International Childhood Cancer Day 2020: The diagnosis of cancer is earth-shattering. When this diagnosis is made in a child, it is worse. Parents and older children will have questions like, ‘Why my child?’ or ‘Why me?’ or ‘What now?’ Fear of what cancer means to their present and the equally important future makes the diagnosis and its treatment stressful. Here is something about Pediatric Cancers that will help you with your questions. The best person to talk to is your Pediatric Oncologist. These are a few general points to help you prepare yourself.
The bad news
Cancer in children isn’t unheard of disease. It happens and is fairly frequent. It is one of the most common causes of death among children in the developed world. World over about 3 lac children is diagnosed with cancer each year. Roughly 50,000 of them are in India. Cancer is the 9 th most common cause of childhood mortality in India. In most cases, there are no screening tests available as of now for early detection of pediatric cancers. There are exceptions to this rule, however, those exceptions are a very select group of children who need to be screened and that will be told by a doctor.
The good news
While cancer diagnosis and treatment is expensive, there are a lot of avenues that provide financial, social, moral support for parents and children who are fighting this dreadful disease. The most common of all the cancers among children are those of the blood. Leukemias. They along with Lymphomas (cancer of the lymph nodes or immune tissue) form about 45% of all the cancers diagnosed in children.
With the available supportive care, the suffering is almost non-existent. Next time you hear someone say a child has blood cancer- do not make a tragic face and down their morale. It is a big disease, yes, but we have an excellent armamentarium of drugs and supportive care to fight it.
Another common cancer among children is a brain tumour
While its presentation is very dramatic, most children with brain tumours survive and survive well. It is a myth that all brain tumour survivors become mentally retarded. This is a myth and needs to be busted. Yes, the treatment involves brain surgery and more often than not radiation and chemotherapy, but with presently available precision techniques and anticipation and timely treatment of short as well as long term complications, most brain tumour survivors do well.
Other cancers that affect children are those of the bone. Earlier tumours of the bone invariably meant amputation. That isn’t the case now. This cancer that mostly affects adolescent children has advanced tremendously not only in the chemotherapeutic agents available but also with surgical advances that lean progressively towards conserving the limb rather than amputate it.
- Cancers of the kidney- Wilms tumour
- Nerves- Neuroblastoma
- Muscle- Rhabdomyosarcoma
- Eyes- Retinoblastoma
are a few more examples of cancers that affect children. But they all have well-developed treatment protocols and when detected, carry an excellent chance of survival. The diagnosis of various cancers is different. There is no one test that diagnosis everything. Regular follow up with your paediatrician will help her/him pick up disease early on.
It could be exposed to radiation/some infections/environmental exposure/parental smoking. But unlike an infection where 1 bacteria is identified and vaccination against it will provide life-long protection, no 1 thing leads to cancer in childhood. Hence it follows that apart from eating healthy, regular vaccination and having an active life, there is little you can do to prevent it.
A short insight into what treatment generally entails
Chemotherapy, surgery and radiation are the ways most cancers are treated. Anyone or a combination of the above modalities are used based on the type of cancer, its stage, its risk classification, patient’s age and co-morbidities. Chemotherapy is the use of drugs that kill cancer. They aren’t very specific so they are also toxic to our normal body cells, hence the side effects. However, currently, there are excellent drugs and supportive measures to prevent and minimize adverse effects. Radiation uses ionizing rays to burn/kill cancer cells. The normal tissue surrounding bears the brunt. However, advances in radiation oncology have enabled highly precise targeting of the disease and thereby minimizing the complications. Surgical techniques, real-time imaging help minimize risks during surgery while ensuring efficacy.
One major issue with pediatric cancers is long term survival
Children have 5-6 decades more of life and hence therapy is planned such that the child can live with no or minimal long term effects. Cancer therapy, like other faculties of medicine, is a growing branch. We are at a better place now than we were before and hope to continue to be better. Immunotherapy, targeted therapy are some of the newer modalities of treatment. Social media is not an authority. Talk openly to your doctor and get all your doubts cleared. Read referenced matter and ask your consultant. Do not believe a random forward and doubt your doctor.
Last but not least
There is help available in many forms to fight childhood cancer. From support groups to schools for children undergoing therapy so they don’t miss out on studies, financial aid right from day 1 are available along with social workers to guide you. Do not refuse treatment for such a curable disease due to financial constraints. That would be a failure of therapy too. Remember, cancer occurs in children too, but they are very durable and there is help available in various forms if you need it.
(Inputs by Dr Nisha Iyer Paediatric Medical Oncologist & Hematologist, Asian Cancer Institute)
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