Perhaps old people or smokers can get cancer - but not my child! That's what many parents think - but every year, around 2000 children and teenagers are diagnosed with the disease in Germany.
"It's just like someone pulled the rug out from under your feet." Simone Klapsing recalls the day she heard the diagnosis. Her then six-year-old son Julian had lymphatic cancer.
He often had abdominal pain. It started shortly after he began school. "The doctors all thought it was from the stress, from being the new kid in school. We even went to a child guidance center. But no one knew what was going on. "It was only after many exhausting tests that Julian had to go through that we had the horrifying certainty. When it's your child and you know there's nothing you can do, you feel completely helpless. That's really hard," she said.
At first, Julian was less shocked when he heard the diagnosis. He was too young to fully understand the significance of the diagnosis, his mother said: "If I had told Julian his appendix or tonsils would have to come out, it would have been the same thing for him. It took him a long time until he asked for the first time whether you can die of it."
When your own child is diagnosed with cancer, it is always a big shock. But the chances of healing give reason for hope. Nearly 85 percent of children and teenagers can lead normal and healthy lives after cancer. In adults, depending on the type of cancer, only about half survive the disease.
No cherries, no chocolate, no kebabs
Today, Julian is eight years old. He runs wildly through the apartment, sliding across the slippery floor in his socks. It's hard to imagine him recently still being seriously ill. But the intensive therapy was just six months ago, and Julian also remembers well the time when he had to give up many things: "I wasn't allowed to eat cherries or nuts - or bell peppers, plums, onions, lettuce, or döner kebabs."
Julian's immune system was weakened by chemotherapy. Raw vegetables or stone fruit could mean too much stress for his body's defenses. That's also why Julian had to avoid groups of people - there was always the danger of infection. The large wading pool in Julian's garden has never been used since his parents bought it a year ago. Water can also carry many germs. But worst of all was that he could no longer accompany his father on his tractor. Julian's father is a farmer and Julian says he wants to be a manual laborer. "That's something like a farmer, he does all the field work for the farmer," said Julian.
Association fulfills wishes for children
Julian runs through his room and laughs. "Tractors, tractors and more tractors." Carpets, wallpaper, window decorations, books, bed sheets: everything has pictures of tractors on it. The floor is covered with hundreds of small tractor models - which he has neatly lined up side by side. Julian is well prepared for his future job. He loves tractors and knows all the brands.
Recently, he was even allowed to visit the place where his favorite model comes from - the Claas tractor factory. The Heart's Desires association of Münster made the trip possible - it fulfills the wishes of seriously ill children. Together with his best friend Felix and his father, Julian could have spent the whole day admiring the new super-tractors.
The trip was a special treat for Julian. For two years he had to go again and again to the hospital. Even today, it's every week for follow-up tests. Besides his weak immune system, he had to fight with many other side effects: his hair fell out, he had constant nausea and he had sores in his mouth.
Children suffer more than adults
The drugs that Julian had to take for his chemotherapy not only kill cancer cells but also healthy cells. Children also receive much more intensive treatment than adults. Children can tolerate more drugs and the therapy thus works better. That's because cancer cells in children are often not as well developed as those of adults, says Dr. Heribert Jürgens, head of the Clinic for Pediatric Hematology and Oncology in Münster. "Childhood cancers originate from cells that partially still have an embryonic character and are therefore much more vulnerable. In contrast, adult cancers originate from tissue that is very mature and thus has more mechanisms to resist the drugs."
Leukemia most common in children
And there's another difference between adults and children. In older cancer patients, external factors such as diet, stress or smoking often cause cancer. In children, it is rare that external factors would trigger the disease. They have not been alive long enough to trigger such a cancer: "Cancer in children and adolescents has something to do with what children do - growing and developing - and that means more cell division. During this cell division, mistakes can occur, and therefore cancers often develop in children where tissues grow fastest. The fastest developing system is the immune system, and in children and adolescents it has a lot to do."
This defense system consists largely of the lymph nodes. Nearly half of children are diagnosed with lymphoma or leukemia (cancer of the blood). Similarly, bone cancer is most often diagnosed in adolescents, because they grow very quickly during puberty.
Julian still has to go to the university hospital for tests once a week. But he has survived the worst. After the summer holidays, he will be going back to school regularly, and will take his classes again. But first, he is looking forward to the summer weather. Then he can help his father in the field and ride a lot of tractors.