Nutrition in children, teenagers and young adults with cancer
Cancer registration in the United Kingdom for children is from birth to 14 years (i.e. before 15th birthday) and for teenagers and young adults (TYA) is from 15 years to 24 years (i.e. before 25th birthday). The abbreviation CTYA applies to this entire age range.
Cancer in CTYA is considered a rare event but although this represents less than 2% of all cancer seen in developed/high income countries such as the UK, the risk of a cancer diagnosis occurring in a child is about 1:500 by the age of 15 years and, as the incidence of cancer continues to increase with age, about 1:200 between ages 15 -24 years. Furthermore, because of the young age at which they are diagnosed and the relatively high overall survival rates now seen, survivors of CTYA cancer account for a significant proportion of the total population who are living with and beyond a cancer diagnosis.
Cancer and Nutrition
Cancer occurs when control of cell behaviour is lost: cancer cells grow how, when and where they should not. Nutrition is the balanced provision of the energy and nutrients needed for cell life. Change to the nutritional environment may influence both the development of cancer and become altered as a result of its development and treatment. It may contribute to the complications and outcome of treatment and to long-term problems experienced by survivors. This may present particular challenges and consequences in children and young people in whom linear growth and the development and maturation of body organ systems is continuing.
Nutrition may have a role in all elements of CTYA cancer: prevention, diagnosis, treatment, and in living with and beyond cancer. Work in exploring the interface between nutrition and cancer could serve to contribute to three possible ambitions:
- A reduction in the risk of cancer.
- An improvement in care during, and outcome after treatment
- To enable the achievement of “healthier” function and body composition when living with and beyond cancer.
Whilst there are opportunities to explore nutritional issues implicated in the causes of CTYA cancer (ambition 1), it is currently less clear what possible interventions might follow. At present, it is believed that the greatest immediate benefit would derive from a focus on ambitions 2 & 3. It is to that end that the CTYA work stream will initially focus its activities. The purpose of its work will be to facilitate collaboration, advocate for progress, and to create clinical and scientific visibility for better nutrition care and research in CTYA living with and beyond cancer.
Dr Mark Brougham – Consultant Paediatric Oncologist, Royal Hospital for Children and Young People in Edinburgh
Dr Raquel Revuelta Iniesta – Lecturer in Nutrition, University of Exeter
Dr Jessica Bate, Consultant Paediatric Oncologist, Southampton General Hospital. Jessica is the Chair of the CCLG (Children’s Cancer &Leukaemia Group) Supportive Care Group and is the CCLG nominated representative on the group
Breeana Gardiner, Specialist Paediatric Dietitian in Haematology/Oncology and NIHR Pre-Clinical Academic Fellow & Visiting Researcher, Great Ormond Street Hospital for Children NHS Trust
Professor Faith Gibson – (Professor of Child Health and Cancer Care, University of Surrey and Great Ormond Street Hospital for Children NHS Foundation Trust)
Louise Henry – (Senior Specialist Dietician – Paediatric & TYA Cancer, Royal Marsden)
Dr Martin McCabe – (Consultant in Paediatric & TYA Oncology, Christie Hospital)
Dr Bob Phillips – Senior Clinical Academic at The Centre for Reviews & Dissemination at the University of York, and an Honorary Consultant in Paediatric / Teenage-Young Adult Oncology at Leeds Children’s Hospital
Dr Gemma Pugh, Lecturer, Sports & Exercise Medicine, Queen Mary University London
Laura Sealy, Specialist Paediatric Dietitian, Department of Paediatric BMT, University Hospitals Bristol NHS Foundation Trust
Monika Siemicka, Senior Specialist Haematology and TYA Dietitian, Guy’s Hospital, London
Professor Rod Skinner – (Professor of Paediatric Oncology & BMT, Newcastle upon Tyne)
Dr Dan Stark – (Consultant in Medical & TYA Oncology, Leeds)
Dr Sara Stoneham – (Consultant Paediatric Oncologist, UCL)
Work stream publications
Henry, L., Aldiss, S., Gibson, F., Pugh, G. and Stevens, M. (2022). Nutritional assessment and dietetic resource for children and young people with cancer in the United Kingdom. Pediatric Blood & Cancer. doi:10.1002/pbc.29743.
- Metabolic dysregulation in skeletal muscle and adipose following allogeneic
haematopoietic stem cell transplantation (HSCT) in children, teenagers and young adults – Programme Development Grant funded by the Wellcome Trust (see work stream strategy for further details)
- Review article: The influence of nutrition on clinical outcomes in children with cancer