| Chapter 1: | Introduction |
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Cancer in childhood is rare, with only 1 or 2 children per 10,000, or 0.01%–0.02% of all children, diagnosed with cancer each year (Moore, 2005). Nevertheless, cancer is the leading cause of death by disease in children (Brown, 2006). Approximately 8,000 children and 11,500 adolescents were diagnosed with cancer in the United States in 1999 (Castellino & Hudson, 2002), suggesting that each year, approximately 20,000 youths in total are diagnosed with cancer. Over the past 30 years, however, 5-year survival rates have also improved markedly, from less than 50% before the 1970s to nearly 80% today (American Cancer Society, 2007). Rates do vary considerably depending on cancer type, though, such that for the most recent time period (1996–2002), 5-year survival for neuroblastoma was 69%, 72% for bone and joint cancers, 74% for brain and other CNS cancers, 81% for leukemia, 86% for non-Hodgkin’s lymphoma, 92% for Wilms’ tumor, and 95% for Hodgkin’s lymphoma (American Cancer Society, 2007). This improvement in survival rates is due to significant advances in treatment, resulting in cure or long-term remission for a substantial proportion of children with cancer.
Given such dramatically improved survival rates, cancer has come to be known as a chronic illness as opposed to a terminal illness. Nevertheless, a diagnosis of pediatric cancer remains one of the most stressful situations a child and family must face. Treatments remain lengthy and intensive and often involve fundamental changes in the child and family’s lives (Kupst & Bingen, 2006). In particular, a diagnosis of cancer in adolescence occurs at a critical time of social and interpersonal development.