Childhood Cancer and the Environment

Overview

When children are diagnosed with cancer, parents often ask their doctors, “How did this happen? Did the environment have something to do with it?”

The PEHSU Network, led by the Western States PEHSU (WSPEHSU) and in collaboration with the American Academy of Pediatrics (AAP), conducted a groundbreaking education and training project Childhood Cancer & the Environment in 2022-2023 (officially known as POCES, the Pediatric Oncology Clinician Education Supplement). It was so successful it continues to receive funding. Childhood Cancer & the Environment was developed to help pediatric health care providers answer questions from parents and caregivers about environmental influences on childhood cancers, including leukemia. Check out the program’s overview of accomplishments for 2023-2024 here.

Environmental hazards and childhood cancers

Research shows that exposure to environmental hazards such as, pesticides, traffic air pollution, solvents in paints and gasoline, and tobacco smoke can increase the risk of getting childhood cancers – yet most pediatric cancer specialists don’t know about these links. Nearly 90% of them reported getting questions from families about environmental exposures, but few were comfortable discussing them. Over 90% said that more information would be helpful in addressing these issues with patients.

“When our daughter was diagnosed with Wilms’ Tumor, a kidney cancer, I wanted to know why,” said journalist Alexandra Zissu. “Could there be an environmental link? Our beloved oncologist’s work is to cure, not to sleuth. But, as an environmental health journalist, it didn’t sit well with me there was no one on staff at our hospital—one of the top cancer facilities in the country—who asked questions about home environment at intake, or gave us any specific environmental advice during or after active treatment. I was left to do my own research. Exhausted patients and caregivers rely on our doctors, nurses, child life specialists—and more—to guide us through this unique hell. I would vastly have preferred to collaborate on her care—as we were able to in every other realm—rather than arrive at my own environmental health conclusions.”

Ms. Zissu concluded, “I’m thrilled to know this project is happening. I know exactly how much it will help many families.”

Childhood Cancer & The Environment Goals

The PEHSUs are a national network of experts in health issues that arise from environmental exposures from preconception through adolescence. This new project will develop “PEHSU champions” on environmental contributors to childhood cancer, and enable them to provide support to pediatricians and the public nationwide. It will also train pediatric oncology fellows and nurse practitioners and give them the tools to offer practical guidance on how to prevent exposures to toxic chemicals associated with childhood cancer risk.

With additional knowledge, pediatric healthcare providers could make a positive impact on patients’ health by providing counseling to them on protective personal actions. For example:

• Recommending they avoid common household toxicants, such as pesticides;
• advising they take vitamins and folate in the period before conception and during pregnancy;
• informing families of children undergoing chemotherapy about the increased risk for respiratory illness from particulate air pollution, so that they can make protective choices when air quality is poor.

“When a child is diagnosed with cancer it is traumatic for the child and family” said Dr. Mark Miller, a pediatrician and lead of the project. “As health care providers, we need to be able to hear and respond to family’s concerns about the potential causes of children’s cancers, including risks from environmental exposures. This information can help provide common sense guidance on navigating the hazards in our everyday environment associated with increased risk of childhood cancer.”