Recent advances in childhood cancer: Fifty years of progress

Treatment of childhood cancer has been one of the biggest success stories of modern medicine. Today, upto 75% of children with access to optimal medical treatment are cured of cancer, with cure rates of some of the common cancers reaching upto 90%. This can largely be attributed to multimodality, multidisciplinary management. Childhood cancer has provided the most successful model for collaborative research integrated with clinical care and systematic application of evidence based medicine.Depending on the type of cancer and the stage at which it is diagnosed, children may be treated with one or more modalities, including chemotherapy, radiotherapy, and surgery. Various combinations of chemotherapeutic agents have been extremely effective in inducing, consolidating, and maintaining remission. It has also facilitated limb-sparing and organ preserving surgeries for a number of cancers. Growing knowledge of the immunohistological, genetic and molecular characteristics of many types of cancer have facilitated the accurate diagnosis and stratification of patients into risk groups. As a result, children can receive individualized treatment and many low-risk patients can receive less intensive therapy, thus avoiding some of the late sequelae of intensive cytotoxic therapy, such as severe organ damage, infertility, and second malignancies.