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Appendix B

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Causes and risk factors, including environmental risks * According to the American Cancer Society (2013) states, “A risk factor is anything that affects your chance of getting a disease such as cancer” (American Cancer Society, 2013). “There are a few known risk factors for childhood leukemia” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Genetic risk factors are those that are part of our DNA (the substance that makes up our genes)” (American Cancer Society, 2013). The genetic risk factor is what we get from our parents that is most of the time inherited (American Cancer Society, 2013). “Most cases of leukemia are not linked to any known genetic causes” (American Cancer Society, 2013). * Other risk factors of leukemia would be “inherited disorders, this can increase a child’s risk of developing leukemia” (American Cancer Society, 2013). Here is a listed of syndromes: “Down syndrome (trisomy 21), Klinefelter syndrome, and Li-Fraumeni syndrome” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Certain inherited diseases cause children to be born with immune system problems” (American Cancer Society, 2013). “These include: Ataxia telangiectasia, Wiskott-Aldrich syndrome, and Bloom syndrome” (American Cancer Society, 2013). * According to the American Cancer Society (2013) states, “Lifestyle-related risk factors are important in many adult cancers, but they are unlikely to play a role in most childhood cancers” (American Cancer Society, 2013). “Environmental risk factors are influences in our surroundings, such as radiation and certain chemicals that increase the risk of getting disease such as leukemias” (American Cancer Society, 2013). Environmental risk factors would include: “Radiation exposure, exposure to chemotherapy and certain other chemicals, and immune system suppression” (American Cancer Society, 2013). *
Prevention and detection * According to the American Cancer Society (2013) states, “Most adults and children with leukemia have no known risk factors, so there is no sure way to prevent their leukemias from developing” (American Cancer Society, 2013). “Some leukemias result from treating cancers with radiation and chemotherapy, or the use of immune-suppressing drugs to avoid rejection of transplanted organs” (American Cancer Society, 2013). “Doctors are looking for ways to treat patients with cancer and organ transplants without raising the risk of leukemia” (American Cancer Society, 2013). “But for now, the obvious benefits of treating life-threatening disease with chemotherapy, radiation therapy, or organ transplants must be balanced against the small chance of developing leukemia several years later” (American Cancer Society, 2013). “There are very few known lifestyle-related or environmental causes of childhood leukemias, so it is important to know that in most cases there is nothing these children or their parents could have done to prevent these cancers” (American Cancer Society, 2013). “The best way to find these cancers early is to pay attention to the possible signs and symptoms of this disease” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Childhood leukemia is often found because a child has symptoms that prompt a visit to the doctor, and blood test results are abnormal, which then points to the diagnosis” (American Cancer Society, 2013). If there is an increased risk of leukemia, “most doctors recommend careful, regular medical checkups and possibly other tests” (American Cancer Society, 2013). The signs and symptoms of childhood leukemia would include: fatigue (tiredness), pale skin, infections and fever, easy bleeding or bruising, bone or joint pain, swelling of the abdomen (belly), and loss of appetite or weight loss” (American Cancer Society, 2013) Other signs and symptoms include: “swollen lymph nodes, coughing or trouble breathing, swelling of the face and arms, headache, seizures, vomiting, rashes, gum problems, and extreme fatigue, weakness” (American Cancer Society, 2013). * * *
How the cancer affects the body
According to the American Cancer Society (2013) stated, “Childhood cancers are often the result of gene changes inside cells that take place very early in life, sometimes even before birth” (American Cancer Society, 2013). “Unlike many cancers in adults, childhood cancers are not strongly linked to lifestyle or environmental risk factors” (American Cancer Society, 2013).
