Helpful Links

Children’s Cancer Research Fund: Their mission is to fund childhood cancer research which needs safer, more effective treatments and cures for kids with cancer, and to support the research of bright scientists across the country, whose ideas can make the greatest impact for children fighting cancer. They do this by focusing on hard-to-treat diseases, survivorship, and health disparities for racial and ethnic minority groups.

Donate to Children’s Cancer Research Fund

National Pediatric Cancer Foundation (NPCF): A nonprofit organization dedicated to funding and developing novel research and clinical trials to find less toxic, more effective treatments for childhood cancer. Their purpose is to reduce the side effects of current treatments, improve survival rates, and ultimately eliminate childhood cancer. 

Donate to National Pediatric Cancer Foundation (NPCF)

Transcript

Introduction - Kodi

Welcome to Mirroring Medicine with Kodi and Isabel! In this episode of Mirroring Medicine we will be highlighting Childhood Cancer. We will go over the biological mechanisms, incidents, cancer type, morbidity, treatment modalities. If you have any medical questions about childhood cancer, please contact your nearest pediatrician. As we have stated in previous episodes, we are just touching the tip of the iceberg when it comes to this information on childhood cancer and this podcast does not constitute medical information. If you would like to learn more, we encourage you to again seek assistance from medical experts and doctors like pediatricians to learn about Childhood Cancer. 

What are Childhood Cancers? - Kodi

So firstly, I wanted to go into the definition of childhood cancers. The definition, according to the American Cancer Society, is that cancers that affect children from birth through age 14 are known as childhood cancers or pediatric cancers. However cancers that affect children ages 15 to 19 are known as adolescent cancers. (https://www.cancer.org/cancer/childhood-cancer.html). According to this website, they state that Leukemia, Brain/Spinal Cord Tumors, Neuroblastoma, Wilms Tumor (nephroblastoma - in the kidneys), lymphoma, rhabdomyosarcoma, retinoblastoma, osteosarcoma (most common bone cancer), Ewing Sarcoma (second most common type of bone cancer), are the most common childhood cancers that often different than how they occur in adults. 

So, I am going to explain a little bit of each common childhood cancers. According to the cleveland clinic, there are three types of childhood cancers including 1. leukemias and lymphomas, 2. brain and spinal cord tumors, and 3. solid tumors. (https://my.clevelandclinic.org/health/diseases/24960-childhood-cancer)

Leukemia and lymphoma are blood cancers. Leukemia is the most common type of childhood cancer. It starts in your child’s bone marrow (where blood cells get made). Lymphoma starts in blood-forming cells in your child’s lymphatic system. It’s the third most common type.

Brain and spinal cord tumors are the third most common type of childhood cancer. Pediatric brain cancers affect over 5,000 kids in the U.S. each year. They happen when cells that are a normal part of your child’s central nervous system transform into cancer cells.

Solid tumors develop when cancerous cells divide, multiply and form masses. They can develop throughout a child’s body. This includes bone cancers. 

Charity - Kodi

This podcast on Childhood Cancer and Childhood Cancer Awareness Month of September was inspired by 2 charities. The first one that we will highlight is the Children’s Cancer Research Fund in which they state “At Children’s Cancer Research Fund, we believe a world without childhood cancer is possible.” Their mission is to fund childhood cancer research which needs safer, more effective treatments and cures for kids with cancer, and to support the research of bright scientists across the country, whose ideas can make the greatest impact for children fighting cancer. They do this by focusing on hard-to-treat diseases, survivorship, and health disparities for racial and ethnic minority groups. (http://childrenscancer.org/about-us/). If you would like to contribute to this cause, we will place this charity website link for donations in our caption notes and on our website. 

The other charity that inspired this podcast is the national pediatric cancer foundation (NPCF) which is a nonprofit organization dedicated to funding and developing novel research and clinical trials to find less toxic, more effective treatments for childhood cancer. Their purpose is to reduce the side effects of current treatments, improve survival rates, and ultimately eliminate childhood cancer. If you would like to donate to this cause, the link will be provided down below in our caption notes and on our website. (https://nationalpcf.org/about-us/#history) 

Biology Mechanisms of Childhood Cancer

We will now explore the biological mechanisms of childhood cancers. To do so, we must first understand the mechanisms of adult cancer cells. This information has been adapted from the textbook, “The Cell: A Molecular Approach. 2nd Edition” by Geoffrey Cooper (1).

