How are children surviving cancer today? Better than ever before. Some childhood cancer patients, now in their young adult years, are expecting to reach milestones in their lives others before them never would have reached.

Today, 1 in 1,000 young adults in the United States is a childhood cancer survivor. In the 1970s, the chance a child would outlive leukemia or lymphoma was 25 percent. Today, it's 80 percent. That's better than most adult recovery rates.

As recovery rates rise, a new frontier is on the horizon -- follow-up for these young people as they age. You see, the very treatments that saved these individuals may cause them complications later in life. It's not yet clear what happens when kids live 20 to 30 years beyond diagnosis. But teams at St. Jude Children's Research Hospital in Memphis, Tennessee, plan to find out as they launch one of the most ambitious follow-up programs to date. Contacting 5,000 patients who have survived for more than 10 years, doctors hope they will recruit a group to receive free check-ups for life. They'll also receive blood tests, MRI scans, even fertility counseling. Their medical histories will serve as rich textbooks for medical professionals and future patients -- so the war on childhood cancer can continue.

Overview of osteosarcoma:

There are about 900 new cases of osteosarcoma diagnosed in the US each year. About 400 occur in children and adolescents younger than 20 years of age.

Osteosarcoma forms in the bones. It is most commonly diagnosed in those who are 15 to 25 years of age. It is also the most common type of bone cancer, and the sixth most common type of cancer in children.

Other types of cancer can eventually metastasize to the bone, however this disease originates in the bone and can spread elsewhere to other parts of the body.

Many cases of osteosarcoma, around 80 percent, begin in or around the knee area.

What are the risks of osteosarcoma?

The disease is most seen in boys and can arise from unpredictable errors in the DNA of growing bone cells during times of intense bone growth. Currently, there is no effective way to prevent this type of cancer but with proper treatment most kids diagnosed with osteosarcoma do recover.

We have written here at the cancer blog about Courtney Nicole a few times. You can find posts here and here. Courtney passed way about eight months ago. Her mom still keeps a journal of what is going on in her life and how she is coping with the loss of her nineteen year old daughter.

I find myself going to her site often to see how she is doing. It is heartbreaking to read her words at times and encouraging at other times. She is trying to go on -- but how, without her daughter?

Recently, Court's mom posted Its Like a Scab! on her website. Here's what she said:

When researching children's hospitals and oncology programs, you should have a list of questions that are relevant to the child's cancer. The same questions should be asked at each hospital so you can compare answers and make an informed decision about where to seek treatment.

Some questions include:

• What clinical trials are available?
• What type of research is going on for this type of cancer?
• What are the success rates?
• How many of these type of cancer cases do you see each year?
• Have you treated a child with this type of cancer?
• What cancers do you specialize in?
• Do you offer support groups?
• Do you allow family-centered care which allows families to be part of the treatment plan?

Pediatric cancer care is much different than cancer treatments in adults, many parents decide to go to a children's hospital like St. Jude's for care. Whatever the choice, make sure that you are getting the best possible care for the child as you can. Since you are their voice and their advocate, you have to do what you can to make sure that you are giving them the best opportunity to fight and beat childhood cancer.

Young patients that are diagnosed with a form of leukemia called acute lymphoblastic leukemia (ALL) are at an increased risk of relapse if they have a high body mass index at the time of diagnosis.

Dr. Anna M. Butturini, lead investigator of a study that reported the findings, said "Obesity is associated with lower probability of cure in pre-adolescents and teenagers with ALL. A current analysis suggests that the same is true for adults with the same disease".

Dr. Butturini thinks that there is a need for better understanding of why obese patients have an increased risk of relapse. If this is found out, then better therapies for these young patients could be potentially designed.

A reader , Jim Waldenfels, commented on my recent post on protecting children's skin now to prevent skin cancer later. He made a good point on the necessity of Vitamin D to protect against other cancers.

