Because of new and better therapies, cancer survival rates for children have improved dramatically during the last several decades. Scientists continue to search for the causes of childhood lymphoma so they can develop better treatments with less toxic side effects.         

• To access information about coping with childhood cancer, click here.
• Click here for childhood NHL statistics.

Click on the links below for more information about childhood Hodgkin lymphoma:

• Treatment
• Survivorship and Special Healthcare Needs
• Follow-Up Care
• Long-Term and Late Effects of Treatment
• Returning to School
• Ongoing Research

Treatment

A child's cancer diagnosis can bring with it feelings of uncertainty for parents and other family members. Suddenly, you're thrust into a fast-paced world of change, worry, fear and concern. You'll need to make treatment decisions while taking the time to comfort your child - and at the same time trying to cope with your own emotions.
 

Your child's treatment depends on certain factors:

• The disease's stage
• The disease's subtype
• Whether the disease is aggressive (fast growing) or indolent (slow growing)
• Whether the lymphoma is in areas of the body other than the lymph nodes (extranodal involvement)
• Potential risk factors that may be found during lab tests

Your child's oncologist (cancer specialist) should develop a treatment plan that limits the amount of therapy needed to bring about a remission. Be sure to ask the oncologist about potential side effects and long-term effects when considering treatment options. Some long-term effects, like infertility, can be serious. Download or order The Leukemia & Lymphoma Society's free fact sheet Fertility Facts.

Children with NHL may sometimes be treated differently than adults. Choosing the most effective therapy for adolescents and young adults (ages 15 to 29) can be challenging and is a topic of ongoing research. In fact, the treatment used on adults for certain NHL subtypes, including Burkitt lymphoma and lymphoblastic lymphoma, is actually already a pediatric therapy.

Clinical Trials

A clinical trial may be an option when it comes to finding the right treatment for your child's cancer. Clinical trials for children, adolescents and young adults with cancer are generally designed to compare potentially more effective therapy with therapy that's currently accepted as standard. Your child will have access to new or improved therapies under study and not yet on the market. Discuss with your child's doctor the possibility of taking part in a clinical trial, where treatment is administered in a safe, closely monitored environment.

 
Survivorship and Special Healthcare Needs

After treatment, most children can expect to have full and productive lives. Many survivors return to school, attend college, enter the workforce, marry and become parents.

You may want to consider a survivorship program for your child that focuses on life after cancer. Several major hospitals around the country offer these programs.

Follow-Up Care

Your child should visit his or her pediatrician or primary care physician at least once a year for a complete physical exam and any additional needed tests. Your oncologist should also regularly examine your child.

Regular doctor visits are encouraged to:

• Enable doctors to assess the full effect of therapy
• Detect and treat disease recurrence
• Identify and manage long-term and late effects of treatment

Your pediatrician should recommend a schedule for having your child's learning skills assessed. If your child appears to be experiencing learning disabilities, special education methods can help.

Coordination between your child's pediatrician and oncologist is important for the best care possible. Some treatment centers offer comprehensive follow-up care clinics for childhood cancer survivors. To find one near you, visit The Pediatric Oncology Resource Center.

Long-Term and Late Effects of Treatment

Some side effects of cancer treatment, such as fatigue, can linger for months or years after therapy. Some medical conditions like heart disease and other cancers may not appear until years after treatment ends. Long-term and late effects can impact your child's physical, mental and cognitive (brain function) health.

Most childhood survivors of lymphoma don't develop significant long-term or late effects of treatment. However, for some patients the effects can range from mild to severe.

Long-Term and Late Effects of Chemotherapy

Children treated for lymphoma may be at increased risk for:

• Fatigue
• Growth delays
• Thyroid dysfunction
• Hearing loss
• A secondary cancer

Some long-term and late effects become evident with maturation (puberty), growth and the normal aging process. Early intervention and healthy lifestyle practices (not smoking, good nutrition, exercise, regular screenings and follow-up) help.

Long-Term and Late Effects of Radiation Therapy

Girls (as well as women under age 30) who had radiation to the breast area are at risk for developing breast cancer 15 to 20 years after treatment. Male survivors of childhood cancer are at risk for developing second cancers, but they don't have as high a risk for developing breast cancer as female childhood cancer survivors do.

Girls who had radiation therapy in the chest area (mediastinal) should:

• Perform monthly self-breast exams
• Get a baseline mammogram at age 25 to 30 or 10 years after radiation therapy
• Have an annual clinical breast exam
• Have a mammogram every two to three years, depending on breast tissue density

Both girls and boys who've undergone mediastinal radiation therapy should have baseline testing for heart function. This should be followed by testing every three to five years after treatment or more regularly if any abnormalities are found.

 
Returning to School

Learning disabilities can begin during treatment or appear months or years after. Educate family members, friends, school personnel and healthcare providers about your child's possible long-term and late effects of treatment. Talk with teachers about your child's needs before he or she returns to school. Work with your child's teachers and medical providers to develop a program tailored to his or her needs that features baseline testing, special accommodations and long-term planning.

Click here to read about children with cancer returning to school.

Ongoing Research

Researchers are working to improve their understanding of long-term and late effects and to create guidelines for follow-up care. They're also seeking to understand how factors like aging and social and economic status influence long-term and late effects. The Leukemia & Lymphoma Society is currently funding an initiative at Children's Hospital of Philadelphia to discover and eliminate the causes of cancer treatment's late effects.

Related Links

• Download lists of suggested questions to ask your healthcare providers
• Download or order LLS's free booklets:
  • Fertility Facts
  • Learning and Living with Cancer: Advocating for Your Child's Educational Needs
  • Long Term and Late Effects of Treatment for Childhood Leukemia or Lymphoma Facts
  • Choosing a Blood Cancer Specialist or Treatment Center
  • Knowing All Your Treatment Options
• About Childhood Blood Cancer
• Long-Term And Late Effects Of Treatment For Childhood Cancer Survivors
• Follow-Up Care for Childhood Cancer Survivors