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Kids and Cancer: Why Pediatric Cancer Cure Rates Have Improved So Much

January 12, 2012 at 12:00 AM EST
Four decades ago, President Nixon signed a law that would change the way cancer research was funded in an effort to develop better treatments and cure more patients. Health correspondent Betty Ann Bowser explores the positive developments pediatric cancer research has realized in the last 40 years.
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JUDY WOODRUFF: Now to the first of a two-part report about how patients and their doctors are faring in their efforts to cure or manage different cancers.

It’s been four decades since President Nixon signed a law that would change the way cancer research was funded, in an effort to develop better treatments.

Tonight, NewsHour health correspondent Betty Ann Bowser looks at what’s happening in the battle against pediatric cancer.

BETTY ANN BOWSER: Sixteen-year-old Kate Albrecht knows this drill all too well. After she lies down on the table, a big machine called a linear accelerator delivers high-energy radiation to shrink and kill the cancer cells she has from stage four Hodgkin’s lymphoma.

While most teenaged girls busy themselves with boyfriends and text-messaging, Albrecht’s days have been filled with more sobering activities, three months of chemotherapy followed by these radiation treatments. The cancer was discovered last summer.

KATE ALBRECHT, Hodgkin’s Lymphoma survivor: I was totally surprised that I even had cancer. It wasn’t something that I was expecting.

BETTY ANN BOWSER: Nobody saw it coming. Except for a slight cough, Albrecht had been an active, healthy competitive runner and skier in Lake Tahoe. But after the diagnosis, Albrecht and her mother, Linda, moved temporarily to Palo Alto to have treatment at Lucile Packard Children’s Hospital at Stanford University.

LINDA ALBRECHT, mother of Kate Albrecht: How about this one, you and your grandpa?

KATE ALBRECHT: I actually like that one, even though I have no hair.

LINDA ALBRECHT: That’s a pretty cute picture of you.

BETTY ANN BOWSER: Today, Albrecht is counting the days until her red hair grows back. Her prognosis is excellent. And her mother, who’s been at her side through all the treatment, is optimistic.

Forty years ago, if this had happened, what do you suppose the two of you would have been looking at?

LINDA ALBRECHT: Oh, boy. Definitely not as good a prognosis as we have had. I don’t know what they would have done 40 years ago, as far as all the drugs and treatments that they’ve come up with. They didn’t have that then. So, we may have been looking at something a whole lot scarier.

BETTY ANN BOWSER: You will get no argument from cancer researchers on that point. Forty years ago, more Americans were dying from cancer than all the people killed in World War II.

But, in 1971, the National Cancer Act was signed. It provided billions of federal dollars for cancer research and became known as the war on cancer.

DR. MICHAEL LINK, American Society of Clinical Oncology: how are you?

BETTY ANN BOWSER: Dr. Michael Link was a young pediatric oncologist 40 years ago. Today, he’s one of Albrecht’s doctors at Stanford and the current president of the American Society of Clinical Oncology.

DR. MICHAEL LINK: At that time, we were curing about 40 percent of children with cancer. And in that interval, in that past 40 years or 35 years that I have been on scene, the cure rates have improved dramatically, such that now we cure probably 80 percent of all children with cancer. And we cure almost 90 percent of children with acute lymphoblastic leukemia, the most common childhood cancer, and a disease that was absolutely incurable in the 1960s.

BETTY ANN BOWSER: One of the discoveries that has led to success with children was learning the nature of the disease, something that was not fully understood 40 years ago.

DR. MICHAEL LINK: Cancers are diseases of our genetics, of our DNA. And we develop mutations in those cancer cells. And those mutations are what cause the cancer and what drive the cancer. And we now understand, for example, in a disease like leukemia, that there are multiple different types of leukemia, even though they look the same under the microscope, which are driven by a different one of these DNA mutations.