Cancer is characterized by unregulated cell division, resulting in the formation of cancer cells. This cell type can invade normal tissues and organs, and in severe cases, it spreads throughout the body. To specify, cancer can originate from many different cell types, and like our breast cancer episode, we mentioned there that breast cancer is the uncontrolled cell growth in breast tissue. However, due to the vast range of cancer types, these cancers differ in behavior, response to treatment, and growth rate. 

According to Alzahrani et al, in the journal Molecular and Clinical Oncology (2), cancer is defined in three stages: initiation, promotion, and progression.

Initiation: Initiation refers to the genetic, metabolic, and carcinogenic factors that damage DNA, leading to its subsequent mutation. Carcinogens are defined by Alzahrani et al. as any agent, either from the body or external, that damages DNA, thereby creating mutations. This process of DNA damage is a key step in carcinogenesis. This DNA damage includes the activation of oncogenes, which promote cancer, and the inactivation of tumor suppressor genes, which promote cancer cell apoptosis (also known as self-directed cell death). 

Promotion: The promotion stage, according to Alzahrani et al., is a prolonged state that begins when cancer cells proliferate, meaning they divide. These cells are defective (as they carry damaged DNA, which was created during the initiation phase, which I mentioned earlier). 

Progression: Progression, according to Alzahrani et al, is the metastasis of tumor cells. Metastasis, according to the Cleveland Clinic, is the process by which cancer cells spread from the original site (where they were created) to distant parts of the body. These cancer cells then form secondary tumors, which are composed of the same type of abnormal cells.  

A simple DNA mutation, as defined by the National Human Genome Research Institute, is a change in the DNA sequence of an organism. However, it is not enough to drive cancer forward, which can result from an error in DNA. As Alzahrani et al. state, the multiple-hit hypothesis suggests that cancer results from the accumulation of genetic mutations in a cell's DNA. 

Interestingly, Alzahrani et al mention that when classifying the characteristics of cancer cells, the characteristics are as follows: 

• Can grow and proliferate without growth signals

• Resistant to growth-inhibitory signals

• Evasion of apoptosis (self-directed cell death, as I mentioned earlier) 

• Unlimited reproduction potential

• Angiogenesis (The creation of blood vessels to supply cancer cells with nutrients from the general bloodstream).

• Tissue invasion

• Metastasis (process of cancer cells spreading from the original site (where they were created) to the distant parts of the body, where these cancer cell, as I mentioned earlier, can grow) 

What differs in childhood cancer?

According to the NIH, the article titled “Developmental origins shape the pediatric cancer genome” by Chen et al, from Dec 2024, they state that pediatric cancers are distinct from adult malignancies that I explained earlier, in their cellular origins, epidemiology, and genomic landscapes. They cite that pediatric cancers have a low mutation burden (citing a 10-fold lower mutation burden) based on whole-genome sequencing data and are driven by variants that disrupt transcriptional activity, including the chromatin state, non-coding cis-regulatory regions, and other biological functions. 

Notably, within each pediatric tumor, there are multiple populations of cells with varying states, and the lineages of these cells can be traced back to their fetal origins.

They go on to explain that the most prominent difference is that adult cancer cells originate in epithelial tissue (think of skin, intestines, respiratory tract, abdominal cavity, sweat glands) as a result of aging and the mutagens in the environment, such as UV rays from the sun, radiation, tobacco use, etc. 

In childhood cancer, however, the developing tissues in a child are going through organ formation, growth, and maturation, and tissue development. Many childhood cancers in the brain and solid tumor cancers develop from mesodermal lineage or ectodermal lineage. The mesoderm and ectoderm are two of the primary germ layers formed during embryonic development, a process known as gastrulation. 

The mesoderm makes up the “Middle germ layer,” including the muscle, connective tissue (bone, blood, etc), the notochord, and (think of things that support movement mnemonic)

The ectoderm (the acronym that I used to remember this MINCLEA

Mouth, integumentary, nervous system, neural crest cells, lens of eye, inner ear, and anus

Chen et al. state that when researchers have examined identical twins, they find that initiation events occur in utero.

They cite, “ For cancers originating from the same tissues, the underlying molecular mechanisms differ between pediatric and adult populations. For instance, high-grade glioma (HGG), an aggressive spectrum of brain tumors with poor prognosis in both children and adults, is considered to originate from neural progenitor or glial lineage depending on the particular HGG subtype. In children, more than half of HGG shared somatic histone H3.3 or H3.1 driver mutations,” they state, “[These mutations] are nearly absent in their adult counterpart, indicating the oncogenic potential of these mutations is restricted to a specific window of brain tissue development.”

This article is highly fascinating, and I recommend reading it in its entirety.

