Early detection and comprehensive care is key to defeating childhood cancer
15 Feb 2024 4:18 PM IST
Early detection crucial in improving childhood cancer survival rates. Learn about symptoms and challenges in treatment
Dr Gaurav Kharya, Senior Consultant Paediatric Hematology Oncology and Immunology, Apollo Hospitals
Six months ago, a three-and-a-half-year-old baby from Uttar Pradesh came to my clinic with a high fever. The baby was pale and showed bruisability, a condition in which a person is susceptible to bruising even during normal activities. Thankfully, the pediatrician in the baby's native place found the symptoms unusual and referred the patient to me. When we ran the Complete Blood Count (CBC) tests, we found that the child's hemoglobin and platelet count were very low and the TLC count was high, classic symptoms of leukemia, a common type of blood cancer in children.
We immediately started chemotherapy. Slowly, his condition improved, and the indicators came closer to normal levels, which meant that he was responding well to the treatment. Soon, we are confident we can declare him cured of cancer. It gives me immense pleasure that with timely diagnosis and modern medicine, we can ensure another 60-70 years of a cancer-free life for this kid.
More than 50,000 new cases of childhood cancer occur each year in India, adding to the existing burden of the disease. The most common cancers in children are blood cancers, such as leukemia, which account for about 30 percent of childhood cancers. These cancers are more prevalent among children between the ages of 2 and 6. Brain and spinal cord tumors are the second most common cancers, accounting for 26 percent, followed by neuroblastoma (cancer of nerve cells), bone cancer, retinoblastomas (cancer of the eye), lymphomas, liver cancer, and kidney cancer. The success rate of cancer treatment in children has significantly improved over the past four decades, rising from 20-30 percent to 80-90 percent. After treatment, most children are able to live normal lives. It is a remarkable success story.
However, the biggest challenge we face today is the late diagnosis of cancers, which severely affects the treatment and cure rate of the disease. According to the World Health Organisation ( WHO), only 30 percent of children in low- and middle-income countries are cured of cancer, compared to 80 percent in developed nations. Unlike cancer in adults, the majority of childhood cancers do not have a known cause. Numerous studies have sought to identify the causes of childhood cancer, but unlike in adults very few cancers in children are caused by environmental or lifestyle factors. Current data suggests that about 10 percent of all children with cancer have a predisposition due to genetic factors.
The common symptoms of these cancers are frequent fever or headache, paleness, loss of energy, unexplained weight loss, sudden bleeding, or bruising. Solid tumors such as neuroblastoma can lead to lump formation in the abdominal area, a mass under the skin that isn't tender when touched; besides, abdominal pain and changes in bowel habits such as diarrhea or constipation are among the other symptoms.
In cases of brain tumors, children often complain of morning nausea with forceful vomiting, sudden loss of vision, headaches, lethargy, and drowsiness. Macroencephaly (enlarged head) in infants whose skull bones are not completely fused, seizures are also not so uncommon symptoms. Kidney cancers commonly present as lump and/or pain abdomen. At times it might be associated with blood in urine.
While these cancers can all be diagnosed by an observant doctor, the challenge lies in getting these children to the right facility at the right time. The frustration and sadness of losing a patient who could have been saved with timely treatment is enormous. One of my patients, a teenage girl, came to us with a frank relapse of T-cell lymphoblastic lymphoma (T-LBL), a severe form of cancer. We attempted salvage chemotherapy, but probably since the treatment is harsh and have side-effects, she didn't come for the third cycle even after responding to the earlier two cycles of chemotherapy. We could have managed her cancer for a few years, but unfortunately, we lost her a few weeks later.
Cancer treatment is more than surgery, chemotherapy, radiation therapy, or Bone Marrow Transplant. It must be a holistic approach that begins with timely diagnosis. When identified early, cancer is more likely to respond to less intense treatment, increasing the chances of survival. It is also less expensive. Equally important is counseling parents so that they do not lose hope. Often, the mention of the word "cancer" can devastate parents, leaving them feeling hopeless.