I have also written about this dilemma in my post of May 14th. We have to make sure that we look at research with a questioning mind and weigh the risks and benefits. The article I quoted in my post, about the flip side of sun protection, seems to feel that it is worth the risk of contracting skin cancer to prevent other cancers. The writer felt that most skin cancers are easily treatable, whereas other cancers might not be.

It might be true up to a point, but there are certainly types of skin cancer that are very serious and that can lead to metastases which might not be so easily treatable. Supplements might be of benefit, but we need further research into how much is safe to take and whether it truly gives the same benefit as unprotected sun exposure.

I do believe that awareness is key and I thank our readers for their thought provoking comments. We love to hear from you, especially from those readers that have been affected by cancer, as we can learn from your experience.

Nicole Labrecque was only three years old when she lost her battle with hepatoblastoma, a rare liver cancer. That was 16 years ago and for the last six years, Nicole's father Richard has been raising money to help seriously-ill children like his daughter have their special wish come true.

Richard said his daughter died suddenly three days after the family's Make-A-Wish trip to Disney World. Richard Labrecque told reporters, "She spent a beautiful week having fun and for a few days, she was able to forget about the pain of surgeries and chemotherapy. It is priceless to see these kids have fun. Nicole was three years old and we were swept off our feet. I'm dedicated to this organization."

In the past five years, Nicole's walk has raised over $70,000, which has gone to the Vermont Make-A-Wish Foundation. The annual walk, which will be held this year on May 20, 2007 on the Toonerville Trail in Springfield, VT starts at 9:30 a.m. The trail is 6.2 miles.

All participants get a purple T-shirt -- purple was Nicole's favorite color.

Childhood acute lymphoblastic leukemia (ALL) is being studied in a way to examine the chromosomes present in the diseased cells. Extra numbers of specific chromosomes are present and can arise according to a predictable pattern.

What does this mean? Our chromosomes carry the genes in all cells, which normally have 46 chromosomes. The ALL cells that are being studied can have more than 80 chromosomes.

This could help to understand what early events can cause this type of leukemia. The researchers also want to understand why children with ALL that have 51 or more chromosomes generally respond better to treatment than those with 50 or fewer chromosomes.

One of the authors of the study, Nyla A. Heerema, professor of pathology, states "The fact that an excess of certain chromosomes is associated with the particular overall number of chromosomes tells us that something significant happens when that first abnormal cell divides and initiates the disease"

Researchers are trying to figure out why these certain patterns occur and whether it can help guide decisions about therapy.

Alex's Lemonade Stand Foundation is all about the fight against childhood cancer. Tasty Baking Company is joining forces with Alex's Foundation by creating a new product called Alex's Lemon Krimpets. The Krimpets can be purchased anywhere Tastykakes are sold. The baking company will donate $.50 from every box sold to the foundation.

Alex Scott was four years old when she opened up her first lemonade stand to help raise money for Children's Hospital of Philadelphia. Sadly, Alex passed away in 2004 at the age of eight. But her legacy still lives on.

For more information about Alex's foundation you can go to www.alexslemonade.org. You can also visit http://www.tastykake.com to purchase some yummy Alex Lemon Krimpets and help the fight against childhood cancer.

I never thought I'd hear this one -- that women whose tonsils were removed during childhood may be at increased risk of developing pre-menopausal breast cancer. But sure enough, that's what researchers at the University of Buffalo are reporting.

Think about this:

Researchers say the association between tonsillectomies and breast cancer may be related to the loss of protective function when tonsils are removed. Also, tonsils can be markers for infection in childhood. Some infections cause inflammation which can contribute to cancer. When the tonsils are gone, markers are gone.

Other studies have linked tonsillectomies with an increased risk of Hodgkin's lymphoma, leukemia, and breast and prostate cancers. This study, reported at the 100th annual meeting of the American Association of Cancer Research, confirms the breast cancer connection -- but further study is still necessary.

