rays and other medical imaging. Children have a lower tolerance for radiation exposure and have a longer time to develop complications from exposure.
Early Warning Signs and Symptoms of Childhood Cancer
In adults, there are screening tests to detect certain cancers, such as breast cancer and colon cancer. But with kids, that’s not the case. Instead, it’s about taking action when symptoms might point to cancer – and of course, that’s not necessarily obvious.
In fact, symptoms are often similar to those that are due to more common illnesses and injuries. Still, some signs and symptoms may be linked to childhood cancers. While there’s no obvious tell, symptoms that come on suddenly and those that can’t be explained by any other cause, as well as illnesses that persist without a known reason, should be heeded.
Some possible symptoms to look for include:
- An abnormal lump
- Swelling, like in the joints or back
- Changes to the eye, such as white coloring behind the pupil
- Impaired vision
- Pain in one area of the body, such as bone or joint pain
- Headaches, often accompanied by vomiting in the morning
- Fever or another illness that persists
- Memory loss, confusion or other cognitive changes
- Speech problems
- Seizures
- Changes in personality or behavior
- Rapid unexplained weight loss
Signs and symptoms differ by individual childhood cancers. For example:
- Leukemia symptoms may include fever, bone pain, paleness, bruising, enlarged lymph nodes and an enlarged liver or spleen.
- Bone and soft tissue cancers might manifest as bone pain, lumps or soft tissue swelling.
- Lymphomas may cause enlarged lymph nodes.
- Brain tumors might give a child a headache, vomiting or balance changes.
Experts stress that it’s best to talk with your child’s doctor about any concerns to ensure early detection and treatment in the less common cases where cancer is to blame.
How Is Childhood Cancer Diagnosed?
“Childhood cancer is diagnosed based on signs or symptoms of the cancer, and as such will differ from cancer to cancer significantly,” Friedman reiterates.
It also takes time to determine if what a child is experiencing is, in fact, cancer.
“Most children go back and forth to their primary care providers a number of times before getting diagnosed, because most of these symptoms are not specific to cancer and are usually not cancer,” Friedman says.
Childhood cancer is diagnosed by considering the following elements:
When cancer is confirmed, a closer evaluation and additional testing may be done. This can range from blood tests to bone scans to provide more detail on the cancer, from type to stage – or how far it has spread. This will help guide treatment.
Communicating a cancer diagnosis with children
When explaining a cancer diagnosis or prognosis to children, it’s important they receive a clear but simple explanation of the disease.
ACS urges parents and medical providers to explain to children that cancer is not contagious and is not the child’s fault.
Consider the age of the child when explaining cancer, but remain direct and honest. Brown says as a 13-year-old, her medical team avoided words like “tumor,” “chemotherapy” or “cancer.” They used “growth,” “strong medicine” and “sick,” respectively. She was ill-equipped for the invasive procedures ahead of her.
An employee at her school was the first person to use the word “cancer” when talking about her condition, rather than her parents or medical providers.
“I felt like I was the last person to know what was going on,” Brown recalls.
Childhood Cancer Prognosis
In 2026, about 9,680 children in the U.S. are expected to be diagnosed with cancer, according to the ACS.
Fortunately, advances in care have dramatically improved cure rates here in the United States and in other developed high-income countries, so that most survive childhood cancer – and it never comes back. Overall, about 85% of children with cancer now live for at least five years after diagnosis. That’s a substantial improvement from the mid-1970s, when the five-year survival rate was about 58%.
However, a child’s prognosis can vary considerably depending on the type of cancer, age at diagnosis, genetics, whether the cancer has spread and other factors.
Some childhood cancers, including acute lymphoblastic leukemia and Hodgkin lymphoma, have particularly high cure rates. However, cancer remains one of the leading causes of death among children in the U.S. according to the ACS.
Even as treatments continue to improve, children may experience serious short- and long-term side effects from cancer and its treatment.
