Golden September: figures, issues… a month to raise awareness of pediatric cancers

Septembre en or : un mois pour sensibiliser aux cancers pédiatriques

Golden September is the month dedicated to the fight against childhood and young adult cancers. Each year, between 2,000 and 2,500 new cases of cancer are detected in children aged 0 to 17. The fight against these cancers, which are not like those of adults, involves donations in order to finance research.

Initiated in the United States in 2012, Septembre en or, organized for the 7th year in France, aims to raise awareness, mobilize and develop initiatives against pediatric cancers. These are complex and evolve rapidly. And for 20% of children, current treatments remain ineffective. Cancers are the second leading cause of death in children, after accidents.

These cancers are very different from those in adults, such as lung, breast and prostate cancer. While adults mainly develop carcinomas (which develop from epithelial tissue), in those under 15, we find leukemia, lymphomas and embryonal tumors. These are formed from developing tissue. “These differences explain the often extreme speed of their growth, in a few weeks, sometimes in a few days, which is however not proportional to their severity. It is due to the high proportion of dividing cells in these tumors”,specifies the Curie Institute.

Pediatric cancers in figures

Over the period 2014-2020, each year, an average of 1,818 children aged 0 to 14 were diagnosed, according to the report from the National Cancer Institute published at the beginning of September. There were 443 among 15 – 17 year olds.

In children aged 0 to 14, the most common cancers are:

Leukemias (28.1%): cancers of bone marrow cells that will become blood cells; central nervous system tumors (26.7%): cancers that develop in the brain and spinal cord; lymphomas (11%): a cancer of the immune system at the level of lymphocyte production; neuroblastomas and ganglioneuroblastomas (7%): these cancers originate in immature nerve cells of the sympathetic nervous system; renal tumors (5%).

In adolescents, we find:

lymphomas (29.1%); central nervous system tumors (16.9%); leukemias (15.3%); melanomas and epithelial tumors (14.7%); bone tumors (9.2%); germ cell tumors (ovaries and testes) (6.8%) .

Over the period 2010 – 2016, the 1-year survival rate was 92%; 83% at 5 years.

What are the challenges of research ?

One of the challenges of research in pediatric cancers is to avoid long-term aftereffects, what specialists call ‘late complications’. Various complications, such as a second cancer, linked to the first and its treatments can occur up to 50 years after cancer in childhood. A frequent phenomenon that occurs in two thirds of children who are cured. “Among these long-term effects, heart failure, heart attacks and strokes have a severe impact on the lives of adults cured of pediatric cancer and are responsible for approximately 15% of late mortality (not linked to the first cancer)”, specifies the Gustave Roussy anticancer center.

Another challenge is the development of immunotherapy, which involves using the patient's immune system to recognize cancer cells. At the heart of immunotherapy research are CAR T cells (Chimeric antigen receptor T-Cells), immune cells taken from the patient and modified in the laboratory so that they directly attack cancer cells. Already used to treat leukemia, researchers hope to develop new generations of Car-T cells capable of attacking other cancers.

Gustave Roussy also highlights the need to better understand the genetic causes of cancer in order to better combat it. Currently, it is possible to identify the cause of tumors in 10% of children and adolescents. Research aims to identify predisposing genes in order to improve the care of patients who carry them.

Finally, scientists hope to develop therapeutic solutions for so-called incurable cancers. According to Gustave Roussy, brainstem invasive glioma (BIIG) remains the most important challenge for pediatric oncologists; a disease considered incurable, with a poor prognosis despite a few exceptions. Very aggressive, the tumor is located in a deep area of ​​the brain that affects vital functions. Cancer cells infiltrate healthy cells, making it inoperable.

Donate to the Gustave Roussy anti-cancer center