Toby Keith has been touched by childhood cancer. One of his original band mates lost his daughter Allison in August of 2003 to a form of kidney cancer called Wilm's tumor.

The country singer is sponsoring the fourth annual charity golf tournament that will once again benefit the families of children fighting cancer. The event will begin with an auction and party in downtown Oklahoma City on April 27, and continue with the golf tournament the following morning.

The proceeds will benefit Ally's house, which Keith helped establish in memory of his friend's daughter. The charity helps pay for medical bills, prescriptions, housing, transportation, toys, food, clothing and other expenses for families that have children with cancer.

Some of the items to be auctioned off are:

• Trip to see Keith in concert in Las Vegas
• Memorabilia from Garth Brooks, Sammy Hagar and Bob Seger
• Sports memorabilia autographed by Tiger Woods and baseball Hall of Famer Mickey Mantle

Toby Keith comments about Ally's House -- "This is a special charity to me. I saw firsthand how a child's cancer diagnosis can devastate a family. Please join me in supporting these kids through Ally's House."

I read a two articles about treatments for recurrence of rhabdomyosarcoma recently. I first got interested in this childhood and young adult cancer when I read Karen's blog. Karen was diagnosed as a young adult and wants to raise awareness for this rare cancer, sometimes just called rhabdo, that does not have a great survival rate. I did a post about her and her cancer journey that you can read called Raising awareness about rhabdomyosarcoma.

This brings me to the two articles that I recently read about treatments for recurrent rhabdomyosarcoma:

A Phase II clinical trial was published in the Journal of Clinical Oncology. The drug Camptosar (irinotecan) reduced or eliminated detectable cancer in 11 percent of the children who had relapsed rhabdomyosarcoma. The study states that patients with recurrent disease have a very poor prognosis. Eleven percent, (four out of thirty five patients), does not seem like a very high success rate however, these trials are needed to find treatments to improve survival for this deadly cancer.

The other article I read was also published in the Journal of Clinical Oncology. It states that treatment with the chemotherapy drug combination of Camptosar (irinotecan) and vincristine reduced or eliminated detectable cancer in 70 percent of children with metastatic rhabdomyosarcoma. It stated that treatment alone with Camptosar is not good enough. The combination of Camptosar and vincristine, 70 percent of children experienced a partial or complete disappearance of detectable cancer. This is better news!

You can read more about rhabdomyosarcoma in the post called Cancer by the Numbers: Rhabdomyosarcoma.

A mom of a daughter who has died of a cancer related illness has expressed on her blog how angry she is after seeing the broadcast on the news about cancer death rates declining....I think these are valid points that need to be addressed.

This week has been kind of emotional for me. I'm not going to spend a lot of time writing about me, because I am kind of angry right now. Yesterday, as I was watching the news while getting ready for work, there was a spot that they were talking about how excited they were that deaths from cancer showed a tremendous decrease last year. I agree, it is good news - however, the only cancers they talked about and showed the figures for were ADULT cancers (breast cancer, colon cancer, prostrate cancer, etc). Where are the numbers on childhood cancers? And - until the number is 0, I see no reason to get really excited.

According to the Lance Armstrong Foundation - With every second of 2006 two Americans were diagnosed with cancer and one died. Think about that! That is like re-living the horror of 9/11 every two days for the entire year. As a nation we have become too complacent about this disease (last year, for the first time in 35 years, governmental funding for cancer decreased) and that can no longer be tolerated.

After spending hours on the computer doing some research - I found this:

Leukemia, which is the most common childhood cancer, INCREASED by more than15% over the past 20 years. Most of the increase in leukemia rates in the past 20 years has been in a kind of cancer called acute lymphoblastic leukemia or ALL. A recent study in the American Journal of Public Health reported an association between household chemicals and ALL. In the study, the researchers from the National Cancer Institute (NCI) and the University of Minnesota found children were more likely to develop ALL if they lived in households where family hobbies involved the use of solvents (such as refinishing furniture, or building models). They were also more likely to develop ALL if more than 4 rooms in the house had been painted while their mothers were pregnant. According to the Children's Cancer Group Epidemiology Program, a network of pediatric epidemiologists, children are 5 to 6 times more likely to develop leukemia and brain cancer if their families use pesticides at home.

