By 2040, all childhood cancer patients will survive, says top Israeli physician

‘I say to every parent that our goal is for your child to become a grandparent,’ Prof. Shai Izraeli tells ‘Post’

By 2040, all children who are diagnosed with cancer will survive, according to Prof. Shai Izraeli, director of the Department of Hematology-Oncology at Schneider Children’s Medical Center in Petah Tikva.

“I say to every parent that our goal is for your child to become a grandparent,” he told The Jerusalem Post, “which means our aim is to cure every child with cancer.”

When Izraeli was growing up, he said that most children with cancer died. By the time he was in medical school in the 1980s, the survival rate had increased to around 30%. Today, overall, 83% of childhood cancer patients become long-term survivors.

“When you talk about specific cancers, like Hodgkin lymphoma and standard-risk acute lymphoblastic leukemia, the rate of survival is more than 90%,” he said.

According to the National Cancer Institute, a division of American’s National Institute of Health, improved treatments introduced beginning in the 1960s and 1970s raised the five-year survival rate for children diagnosed with acute lymphoblastic leukemia at ages 0 to 14 years from 57% in 1975 to 92%. Similarly, the fiveyear survival rate for children diagnosed with non-Hodgkin lymphoma at ages 0 to 14 years has also increased, from 43% in 1975 to 91%.

There are several reasons for Izraeli’s optimism, he said, and the first is improved genomics, which allows doctors to better understand the interactions between genes and the environment, and provide a more precise diagnosis.

The second is better diagnostic tools that allow doctors to get a better view into how patients are responding to treatments and improves their ability to provide personalized care.

Finally, several new drugs and drug combinations are being developed, he said.

Izraeli noted that while in the past pharmaceutical companies were less inclined to develop drugs for children with cancer, since it is much rarer than in adults, changes in Food and Drug Administration and European Medicines Agency regulations have shifted this reality.

Approximately 1 in 285 children in the US will be diagnosed with cancer before their 20th birthday, according to the American Childhood Cancer Association. In Israel, 300 to 400 children with cancer are diagnosed each year, according to the Israel Cancer Association.

In Israel, the most prevalent kinds of cancer are leukemia, malignant brain tumors and cancer of the lymph nodes.

Izraeli said childhood cancer is different from adult cancer in that “in adults, the cause of cancer is mainly getting old. The older we get, the more wear and tear, more exposure to carcinogens, and more likely we are to get cancer.”

He said that in contrast, cancer in children is “bad luck,” usually the result of rare accidents during embryonic development or growth. Furthermore, treating childhood cancer is easier, as the tumors tend to be biologically simpler, because they have had less time to develop.

“A three-year-old with leukemia only had three years and nine months to develop it,” Izraeli said. “On the other hand, we know that leukemia in a 50-year-old could have been brewing for the last 50 years.”

He added that international collaboration in the field of childhood cancer is “organized” and consistent, as opposed to with adult cancer treatments, which seem to be more diverse and fragmented.

But surviving cancer is not the only goal, Izraeli admitted, saying that the next phase is working on how to lower the toxicity of treatments and make them more precise, he said.

Several recent studies have shown that while the cancer is cured, childhood cancer survivors are not necessarily healthy.

One study published in the Journal of the American Medical Association found that a large percentage of 1,700 people ages 18 to 60 who were treated with chemotherapy, radiation or both had problems in the year ahead. These included hearing loss (62%), abnormal cholesterol levels (61%), male infertility (66%), hormonal dysfunction (61%) and abnormal lung function (65%), among other complications.

“Will cancer ever be eradicated completely?” an article published on the site Cancer Research UK asks. The answer: Cancers do not have a single cause, and not all cases are preventable.

“But it’s not just about prevention,” Professor Richard Martin, a Cancer Research UK-funded expert on cancer prevention at the University of Bristol told the website. “It is about reducing the burden of cancer when it’s there. And we’re making great progress.”