Young Promise
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By Ann Giordano (photographs) and Jenny Song (text)

Young Promise

A personal look at pediatric cancer

By Ann Giordano (photographs) and Jenny Song (text)


In August 2005, 9-year-old Valeria Reyes-Rivera’s prognosis looked poor. Her stage III brain tumor had grown from 4 centimeters to 7 centimeters, despite radiation and chemotherapy treatment at New York University Medical Center.

Valeria’s parents, Nayda Rivera and Gerardo Reyes, were told the treatment wasn’t working. Doctors at two other prominent New York City hospitals gave similar opinions. “They said it wouldn’t be worth it to give any treatment and it would be better to go for quality of life,” recalls Valeria’s mother. “We declined that option.”

When the parents heard about a clinical trial at New York City’s Memorial Sloan-Kettering Cancer Center for which Valeria was eligible, they quickly enrolled their daughter.

“We started our first dose on Aug. 29,” says Nayda Rivera. A year into the trial, her daughter’s tumor is now 2 centimeters.

The family’s decision to treat Valeria with an experimental therapy isn’t unusual. About 70 percent of pediatric cancer patients are enrolled in National Cancer Institute–sponsored clinical trials. In contrast, less than 5 percent of eligible adults with cancer join trials.

Participation by children in clinical trials over the last 40 years has markedly increased the pediatric cancer survival rate, says pediatric oncologist Paul Meyers of Memorial Sloan-Kettering. According to the American Cancer Society, the current five-year survival rate for childhood cancer is nearly 80 percent. Before the 1970s, the rate was less than 50 percent.

Clinical trials showed researchers that children are generally responsive to chemotherapy, says Anna T. Meadows, a pediatric oncologist at the Children’s Hospital of Philadelphia. “So over the years, we learned that using chemotherapy for very large tumors could enable doctors to give less radiation and perform less mutilating surgery. And that’s very important in children, who have many years of successful life ahead.”

While progress in childhood cancer survival has been substantial, there’s still much to accomplish. “We cure about 75 percent to 80 percent [of pediatric patients], depending on the disease,” says Meadows. “But there’s the 20 percent not now being cured, so efforts are being made to treat those patients in a better way.”

Research is ongoing to investigate how best to reduce the intensity of therapy for some children while maintaining its effectiveness. Other research aims to make some young patients’ treatments more aggressive. Completely new therapies are under consideration, too. According to Meyers, one emerging area of research for pediatric cancer focuses on new drugs that interact with very specific targets in children’s tumors, similar to drug therapy being developed for adult cancers. “The same kind of thing exists for pediatrics, if we can find it,” he says.

In this issue of CR, we look at the face of pediatric cancer through four children who have undergone treatment at Memorial Sloan-Kettering. Last July, CR visited the recreation center there for a photo shoot, during which Valeria, Hazen Kennedy, 5, Leila Biberaj, 4, and Daniel Singh, 13, shared their artwork, songs and poems—and gave us a glimpse of life with cancer through the eyes of a child.



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