According to the American Cancer Society (2013) stated, “Leukemia is a cancer that starts in early blood-forming cells” (American Cancer Society, 2013). “Most often, leukemia is a cancer of the white blood cells, but some leukemias start in other blood cell types” (American Cancer Society, 2013). “Any of the cells from the bone marrow can turn into a leukemia cell” (American Cancer Society, 2013). According to the American Cancer Society (2013) stated, “Once this change takes place, the leukemia cells don’t go through the normal process of maturing” (American Cancer Society, 2013). There are changes that leukemia cells can quickly reproduce themselves and not die when they are suppose too (American Cancer Society, 2013). “They survive and build up in the bone marrow, crowding out normal cells” (American Cancer Society, 2013). “In most cases, the leukemia cells spill into the bloodstream fairly quickly” (American Cancer Society, 2013). “Almost all childhood leukemia is acute leukemias” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Acute lymphocytic (lymphoblastic) leukemia (ALL): About 3 out of 4 cases of childhood leukemia are ALL and this starts form the lymphoid cells in the bone marrow” (American Cancer Society, 2013). “Acute lymphocytic (lymphoblastic) leukemia (ALL), the most common type of childhood leukemia, develops from early forms of lymphocytes” (American Cancer Society, 2013). “Although both B cells and T cells can develop into leukemia, B-cell leukemias are much more common than T-cell leukemias” (American Cancer Society, 2013). * *
Treatment options * According to the American Cancer Society (2013) states, “Children with leukemia and their families have special needs, these needs can be met best by cancer centers for children, working closely with the child’s primary care doctor” (American Cancer Society, 2013). “Treatment in these centers gives you the advantage of having teams of specialists who know the differences between cancers in adults and those in children” (American Cancer Society, 2013). “For childhood leukemias, this team is typically led by a pediatric oncologist, a doctor who uses chemotherapy and other medicines to treat children’s cancers” (American Cancer Society, 2013). “The team usually includes pediatric oncologists, surgeons, radiation oncologists, pathologists, pediatric oncology nurses, and nurse practitioners” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Most children with cancer in the United States are treated at a center that is a member of the Children’s Oncology Group (COG)” (American Cancer Society, 2013). “All of these centers are associated with a university or children’s hospital” (American Cancer Society, 2013). “As we learned more about treating childhood cancer, it has become even more important that treatment be given by experts in this area” (American Cancer Society, 2013). “Any time a child or teen is diagnosed with cancer, it affects every family member and nearly every aspect of the family’s life” (American Cancer Society, 2013). * According to the American Cancer Society (2013) states, “Treatment of acute forms of childhood leukemia (lymphocytic and myeloid) is usually very intensive, so it is important that it takes place in a center that specializes in treating childhood cancer” (American Cancer Society, 2013). * Your child’s doctor should make sure that treatment reflect your child’s risk group (based on certain prognostic factors) and that he or she will be treated according to a protocol or guidelines of the National Cancer Institute or a cooperative study group (American Cancer Society, 2013). * According to the American Cancer Society (2013) states, “Some children with leukemia are critically ill when they are first diagnosed with leukemia” (American Cancer Society, 2013). Children may become critically ill when “a shortage of normal white blood cells might lead to very serious infections” (American Cancer Society, 2013). The child might experience “low levels of platelets or clotting factors in the blood can cause severe bleeding” (American Cancer Society, 2013). “Not having enough red blood cells can lower the amount of oxygen getting to body tissues and put a tremendous strain on the heart” (American Cancer Society, 2013). All of “these problems must often be addressed before treatment of the leukemia can begin” (American Cancer Society, 2013). “Antibiotics, blood growth factors, and transfusions of platelets and red blood cells may be given to treat or help prevent some of these conditions” (American Cancer Society, 2013). Leukemia cells move from bone marrow to other parts of the body thru the blood and surgery can’t help with treating leukemia (American Cancer Society, 2013). To find out if the child has leukemia many doctors order a lymph node biopsy which will tell you if the child has leukemia or not (American Cancer Society, 2013). The most common treatment for leukemia in children would be chemotherapy” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Chemotherapy (chemo) is treatment with anti-cancer drugs that are given into a vein, into a muscle, into the cerebrospinal fluid (CSF), or taken as pills” (American Cancer Society, 2013). This type of treatment is the best and most common type of treatment for young children because the medicine goes directly into the blood stream of the body and it is able to reach all parts of the body (American Cancer Society, 2013). Most doctors will give the chemotherapy treatments in different cycles because of the need for the child’s body to recover from the chemo before the next treatment (American Cancer Society, 2013).”In general, treatment for acute lymphocytic leukemia (ALL) uses lower doses of chemo over a longer period of time, which is usually 2 to 3 years” (American Cancer Society, 2013). A list of drugs that are used to help treat childhood leukemia would include: “Vincristine (Oncovin), Daunorubicin, Doxorubicin, Cytarabine, L-asparaginase, PEG-L-asparaginase, Etoposide, Teniposide, 6-mercaptopurine, 6-thioguanine, Methotrexate, Mitoxantrone, Cyclophosphamide, Prednisone, and Dexamethasone” (American Cancer Society, 2013). * There are a few possible side effects of using chemotherapy as treatment for your child but it is worth it as long as it kills the cancer cells (American Cancer Society, 2013). * According to the American Cancer Society (2013) states, “The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken” (American Cancer Society, 2013). * * The side effects would include: Hair loss, mouth sores, loss of appetite, diarrhea, nausea and vomiting, increased risk of infections (because of low white blood cell counts), bruising and bleeding easily (from low platelet counts), and fatigue (caused by low red blood cell counts)(American Cancer Society, 2013). * * * * * *
Name and contact information of at least one support group…...

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