Cancer is often thought to be a disease of adults. Unfortunately, cancers are also seen in children but what is fortunate is the treatment and outcomes. Yes, most of the cancers in children are curable if treated effectively with adequate supportive care.
Globally around 4 lakh children and adolescents (0-19 years old) are diagnosed with cancer. In India annually greater than 50 thousand children are diagnosed with cancer. This accounts to nearly 20% of the global childhood cancer burden, according to world health organization (WHO).
In high income countries 80% of the children with cancer are surviving whereas it is reverse in low- and middle-income countries including India where only 20% of children with cancer are surviving. This is because of lack of diagnosis, misdiagnosis, delayed diagnosis and inadequate treatment/incomplete treatment.
Facts regarding childhood cancers
Cancers in children are completely different from the cancers seen in adults. They are treated by a specialist called Pediatric oncologist trained exclusively for treating the children with cancer.Most common types of childhood cancers are Leukemias [Acute lymphoblastic leukemia (ALL), Acute myeloid leukemia (AML), Chronic myeloid leukemia (CML)], brain cancers and solid tumors. Solid tumors include Wilms tumor (arising from kidney), Neuroblastoma (arising from adrenal gland), Retinoblastoma (Eye tumour), hepatic tumors, bone tumors, sarcoma etc.
Why do cancers occur in children?
Unlike adults the reason for cancer in children is not known. About 90% of childhood cancers occur sporadically. Only 10% of children have genetic predisposition.Some infections like hepatitis B (HBV) and human papilloma virus (HPV) have tendency to increase the child’s risk of developing cancer as an adult so it is important to get vaccinated against these viruses. Hepatitis B vaccine to protect from liver cancer and human papilloma virus vaccine to protect from cervical cancer.
When to suspect cancer in children?
Recurrent fever or prolonged fever not responding to antibiotics.Severe bony pains associated with night cries.Paleness of body/ bruising/bleeding episodes.Unexpected weight loss.Whitish pupil in the eye or sudden onset squint.Lump or mass in arm, neck, chest, abdomen or pelvis.Headache especially early morning headache relieved by vomiting.Swelling or persistent pain in joint, bone, or back etc.
How to identify the cancer before it develops?
There is no screening method to identify the cancer. The only way is to be aware of symptoms, timely evaluation and prompt treatment.
How is childhood cancer treated?
Treatment of childhood cancer has gone a long way over the decades. Modality of the treatment depends on the type of cancer and the stage of cancer.
Chemotherapy, surgery, radiation, immunotherapy, targeted therapy and bone marrow transplantation are the different modalities of treatment. No two children would get similar treatment even if it is a same diagnosis. Treatment is tailored according to the risk status and response of the child so that neither the child is overtreated nor undertreated but adequately treated.
Apart from the actual therapy, the most important aspect of the treatment is the supportive care. Appropriate supportive care is the most essential part for the optimal outcomes in childhood cancers.Children also need special attention to their nutrition, growth and development during the process of treatment. Another important part of the treatment is the psychological support to the family as they have to stay strong and support their child in this through various ways.
Is Childhood cancer curable?
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Yes, cure is possible for more than 80% of children with cancer, in the setting of effective evidence-based treatment and adequate supportive care.Children are not mini adults. Cancers seen in childhood are unique and require different kinds of care and Pediatric Oncologist services for better outcome, survival and long-term growth and development.
Dr. Akkineni Veena, MD Pediatrics, DM Pediatric Oncology (Kidwai), Former fellow in Pediatric Hemato-Oncology (Tata medical Centre), Consultant – Pediatric Hemato – Oncology, Rainbow Children’s Hospital, Vijayawada
MD Pediatrics, DM Pediatric Oncology (Kidwai), Former fellow in Pediatric Hemato-Oncology (Tata medical Centre)