Carcinoma Treatment

Carcinoma is a cancer that forms in the skin and tissues lining or covering organs such as the heart, kidneys, and lungs. The main types of carcinomas seen in children and adolescents include:

• Adrenocortical carcinoma (ACT) (See adrenocortical tumors)
  • Occurs in the adrenal cortex, the outer layer of the adrenal gland (located at the top of each kidney), which makes hormones (substances that send message to the body and help the body work properly) 
  • Causes the adrenal gland to make too much or too little of one or more hormones, with symptoms related to the cancer’s location
    
• Thyroid carcinoma (See endocrine tumors): 
  • Occurs in the thyroid gland, located in the neck
    
  • A healthy thyroid gland helps control heart rate, body temperature, energy level, body weight, and calcium levels in the blood
    
• Nasopharyngeal (nose and throat) carcinomas
  • Start in the upper part of the throat (pharynx) behind the nose

Carcinomas are rare in children. In the United States, fewer than 1,000 children and adolescents are diagnosed with carcinoma each year. Most of these are adolescents.

The most common pediatric carcinomas are thyroid carcinomas. Of those, the differentiated thyroid carcinomas are most common.

Carcinoma symptoms

• Adrenocortical carcinoma symptoms differ depending on whether the cancer has spread and the amount and type of hormones made by the tumor. Symptoms may include:
  • A lump in the abdomen (belly)
  • Pain in the abdomen or back
  • A feeling of fullness
  • Changes in genitals
  • Excessive hair growth
• Thyroid carcinoma symptoms may include:
  • A lump on the neck that can be felt beneath the skin
    
  • Increasing hoarseness and other voice changes
  • Problems swallowing
  • Pain in the neck and throat
  • Swollen lymph nodes (small glands that help fight infection) in the neck
• Nasopharyngeal carcinoma can cause a lump in the neck if the cancer spreads to nearby lymph nodes. Other symptoms include:
  • Hearing loss, ringing in the ears (tinnitus), and/or a feeling of fullness in one or both ears
    
  • Frequent ear or sinus infections
  • Nosebleeds
  • Stuffy nose
  • Headaches
  • Pain or numbness in the face
  • Problems opening the mouth to talk or eat

Carcinoma treatment

Carcinoma treatment varies widely based on the tumor’s type, location, spread (if any) outside the original site, and its effect on body functions. Treatment may include:

• Surgery - used to both diagnose and treat carcinomas: 
  • A biopsy (removing a tissue sample to test for disease) is done to determine the tumor’s type and grade (how advanced it is).
    
  • If the biopsy finds cancer cells and your child is still in surgery, the surgeon may take out as much of the tumor as can be removed safely. Chemotherapy and radiation therapy may be used to kill remaining cells.
    
• Chemotherapy (chemo) - uses powerful medicines to kill cancer cells or stop them from growing (dividing) and making more cancer cells: 
  • Chemo may be injected into the bloodstream so that it can travel throughout the body.
    
  • Some chemo may be given by mouth.
    
  • Combination therapy uses more than 1 type of chemo at a time.
    
• Radiation therapy - uses high-energy x-rays or other types of radiation to kill cancer cells or stop them from growing: 
  • External radiation uses machines outside the body to deliver the x-ray dose.
    
  • Internal radiation uses needles, seeds, wires, or catheters to deliver the radiation directly into or close to the cancer.
    
  • Some types of thyroid cancer treatment use radioactive iodine to find where the cancer may have spread and to help treat any cancer that is left after surgery.
    
• Chemoradiotherapy - a combination of chemo and radiation has also been used for nasopharyngeal carcinoma.
  
• Adrenolytic agents – sometimes, medicines that stop the adrenal gland from making certain hormones are used to treat carcinoma. 
  