Pediatric Cancer Treatment Options and Precision Medicine
Treatment for childhood cancer differs based on the cancer type, as with adults. However, these are the mainstays of therapy for childhood cancer, which may be used in combination:
- Chemotherapy. Chemotherapy medications work by targeting and destroying rapidly dividing cancer cells. Chemotherapy can also damage healthy cells, which can cause side effects such as hair loss, nausea and fatigue. Children with cancer commonly receive chemotherapy through an IV, although some chemotherapy drugs are given by mouth or other methods.
- Surgery. Surgery may be used to remove solid tumors, such as certain brain, bone or soft tissue tumors.
- Radiation. Radiation therapy uses high-energy radiation to kill cancer cells. Because radiation can affect a child’s developing tissues and organs, doctors carefully consider its potential benefits and long-term risks when determining whether and how it should be used.
- Laser or cryotherapy. These techniques may be used for certain cancers, including retinoblastoma, to destroy cancer cells while preserving as much healthy tissue and vision as possible.
- Immunotherapy and targeted therapy. These treatments either help the immune system recognize and attack cancer cells or target specific molecular or genetic characteristics of cancer cells. Treatment options in pediatric oncology have continued to expand and now include small-molecule targeted drugs, monoclonal antibodies and other antibody-based treatments, as well as genetically engineered cell therapies such as CAR T-cell therapy for certain cancers.
Precision medicine and emerging therapies
“Advancements in personalized medicine and immunotherapy have been an exciting addition to our therapies to treat childhood cancers,” says Dr. Regina Macatangay, associate professor of pediatrics at the University of Maryland School of Medicine and pediatric hematologist-oncologist. “Approval of treatments like pembrolizumab, blinatumomab, and CAR-T cellular therapy has offered more pediatric patients the chance for cure. “
By analyzing the specific characteristics of a child’s tumor, doctors can increasingly customize cancer care.
“Precision oncology is actively transforming the field of pediatric oncology,” says Dr. Susmita Sarangi, a pediatric hematologist-oncologist at MedStar Health. “Blinatumomab is designed as a matchmaker protein between your immune system and leukemia cells, which is the most common childhood cancer.”
Blinatumomab is approved for certain adults and children with B-cell precursor acute lymphoblastic leukemia, or ALL. Research has also shown that adding blinatumomab to chemotherapy for children with newly diagnosed standard-risk B-cell ALL can improve disease-free survival.
More broadly, the number of therapies available for pediatric cancers continues to grow.
The FDA has approved more than 60 drugs encompassing more than 85 pediatric cancer indications, including targeted therapies, immunotherapies and other newer approaches.
For example, in July 2026, the FDA granted traditional approval to selpercatinib (Retevmo) for adults and children ages 2 and older with certain locally advanced or metastatic solid tumors that have a RET gene fusion and have progressed after previous systemic treatment or have no satisfactory alternative treatment options.
What to expect during treatment
As part of a more aggressive approach to treating childhood cancer, kids often are treated for a longer time.
However, kids’ bodies are equipped to handle treatment in a way adults aren’t.
“Children can tolerate very aggressive treatment that an adult or an older adult sometimes may not,” says Dr. Will Parsons, Beverly and Daniel C. Arnold endowed chair for precision medicine at Texas Children’s Hospital. “They’re younger, generally healthier, stronger. They are much less frequently affected by disease that come with older age, like diabetes or heart disease.”
HealthCare Providers That Treat Childhood Cancer
Long-Term Side Effects and Complications of Cancer Treatment
Still, as well as pint-sized bodies may respond to some cancer therapies, treatment takes a serious toll. In addition to enduring a range of side effects – just as adults do – kids are vulnerable in another way: Treatment can impact their growth and development. That’s a trade-off clinicians and parents must consider in making difficult choices about treatment.
There may be long-term complications of certain childhood cancer treatments such as:
- Chemotherapy. During chemo, it’s common to have hair loss, nausea, fatigue and a host of other side effects. After chemotherapy, kids may have tooth decay, heart problems or issues with fertility later in life.
- Radiation. Depending on the dose, treating brain cancer with radiation can cause cognitive impairment, as well as interfere with the brain’s ability to produce growth hormones and stunt growth. Those kids require growth hormone supplementation. “If you give radiation to the spine, you can cause shortening of what’s called ‘sitting height,’” Friedman explains. “The vertebrae in the spine kind of collapse down a little bit on each other, and they don’t grow as well because they’ve been radiated.”
