Children's Cancer

Melanoma is a type of skin cancer that affects melanocytes, the cells in the outer layer of the skin. Melanocytes form melanin, which is the pigment that gives your skin its colour.

Melanoma is serious because it can spread from the skin to other parts of the body quickly.

Chance of a cure

One of your biggest concerns on learning your child has cancer may be about their chance of being cured.

Due to major advances in treatment, many children treated for cancer now survive into adulthood. Children diagnosed with cancer between 2004 and 2012 have a 5-year survival rate of 85%. In the 1980s, the 5-year survival rate for all cancers was about 73%.¹

Talk to your child’s doctor about your child’s diagnosis, treatments and long-term survival. Long-term survival is also called the outlook or prognosis. It on depends several things, including:

• age of your child at diagnosis
• extent or stage of the cancer
• how the cancer cells look under a microscope (the shape, function and structure of the cells)
• how the cancer responds to treatment
• cancer or tumour biology, which includes
  • the patterns of the cancer cells
  • how different the cancer cells are from normal cells
  • how fast the cancer cells are growing.

To learn more about survival for melanoma in children, visit Australian Cancer Childhood Statistics Online.

References

[1] https://cancerqld.blob.core.windows.net/content/docs/Childhood-Cancer-in-Australia-1983-2015.pdf

Clinical trials

It’s possible that your child may be able to be part of a clinical trial. Clinical trials are research investigations to test new treatments, interventions or tests, as a way to prevent, detect, treat, or manage various diseases or medical conditions. The patients involved in clinical trials are volunteers.¹

With regard to cancer, researchers run clinical trials to test new ways to:

• treat cancer
• find and diagnose cancer
• manage cancer symptoms and treatment side effects.

If a trial is available, taking part in one will be entirely your decision

It’s important to note that new treatments are strictly regulated and must be approved before they can be used in a clinical trial. Your child’s doctor will explain everything about the trial and give you detailed written information. If you wish your child to be part of a trial, you will need to give permission.

Participating in a clinical trial may or may not directly benefit your child but the results of clinical trials today may help children with cancer in the future. If you’re interested in participating in a clinical trial, ask your child’s doctor if there are any suitable trials for your child.

You can find further information on our Clinical trials and research page. 

References

[1] https://www.australianclinicaltrials.gov.au/what-clinical-trial

Diagnosis

When your child is diagnosed with cancer, it can feel overwhelming. This phase involves finding out if your child has cancer, and determining the type of cancer they have. Children’s cancer can be difficult to diagnose, as many symptoms are similar to those caused by less serious conditions, or injuries. This means that your child may need several tests and medical appointments before you receive confirmation that your child has cancer.

If your doctor thinks your child has melanoma , you child will have several tests, including:

• medical history and physical exam
• medical imaging, such as
  • X-ray
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI)
  • positron emission tomography (PET) scan
• biopsy, with tests to help find the best way to treat your child
• lymph node biopsy, also known as a therapeutic lymph node dissection.

Our section, How is cancer diagnosed? explains these tests in more detail.

Staging

Doctors use staging to describe how much the cancer has grown. Some of the tests for melanoma will also help to stage the tumour. Staging determines:

• where the tumour is
• how big the tumour is
• what nearby organs it affects
• if the cancer has spread to other parts of the body.

Your doctor will use this information to determine the best way to treat the disease. Staging will also give your doctor an idea of how well these treatments are likely to work (prognosis). How doctors assess the stage and extent of disease varies. They often describe melanoma in the following stages:

• Stage 0 (melanoma in situ) – doctors find abnormal melanocytes in the skin’s outer layer (epidermis), which have not spread to other layers of the skin.
• Stage I – the tumour is small. It may or may not be ulcerated (broken on the surface).
• Stage II – the tumour is larger. It may or may not be ulcerated.
• Stage III – the cancer has spread to nearby lymph nodes, lymph vessels or skin.
• Stage IV – the cancer has spread to distant parts of the body. These can include the lungs, liver, brain or bone.

Risk factors 

A risk factor is anything that increases a person’s chance of getting a certain condition or disease. Researchers know about some risk factors that increase the chance of developing cancer. However, for most children with cancer, the cause is unknown.

What we do know is that if a child develops cancer, it’s not because of something they, or their parents did to cause it. No one is to blame if a child develops cancer.

Even if your child has a risk factor, it doesn’t mean they will develop cancer. Many children with a risk factor will never develop cancer, while others with cancer may have had no known risk factors. Even if a child with a risk factor develops cancer, the risk factor may not have had much to do with it.

