What exactly is cancer and where does it come from?”
This is probably the first or second question that families ask once their child has been diagnosed with cancer, and over time I have attempted to refine my explanation of this complicated disease in attempt to make it understandable, so here it is:
Your body is made of trillions of cells and it knows how to maintain a balance of making new cells and letting cells die or killing cells. New cells are needed for healing, growing, and maintaining your body. These new cells are made by making exact copies of existing cells. Usually this process goes smoothly but sometimes a mistake is made and it doesn’t get noticed and even though that cell isn’t right (it’s a cancer cell) it continues to make copies of itself in an out of control fashion. Before you know it, these bad cancer cells are crowding out the normal cells and the body has a hard time functioning because there aren’t enough normal cells around. So cancer can start anywhere there is a cell in your body…your blood, your brain, your lungs, your bones, etc. so “cancer” is a group of diseases and there are many different types and subtypes.
“Why does the mistake happen?”
Here’s where childhood cancer and adult cancers differ the most. Childhood cancers usually happen from a random mistake in the copying of cells, it’s just something that happens. The random mistake usually affects a critical function of the cell and things can get out of control with just one or two mistakes. Adult cancers, on the other hand, usually have many smaller mistakes before things get out of hand. Look at the picture below. On the Y axis (vertical) is the number of mistakes seen in a cancer cells and on the X axis (horizontal) are the types of cancers. When you compare adult and childhood cancers, you can see that the childhood cancers have very few mistakes compared to the adult cancers.
Additionally, we already have some good ideas of what creates some of these more “adult mistakes” and it’s things like smoking, smokeless tobacco, UV exposure, radiation exposure, and certain viruses; the great news is there are ways to reduce your risk to those things. Unfortunately for childhood cancer, what we know is that the majority of the mistakes are random and we can’t prevent it from happening.
This randomness is why I generally tell my patients ‘I don’t know why this happened to you/your child”. I do mean that, I don’t know why some children have these mistakes happen and others don’t (with some very special exceptions that I will likely touch on at a later date). So even though we don’t know why some children get dealt a crummy card, that doesn’t mean that we don’t know why the cancer developed from a biologic sense.
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