Having a life-threatening illness like leukemia as a child can have a lasting impact on both the child and family.

Although you and your child may not completely forget the experience, it can become a small part of her life as she moves forward. Your childs behaviour and emotional health can influence how well she does in the long run.

Age makes a difference

Depending on your childs age at diagnosis, current age, gender, and the life transitions she experiences as a survivor, she may respond in different ways at different times throughout her life after completing leukemia treatment. Young children Because younger children may understand the implications of their disease to a lesser extent than adolescents, they tend to adjust better. However, they can still become socially withdrawn. When children miss time at school because they are in hospital, their existing relationships with friends or ability to make new friends may be compromised. The same holds true if they cannot participate in similar activities as their friends. Classmates may also feel uncomfortable around peers with medical conditions, and may treat them differently if they do not understand their condition. Adolescents Adolescents can understand the implications of their disease and may experience a variety of thoughts and emotions. For example, they may desire to move beyond the cancer experience, or may become depressed or anxious after treatment. Adolescents are also learning many skills that are important for their development. One such important skill is learning to become more independent. Being a survivor of paediatric cancer can influence how prepared and how well equipped teens are to learn these skills. For example, your child will have to become more dependent on you or other caregivers during treatment. Your child's experience may make it difficult for her to become more independent after finishing treatment.

Dealing with uncertainty

Despite having survived leukemia, many childhood survivors do not feel they are completely "free" from their illness. For both survivors and families, the fear of relapse is common. They may be so worried about the future that they are unable to enjoy the present, causing a lot of distress. Your childs uneasiness may be less apparent as other physical symptoms. It is important to talk to your doctor about your child's distress during follow-up appointments.

Feelings of stress and anxiety

Surviving a serious disease like leukemia can be distressing. Dealing with medical procedures, hospitalizations, and separation from family and friends can be difficult. Both your family and your child may experience upsetting thoughts and feelings. Symptoms may be associated with a type of anxiety called post-traumatic stress disorder (PTSD). Symptoms of PTSD can include: re-experiencing the trauma; for example, troublesome dreams, or flashbacks during leukemia treatment frequent problems with sleep lack of concentration phobia of places that remind you or your child of the experience with leukemia (for example, hospitals)

If you or your child develop these symptoms, talk to any member of your health care team so you can connect with a mental health professional such as a psychologist or social worker. They can help you or your child learn to manage these complicated feelings.

What can you do to help?

Watch your own reaction A lot of research suggests that the way you respond to your childs illness can influence how your child responds. Adopt a positive attitude and try not to focus on the fear of the cancer returning. This will allow both you and your child to focus on the present and move forward. Promote independence and social interaction Encourage your child to spend time with friends, exploring interests or hobbies. Support her in developing interests and join clubs to meet others. Teach your child how to discuss any late effects she is experiencing with others, if she wants peers, educators, or teammates to know about them. What is important is that your child accepts that her cancer is part of her identity -- not the defining feature.

Having childhood leukemia can affect your child in positive ways

Many childhood survivors feel "different" from their peers. But this difference can be positive. Your child may feel like she has reached a maturity greater than others her age. As a cancer survivor, she may have a better sense of the purpose of life. She may find more meaning in day-to-day activities and interactions, and appreciate the moment more. In a study, psychologists interviewed 50 long-term survivors of childhood cancer, 1 to 24 years after diagnosis. They found that many childhood cancer survivors go on to lead normal lives and do as well as their peers. However, some of the survivors did even better than others by using their cancer experience to live a more fulfilling life. Finding meaning out of their leukemia experience Going through a life-threatening disease can lead to an appreciation for life. This can be the way to forming new, positive values and priorities. For example, survivors may adopt a healthier lifestyle or show more appreciation for family and friends. Many survivors develop sensitivity and empathy to others less fortunate, choosing careers oriented towards the welfare of others, such as health care. Developing a strong sense of self and place in the world A sense of self refers to those character traits (hardworking, sensitive), occupations (teacher, nurse), and social relationships (sister, brother) we consider most important about ourselves. A childhood leukemia survivor with a strong self-identity sees her experience with a positive perspective. She thinks thoughts like "I am a fighter" and "I can cope." She can incorporate this sense of mastery or strength into a strong sense of identity. Having expectations for the future Being committed to reaching productive life goals your child sets for herself gives her something to work towards. Making use of social support Building a strong network of social relationships, consisting of family and peers, is a key source of support for many childhood cancer survivors. This support network will give your child a chance to share common experiences and resources.

This type of cancer usually gets worse quickly if it is not treated. It is the most common type of cancer in children.

Possible risk factors for ALL include the following:

Having a brother or sister with leukemia. Being white or Hispanic. Living in the United States. Being exposed to x-rays before birth. Being exposed to radiation. Past treatment with chemotherapy or other drugs that weaken the immune system. Having certain changes in genes or genetic disorders, such as Down syndrome.

Causes:

The causes of the disease are not known, but researchers believe that ALL develops from a combination of genetic, biologic, and environmental factors.
Genetic Translocations

Up to 65% of leukemias contain genetic rearrangements, called translocations, in which some of the genetic material (genes) on a chromosome may be shuffled or swapped between a pair of chromosomes.

The most common genetic translocation in ALL is the Philadelphia (Ph) chromosome where DNA is swapped between chromosomes 9 and 22 [t(9:22)]. It occurs in about 20 - 30% of adults and 3 - 5% of children with ALL. Another common translocation in ALL is t(12;21), which is referred to as TEL-AML1 fusion. It occurs in about 20% of patients with ALL. Researchers believe that this translocation may occur during fetal development in some patients