Carcinoma prognosis

Survival rates vary depending on the type of carcinoma, its location, and the length of time before it is found and treated. Five-year survival rates for common carcinomas include: 

• Adrenocortical tumor: greater than 85% if caught early and removed completely 
• Thyroid carcinomas: around 98% 
• Nasopharyngeal carcinomas: around 70% 

Every cancer is unique. Each patient’s prognosis depends on factors including tumor size and location. Your child’s care team can help you understand their prognosis in more detail.   

Carcinoma care at St. Jude

St. Jude provides the highest quality of care for patients with carcinoma: 

• St. Jude is the only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. 
  
• The nurse-to-patient ratio at St. Jude averages 1:3 in oncology, and 1:1 in the Intensive Care Unit. 
• At St. Jude, your child’s care team includes doctors working to cure the disease and services in nutrition, rehabilitation, neurology, surgery, nursing, education, endocrinology, and psychology. This expert team supports each child through diagnosis, treatment, and recovery.  
• Complete, quality surgery is an important part of treating carcinomas. Cancer surgery in children requires expertise because of the risks involved. Excellence in care before, during, and after surgery is key. The expert skills and experience of St. Jude specialty surgeons help improve patients’ chances for best outcomes. 
  
• St. Jude brings together the minds and efforts of doctors and scientists focused on treating childhood cancers. For example, St. Jude scientists created an adrenal tumor model in the lab. Scientists use this model to test drugs for adrenocortical tumors. St. Jude doctors and scientists from the clinic and the lab regularly meet together to discuss the best new ideas for treating this cancer. 
  
• Researchers at St. Jude found specific mutations (changes) in the TP53 gene that increase the likelihood that a person will develop adrenocortical tumors. 
  
• In 1990, St. Jude developed the International Pediatric Adrenocortical Tumor Registry (IPACTR), which collects data about children and teens around the world who have adrenocortical tumor or ACT. IPACTR provides a central place to store and share data and tumor samples. Information from this registry helps scientists understand adrenocortical tumors and their risks and outcomes. It also helps doctors determine the best ways to treat these tumors. 
  
• St. Jude is actively studying the gene changes in the tumor and in patients, which may help scientists find new and better ways to treat patients with rare tumors. 
  
• St. Jude has its own Thyroid Tumor Program. This multidisciplinary program involves oncology, ENT, endocrine, nuclear medicine, and cancer genetics. These teams work together to treat and consult patients with thyroid tumors and nodules. The program has a monthly tumor board meeting to discuss new, active, and consult patients.  
  
• The St. Jude Head and Neck Tumor Program is a multidisciplinary program that takes care of patients with diagnoses that include malignant and benign destructive tumors of the face, paranasal sinuses, mouth, throat, salivary glands, thyroid and parathyroid glands, neck, jaw, and ear/temporal bone. These tumors and sites require complex and intricate approaches that are best achieved by a team dedicated to these types of patients. The program works with your child’s primary care team to care for your child. The program also holds clinics and conferences that focus on difficulty swallowing, voice changes, hearing loss, and facial reconstruction. 

Carcinoma clinical trials

St. Jude clinical trials have produced new, groundbreaking treatments for serious childhood illnesses. Carcinoma patients take part in clinical trials that use some of the most advanced treatments available. Our doctors and scientists work together to find better ways to treat patients. Many times, new treatments are being developed right here on our campus where your child gets care. 

First, we may use therapies that are commonly used to treat your child’s tumor. If these standard treatments do not work, your child may be eligible to enter a clinical trial that uses a new therapy or existing therapies in a new way.    

We also take part in trials developed by the Children’s Oncology Group (COG) and the Pediatric Brain Tumor Consortium (PBTC). Many of our faculty members play key roles in developing these large trials that take place at centers all over the United States.  

Learn more about clinical research at St. Jude and solid tumor clinical trials.    

Contact us

You can start the referral process by letting your physician know you would like a second opinion from St. Jude. Your health care provider can contact our 24-hour beeper service, or contact our solid tumor coordinator.

Learn more