BETTY ANN BOWSER: Understanding the nature of cancers also led oncologists to learn that childhood cancers are genetically less complex than most adult cancers and respond better to both chemotherapy and radiation treatment.

But there was a time when doctors didn’t have the resources they do today to target specific gene mutations with drugs. One of Link’s first patients was Nancy McGee, diagnosed in 1978 with stage four Hodgkin’s lymphoma, just like Kate Albrecht. Back in those days, oncologists tried to kill the cancer in children without killing the patient first.

McGee has vivid, painful memories of all that.

NANCY MCGEE, Hodgkin’s Lymphoma Survivor: They put me into radiation. That was first — and then from there into chemo, which was — I wouldn’t put that on my worst enemy. That’s what, in my mind, almost killed me. I didn’t have all my treatments because it was literally killing me. I was 100 pounds, and I went down to 64 pounds. Yeah. I was skin and bones, literally. I wasn’t eating, because I was constantly sick.

BETTY ANN BOWSER: Dr. Link remembers those days, too.

DR. MICHAEL LINK: In the 1970s, we were desperate to have therapies that worked. And she was lucky to have a disease like Hodgkin’s disease, which was responsive to radiation and chemotherapy. And so we threw the book at her, if you will, to try to cure. And she presented with very advanced-stage disease.

BETTY ANN BOWSER: Today, at 46, McGee is a lab manager at Stanford University’s School of Medicine.

But like most of the pediatric cancer survivors of the 1970s, she has paid a high price for survival. She’s had thyroid cancer, skin cancer and, in 2001, the biggest scare. A routine mammogram identified very early breast cancer.

McGee could have settled on a more conservative treatment, but, because of her previous radiation exposure, she opted for a double mastectomy.

NANCY MCGEE: I could not have a lumpectomy and radiation. I had to have a mastectomy. And as soon as I heard that I had breast cancer, I already knew in the back of my head I was having a double. I wasn’t going to go through this twice, because I was heavily radiated on my right side. The breast cancer was on the left side of my left breast. So it wouldn’t be if Nancy gets it on the right side, it’s when.

NANCY MCGEE: Dr. Link, hi!

DR. MICHAEL LINK: How are you?

BETTY ANN BOWSER: Today, 32 years after being first diagnosed, McGee still sees Dr. Link and takes part in clinical trials.

DR. MICHAEL LINK: We’ve probably learned more from you than almost anybody else. You have had like every possible — every possible thing that we see, so it was worth it.

NANCY MCGEE: I’m here. I was put on this planet for some reason. I’m still trying to figure out what. But, you know, I have a son, who I adore.

I never knew if I would have kids. Back then, I don’t know if they really knew what chemo would do to a reproductive system of a 13-year-old child. So, when I conceived my son, it was like, in my mind, a miracle. You know, and so I just say, hey, carpe diem. I just — I seize the day. I live each day to the fullest that I can, try to be happy.

BETTY ANN BOWSER: In the last decade, Dr. Link has seen the benefits of clinical trials, in which as many as 80 percent of all children with cancer participate.

DR. MICHAEL LINK: For the next generation of the Nancys that come to us for treatment, we are going to do a better job. We’re going to do it with less morbidity, less complication, and hopefully so that they can have an improved quality of life.

This is way more complicated than we thought. Cancer is not one disease. Cancer is a multitude of diseases. The future is based on really understanding this molecular basis or the genetics and the DNA damage that causes cancers. We’re understanding what are the — what drives the cancer. And we’re trying to develop very, very specific drugs that target those — that target those specific abnormalities.

BETTY ANN BOWSER: While doctors like Link are excited about curing more pediatric cancers, many adult cancers remain stubbornly resistant, with no cures in sight.

JEFFREY BROWN: On our website, we’re collecting photos of your connections to childhood cancer. You can find instructions on how to participate on our health page.

And Betty Ann’s next report looks at some of the adult cancers and what’s being done to find breakthrough treatments.