It is difficult to find current information and statistics on childhood cancers. And, I guess one of my questions is, where does Courtney fit in these statistics. Did she fit in the "cured" survival rate because she was considered cancer free for over 5 years? Is her death considered in the cancer death statistic for 2006 - the cause of death was not cancer, but necrotizing faciitis - however, she would not have contracted this deadly bacteria or been immune compromised if not for cancer.

I guess my point is - where are the priorities of our health care leaders and our nation. How can we pay someone $250 million dollars to come to the US and play soccer (Dave Beckham) , when there is such a tremendous need for not only medical research, but children without insurance that are being denied medical treatment (transplants) because they don't have the money. How many children have to die? What is it going to take?

I have been following about 12 online journals written by mothers of cancer patients. I began reading the journals while in the hospital with Courtney - it was what filled the long nights of no sleep. It breaks my heart to tell you that 5 of those children have now passed away and 2 more are home on hospice. I have written before about how mothers of children with cancer are members of a club that we never wanted to join. I now find myself in a new club - mothers who have lost a child to cancer. How big does this club have to get before something more is done? How many broken hearts? How many shattered families?

I have been trying to get through the paperwork to get Courtney's Angel Foundation off the ground - however, it is extremely difficult without the aid of a lawyer. I have not given up - it is just going to take some time and money to get things going. I appreciate all of you who have written to let me know that you want to be part of it and so I ask for you to continue to bear with me. I am still dreaming BIG - I am determined to do it for Court -I am determined to do it for all of the children who are spending their days in the hospital instead of living the life that they deserve.

The primary recipient of the 2006 grants for Curing Kid's Cancer is the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. Curing Kid's Cancer is a charity that raises money for leading edge pediatric cancer research. The organization was inspired by nine year old Killian Owen's battle with leukemia. The $100,000 grant was given to Johns Hopkins for research into new targeted therapies for acute lymphoblastic leukemia.

Curing Kid's Cancer has two national grassroots programs -- Coaches Curing Kid's Cancer and Teachers Curing Kid's Cancer.

The programs fund the development of cutting edge therapies which will revolutionize childhood cancer treatment by replacing traditional chemotherapy.

Curing Kid's Cancer aims to raise both awareness and money to find cures for all types of childhood cancers. Their objective is to turn this killer disease into a curable one in our lifetime.

Sarita Zouvas knows what it's like to have a child in the hospital. Her daughter, Isabella -- who died while receiving treatment for cancer -- spent many days in the hospital, and Zouvas says it's hard to anticipate what items from home will make a child's stay more comfortable.

"We don't go prepared," she says. "You don't take clothes; you don't know what's going on. You get there and they put a gown on them. My first response is, 'I want to make them comfortable because they're scared.'"

Zouvas has found a way to bring comfort to the lives of children at her local Children's Hospital. And her goal is to make sure every child admitted to the hospital during the holiday season gets a complimentary pair of pajamas.

After the death of her daughter, Zouvas became involved with the Friends of Scott Foundation (FSF) -- a non-profit organization founded in memory of Scott Delgadillo who lost his life to childhood cancer. FSF strives to help children with cancer and their families with emotional and financial support in order to cope with this devastating disease. Zouvas became a part of the FSF support team and is thrilled she can help bring comfy jammies to sick children.

Zouvas says the response to her call for help has been overwhelming. Most pajamas are donated and have come from as far away as Boston. Employees of the San Diego Padres, Southwest Airlines, and the district attorney's office have also helped Zouvas in the endeavor she hopes will continue year-round.

For more information on the Friends of Scott Foundation and Zouvas' pajama drive, click here.