Of course, the treatment must be precise. The type and stage of cancer, as well as the age of the child, determine the course of treatment. If treatment is successful, the chances of which are ever-increasing, we just need to handle side effects and ensure the child gets good nutrition. And, in most cases, the child can lead a cancer-free life.
We immediately started chemotherapy. Slowly, his condition improved, and the indicators came closer to normal levels, which meant that he was responding well to the treatment. Soon, we are confident we can declare him cured of cancer. It gives me immense pleasure that with timely diagnosis and modern medicine, we can ensure another 60-70 years of a cancer-free life for this kid.
More than 50,000 new cases of childhood cancer occur each year in India, adding to the existing burden of the disease. The most common cancers in children are blood cancers, such as leukemia, which account for about 30 percent of childhood cancers. These cancers are more prevalent among children between the ages of 2 and 6. Brain and spinal cord tumors are the second most common cancers, accounting for 26 percent, followed by neuroblastoma (cancer of nerve cells), bone cancer, retinoblastomas (cancer of the eye), lymphomas, liver cancer, and kidney cancer. The success rate of cancer treatment in children has significantly improved over the past four decades, rising from 20-30 percent to 80-90 percent. After treatment, most children are able to live normal lives. It is a remarkable success story.
However, the biggest challenge we face today is the late diagnosis of cancers, which severely affects the treatment and cure rate of the disease. According to the World Health Organisation ( WHO), only 30 percent of children in low- and middle-income countries are cured of cancer, compared to 80 percent in developed nations. Unlike cancer in adults, the majority of childhood cancers do not have a known cause. Numerous studies have sought to identify the causes of childhood cancer, but unlike in adults very few cancers in children are caused by environmental or lifestyle factors. Current data suggests that about 10 percent of all children with cancer have a predisposition due to genetic factors.
The common symptoms of these cancers are frequent fever or headache, paleness, loss of energy, unexplained weight loss, sudden bleeding, or bruising. Solid tumors such as neuroblastoma can lead to lump formation in the abdominal area, a mass under the skin that isn't tender when touched; besides, abdominal pain and changes in bowel habits such as diarrhea or constipation are among the other symptoms.
In cases of brain tumors, children often complain of morning nausea with forceful vomiting, sudden loss of vision, headaches, lethargy, and drowsiness. Macroencephaly (enlarged head) in infants whose skull bones are not completely fused, seizures are also not so uncommon symptoms. Kidney cancers commonly present as lump and/or pain abdomen. At times it might be associated with blood in urine.
While these cancers can all be diagnosed by an observant doctor, the challenge lies in getting these children to the right facility at the right time. The frustration and sadness of losing a patient who could have been saved with timely treatment is enormous. One of my patients, a teenage girl, came to us with a frank relapse of T-cell lymphoblastic lymphoma (T-LBL), a severe form of cancer. We attempted salvage chemotherapy, but probably since the treatment is harsh and have side-effects, she didn't come for the third cycle even after responding to the earlier two cycles of chemotherapy. We could have managed her cancer for a few years, but unfortunately, we lost her a few weeks later.
Cancer treatment is more than surgery, chemotherapy, radiation therapy, or Bone Marrow Transplant. It must be a holistic approach that begins with timely diagnosis. When identified early, cancer is more likely to respond to less intense treatment, increasing the chances of survival. It is also less expensive. Equally important is counseling parents so that they do not lose hope. Often, the mention of the word "cancer" can devastate parents, leaving them feeling hopeless.
Of course, the treatment must be precise. The type and stage of cancer, as well as the age of the child, determine the course of treatment. If treatment is successful, the chances of which are ever-increasing, we just need to handle side effects and ensure the child gets good nutrition. And, in most cases, the child can lead a cancer-free life.
This article is written by Dr Gaurav Kharya, Senior Consultant Paediatric Hematology Oncology and Immunology, Apollo Hospitals, New Delhi. Founder & Director, Cellogen Therapeutics, a cell & gene therapy start-up.
( Source : Guest Post )
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