Childhood cancer treatment — how it works

Treatment starts with an accurate diagnosis and a team discussion. Before any treatment begins, the biopsy result, imaging findings, and any molecular or genetic test results are reviewed together by a multi-disciplinary team — paediatric oncologists, surgeons, radiation oncologists, pathologists, and sometimes radiologists — in what is called a tumour board meeting. This review decides which treatment is appropriate for your child's specific cancer type, stage, and overall health. You will then be given a written treatment plan that explains each step, the expected sequence, and what to watch for. Nothing starts without your informed understanding and consent.

Chemotherapy uses medicines that target rapidly dividing cells — which cancer cells are. It is the backbone of treatment for most blood cancers such as leukaemia and lymphoma, and it is also used alongside surgery or radiation for many solid tumours. In children, chemotherapy is usually given in cycles with rest periods in between to allow the body to recover. The specific medicines, doses, and schedule are determined by standardised treatment protocols developed through decades of international clinical trials for each cancer type. Side effects depend on the specific combination used and your child's response; your team will monitor these closely and adjust care to manage them. Chemotherapy does not mean a child will lose all hair in every case — the extent of side effects varies considerably.

Many children with solid tumours do need surgery at some point — either to remove the tumour, to take a biopsy sample, or to place a central venous line for chemotherapy. Whether surgery comes first or after chemotherapy depends on the tumour type and location. For kidney tumours (Wilms tumour), surgery is often the primary treatment. For bone tumours and soft-tissue sarcomas, chemotherapy is usually given first to shrink the tumour before a surgeon removes it. Modern paediatric oncology surgery prioritises limb-sparing and function-preserving approaches wherever possible. Your surgical team will explain the planned approach, what to expect, and the recovery process before any operation takes place.

Radiation therapy uses high-energy beams directed precisely at tumour cells to damage their DNA and stop them dividing. In paediatric oncology, radiation is used selectively because growing bodies are more sensitive to radiation than adults are. It is most commonly used for brain tumours, Hodgkin lymphoma, Ewing sarcoma, and certain other solid tumours — and usually only after chemotherapy and/or surgery. When it is necessary, modern techniques such as proton therapy and intensity-modulated radiation therapy (IMRT) focus the beam as precisely as possible to reduce exposure to surrounding healthy tissue. Your radiation oncologist will discuss whether radiation is part of your child's plan, the technique that will be used, and what to expect during and after treatment.

Treatment length varies enormously depending on the cancer type and stage. Leukaemia treatment typically spans two to three years in total — an intensive initial phase followed by a longer maintenance phase. Many solid tumours are treated over a period of six to twelve months, covering surgery, chemotherapy cycles, and sometimes radiation. After active treatment ends, children enter a follow-up phase with regular check-ups, blood tests, and scans to monitor for response, detect any return of disease early, and manage longer-term effects. Your oncology team will give you a clear timeline specific to your child's treatment plan at the outset.

A diagnosis of childhood cancer affects the whole family, not just the child. Most paediatric oncology centres have a wider support team alongside the medical team — including child life specialists, nutritionists, psycho-oncologists, and social workers. Nutritional support is important because children need adequate intake to tolerate treatment and maintain growth. Psychological support — for the child, siblings, and parents — is equally important and is not a sign of weakness; it is a recognised part of good cancer care. Ask your team about all the services available to you. At CION, our 45-minute consultations are designed to give you time to ask every question, and we walk this journey with you from diagnosis through follow-up.