Statistics of Childhood Cancer

Moving on to the statistics, Chen et al cite the American Childhood cancer organization, in which the “annual incidence of childhood cancer is ~16,000 in the US and ~400,000 globally.” and they go one to say that, “Many of these cancers are rare, with more than 50% having an annual incidence of <200 cases in the US according to the Surveillance, Epidemiology, and End Results (SEER) program statistics.” Chen et al.

Moreover, when examining high-income countries, Chen et al. cite a 5-year overall survival rate of 85% for pediatric cancers. This is defined as the percentage of children who are still alive five years after being diagnosed with cancer.

How is Cancer treated in pediatric patients? 

Treatment is described as:

Radiotherapy or radiation, in which X-ray beams target tumors specifically (Yale Medicine)

Cytotoxic agents, as the National Cancer Institute defines them, are “A substance that kills cells, including cancer cells. These agents may stop cancer cells from dividing and growing and may cause tumors to shrink in size.” 

Chemotherapy, also known as chemo, which Yale Medicine describes as “the agents that attack fast-growing cells, " includes killing healthy cells. Chemotherapy can consist of some cytotoxic agents, but also comprises other drugs that target cells in different ways. The side effects include hair loss, nausea, vomiting, and low blood counts.  is the 

Surgery, as defined by the Mayo Clinic, is the physical removal of cancer. Surgical intervention can actually be done before cancer is found, such as removing an organ before cancer develops, to diagnose cancer, such as a biopsy, to determine cancer stage, as a treatment modality, and to improve symptoms by removing cancers that block the intestine or press on a nerve. 

Immunotherapy is defined by cancer.gov as the “type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection, and other diseases.” This is a broad classification of drugs that can also be used to treat other conditions.

Stem cell transplants: During chemotherapy or radiation, stem cells can be damaged, and blood-forming stem cells are vital to life, as they produce the different blood cells required for survival. Stem cell transplants are procedures in which people donate their stem cells and are transplanted into individuals who have damaged stem cells ( according to cancer.gov)

Conclusion - Kodi

To sum up this podcast, we talked about childhood cancers for childhood cancer awareness month where we looked at the treatments of childhood modalities, what differs in childhood cancer, the biological mechanisms of cancer, the charities that inspired this podcast being the Children’s Cancer Research Fund or the National Pediatric Cancer foundation. If you were also inspired by this podcast, we recommend you take a look at donating to these integral foundations. We also wanted to remind you all that this podcast does not constitute medical advice, but it does go into the tip of the iceberg in terms of thinking of medical conditions from a scientific standpoint. If you have further questions, we encourage you to be curious and ask your care team and pediatrician. Thank you for listening to our podcast on childhood cancer awareness and have a wonderful rest of your day and tune in for special surprises during this season!

Citations

1. “Childhood Cancer.” American Cancer Society, www.cancer.org/cancer/childhood-cancer.html. Accessed 28 Sept. 2025.

2. “Childhood Cancer.” Cleveland Clinic, my.clevelandclinic.org/health/diseases/24960-childhood-cancer. Accessed 28 Sept. 2025.

3. Alzahrani, S. M., et al. “General Insight into Cancer: An Overview of Colorectal Cancer (Review).” Molecular and Clinical Oncology, vol. 15, no. 6, Dec. 2021, p. 271. PubMed Central, https://doi.org/10.3892/mco.2021.2433.
   
   

4. Chen, X., et al. “Developmental Origins Shape the Paediatric Cancer Genome.” Nature Reviews Cancer, vol. 24, no. 6, June 2024, pp. 382–398. PubMed Central, https://doi.org/10.1038/s41568-024-00684-9.
   
   

5. Cooper, Geoffrey M. The Cell: A Molecular Approach. 2nd ed., Sinauer Associates, 2000. “The Development and Causes of Cancer.” NCBI Bookshelf, https://www.ncbi.nlm.nih.gov/books/NBK9963/.
   
   

6. “Cytotoxic Agent.” National Cancer Institute Dictionary of Cancer Terms, https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cytotoxic-agent.
   
   

7. “Immunotherapy.” National Cancer Institute Dictionary of Cancer Terms, https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunotherapy.
   
   

8. “Metastasis (Metastatic Cancer).” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/22213-metastasis-metastatic-cancer.
   
   

9. “Mutation.” National Human Genome Research Institute, https://www.genome.gov/genetics-glossary/Mutation.
   
   

10. “Pediatric Cancer Treatment.” Yale Medicine, https://www.yalemedicine.org/conditions/pediatric-cancer-treatment.
    
    

11. “Stem Cell Transplant for Cancer Treatment.” National Cancer Institute, https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant.