Living in fear of my child's cancer returning

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Living in fear of my child's cancer returning

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The issue of when you can feel comfortable that a child's cancer will not come back is a very tricky one. And it really depends on the kind of cancer. I'll give you an example. The first of all, the longer you are from the end of treatment, without recurrence, the less and less chance there is of having recurrence. That's a general principle. But, certain cancers sometimes they can occur 5 or 10 or even as long as 15 years after the initial cancer was treated. Most cancer will, however, come back fairly quickly. And generally, within 3 to 5 or 6 years, most of the aggressive cancers have not come back, the chances that you're going to see it come back again are essentially zero or pretty close to zero. There are some, as I said, where you can get delayed recurrence. When we talk to families we tell them what particular risk of recurrence is for their cancer. So, for instance, if it's Acute Lymphoblastic Leukemia, where in fact the survival is now about 90%, we will tell them, at the end of treatment, that your chances for recurrence is somewhere in the range of few percents, 10%, 15%. If they are 2 or 3 or 4 years out from the end of treatment, their chances are down to 1 or 2%. And beyond that probably go down to close to 0. So, it really depends on the kind of cancer and how far you are away from it. But, there is a point where you can comfortably say that "That original cancer, we do not think it's going to come back." Remember, that we always have to worry about second different cancers that are caused by the treatment, particularly radiation, that we always need to be on guard for.

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Stuart E. Siegel, MD

Director, Children’s Center for Cancer & Blood Diseases, Children's Hospital Los Angeles

Before recently shifting his focus to international medicine, Stuart Siegel, MD, was Chief of the Division of Hematology/Oncology for 35 years and the founding director of the the Children’s Center for Cancer & Blood Diseases at Children’s Hospital Los Angeles, and Professor and Head of the Division of Hematology-Oncology Department of Pediatrics, Keck School of Medicine of University of Southern California. He remains a leader in supportive care and research in pediatric oncology, with a special focus on neuroblastoma, non-Hodgkin lymphoma, Ewing Sarcoma, acute lymphoblastic leukemia and brain tumors. From developing the first pediatric protective environment in 1971 for children undergoing intensive chemotherapy, to pioneering current efforts to develop academic and clinical care programs nationally and locally for adolescents and young adults with cancer, Dr. Siegel’s contributions have revolutionized the field of pediatric oncology. Dr. Siegel has been honored for his work by the American Cancer Society, Children Foundation, the Cancer Foundation, the Chase Foundation, Padres Contra El Cancer, the Israel Cancer Research Fund and Ronald McDonald House Charities, where he is a member of the National Board, and has consistently been listed among the nation’s top doctors in such publications asAmerica’s Top Doctors and Best Doctors in America. He is a father of one son, Joshua; grandfather of David and Elijah; and lives in Pacific Palisades with his wife of seven years.

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