- Surgery. Some surgeries are minor, but major surgeries may require removal of an organ or large body part. Depending on the surgery, this can have lifelong effects.
Complications of treatment depend on the type and duration of the treatment. There may also be lasting effects from ancillary pieces of having cancer, including:
- Mental health struggles
- Disrupted education
- Decreased mobility due to tumor size or location
- Infections from central lines and ports
- Nerve pain or scarring from procedures, like biopsies
Some health problems related to childhood cancer treatment, known as late effects, may not develop until months or even years after treatment ends. A survivor’s risk depends on factors including the type and location of the cancer, age at diagnosis and the types and doses of treatment received.
Navigating a Childhood Cancer Diagnosis
A childhood cancer diagnosis can leave parents and caregivers with an overwhelming amount of new information to process while also trying to support their child. Maintaining open communication with the child’s cancer care team can help families understand treatment decisions and connect with additional support.
“Parents and caregivers should ask questions often and lean on their pediatric oncology team, remembering that they are not alone,” Macatangay says.
The emotional impact of a diagnosis can extend to the entire family.
“A new childhood cancer diagnosis alters the life for the whole family and it is natural to feel an immediate wave of overwhelming emotions,” Sarangi says. “Healthcare teams, such as ours, are here to provide compassionate partnerships with parents, reminding them to focus on one day at a time.”
Cancer care teams can also connect families with resources they may not initially realize they need.
“While every child and family’s journey is their own, their team can connect them with resources they might not know they need,” Macatangay says. “Adapting takes time, and we will work with everyone in the family to create safe and supportive spaces to answer and explain whatever is needed.”
Parents and caregivers should also make time for their own well-being as they support their child.
“A cancer diagnosis is not anybody’s fault and it is important for parents to take care of themselves so they can help their child’s healing process,” Sarangi says.
Life After Childhood Cancer
Finishing cancer treatment doesn’t necessarily mean the end of cancer-related medical care. Because some effects of childhood cancer and its treatments can appear years later, survivors need ongoing follow-up tailored to their individual risks.
The National Cancer Institute recommends that childhood cancer survivors have a treatment summary and survivorship care plan. This information can help survivors and their healthcare providers understand which treatments they received, potential late effects and what follow-up tests or screenings may be appropriate.
Late effects can involve different parts of a survivor’s health, including the heart and lungs, growth and development, fertility, learning and memory, emotional health and the risk of developing another cancer. The specific risks vary considerably depending on the cancer and treatment.
Regular follow-up with healthcare professionals familiar with childhood cancer survivorship can help identify and manage potential late effects as survivors move through adolescence and adulthood.
The Bottom Line
“Kids need support, not only during treatment, but that they need support after as well,” Brown says. “It isn’t just something that’s a one-and-done.”
With about 85% of children with cancer now surviving at least five years, long-term health and survivorship care are increasingly important parts of childhood cancer treatment. Families should work with their child’s cancer care team to understand both the immediate treatment plan and the follow-up care that may be needed in the years ahead.
Frequently Asked Questions About Childhood Cancer
What should parents do if they suspect their child has cancer?
If you notice persistent or unusual symptoms, schedule an evaluation with your pediatrician immediately. Keep a detailed log of your child’s symptoms, including when they started and how often they occur, to share during the appointment. If symptoms persist after initial treatment, do not hesitate to ask for a referral to a pediatric specialist or request further testing.
How can parents prepare for their child’s first oncology appointment?
Bring a notebook or record device to capture key details, a list of current medications, medical records and a written list of questions for the care team. It is often helpful to have a relative or close friend accompany you for support and to help take notes during discussions about diagnostic findings and treatment plans.
How can parents support a child’s mental and emotional health during cancer treatment?
Maintain consistent daily routines whenever possible and encourage age-appropriate expression of feelings through play, art or talking. Utilizing pediatric child life specialists, child psychologists or family counseling services can help children process anxiety and cope with medical procedures in a safe, structured environment.