Researchers don’t completely understand what causes melanoma in children. However, some things are linked to a higher chance of getting melanoma.

Exposure to UV light

The main risk factor for melanoma is exposure to UV (ultraviolet) light over a long time. This can be natural sunlight or artificial sunlight (like tanning beds). The risk is higher if your child has:

• fair skin that burns easily
• blue or green eyes
• red or blonde hair
• moles on their skin, especially if some are unusual
• a history of blistering sunburns.

Family history

If other members of the family have unusual moles or have had melanoma, this may increase the chance that your child could develop melanoma.

Genetic conditions

Research links certain genetic conditions with a higher chance of getting melanoma. These include:

• giant melanocytic nevi
• xeroderma pigmentosum
• some immune system disorders
• Werner syndrome
• retinoblastoma.

If your child has one of these genetic conditions, they will need specific care. Your health care team will talk to you about which ongoing tests your child will need.

Childhood cancers with links to genetic conditions may also affect the risk for other family members. You can ask your child’s treatment team if you or your family should get genetic counselling.

To learn more about genetic conditions, see the children’s cancer glossary or the Centre for Genetics Education.

Support and more information 

A diagnosis of cancer in a child is difficult time for all involved. It’s normal for you and your family to feel overwhelmed, scared, anxious or angry.

If or others around you are having trouble coping, make sure you speak to your child’s treatment team. They have helped and supported many other families who have been through what you’re currently going through. Sometimes just letting other people know how you’re feeling helps you feel less alone. If you feel supported, then you will feel more able to support your child.

Most children’s hospitals will allocate a social worker to each family to provide support throughout treatment. If you need support, contact your hospital-based social worker to let them know how you’re feeling and to see what support can be made available to you and your family, including music therapists, play therapists or education support staff.

The following webpages and organisations also offer support and/or extra information for children with cancer and their families:

• Living with children’s cancer has information about physical, emotional and practical issues during and after diagnosis and treatment. 
• Organisations that can provide support and information.
• Redkite is a national organisation that provides emotional support, financial assistance, information and resources to families who have a child with cancer. You can reach them through their support line 1800 733 548 (1800 REDKITE), which is open (9am-7pm AEST), email support@redkite.org.au or live chat on www.redkite.org.au
• Canteen provides a service called Canteen Connect, an online community for young people aged 12-25 dealing with their own or a close family member’s cancer, and Parent Connect, an online community with resources, information and peer support on parenting through cancer. Online counselling is available seven days a week, including evenings. Visit https://canteenconnect.org or call 1800 835 932.
• Melanoma Patients Australia supports children with melanoma, as well as their families.
• Melanoma Institute Australia provides support and information about melanoma.
• The Cancer Council in your state or territory can give you: 
  • general information about cancer 
  • information on resources and support groups in your area. 
• You can call the Cancer Council Helpline from anywhere in Australia on 13 11 20.
• Any of the major children’s hospitals and networks in your state or territory can provide information about childhood cancer.

For more information about sun safety and SunSmart schools and early childhood programs, go to your state Cancer Council website.

For more information about childhood melanoma, see:

• Melanoma treatment (PDQ®) for adults or Unusual cancers of childhood treatment (PDQ®), from the National Cancer Institute (United States).
• Skin cancer – child, from Rare Cancers Australia.

Note that information from international organisations may not always apply to children in Australia.

Symptoms

Many conditions can cause the symptoms below, not just cancer. If your child has any of these symptoms and you are worried, talk to your child’s doctor. The earlier cancer is found, the better.

Symptoms of melanoma may include:

• a new spot on the skin, or a spot that is changing in size, shape or colour
• a mole that
  • changes size, shape or colour
  • is more than one colour
  • has irregular edges or is not symmetrical
  • is itchy, bleeding or oozing
• new moles that grow near other moles
• a sore that does not heal
• spread of pigment from a spot into the surrounding skin.
• change in skin colour.

Treatment

Your team of doctors, called a multidisciplinary team (MDT), will care for and treat your child, and will ensure that all your child’s needs are considered while they have cancer treatment. The section called The treatment team has further  information about this.

Treatment for melanoma depends on:

• the age of your child
• the stage of the cancer
• other factors.

Doctors will suggest treatments based on your child’s situation. Treatment may involve one or more of the following:

• surgery
• targeted therapy.

Surgery

Your child will most likely have surgery to treat melanoma. Your doctor will remove the melanoma and some of the surrounding healthy tissue. If the cancer has spread to nearby lymph nodes, your doctor may take these out as well.

See How is cancer treated – surgery for more detail about cancer surgery.