Childhood Cancers

Most of us would be receiving calls or mails from various Not-for-profit organizations to help them treat children suffering cancers. You may wonder if childhood cancer actually exists or if they were bluffing to extract a few more bucks. Yes. Childhood cancers are not so rare and with better technology they are being detected early. However the plight of children remains pitiable as not many go into treatment and some die even before securing funds.

Most of these cancers are extremely dangerous and end up being fatal for the child. It is the second commonest cause of death in children after accidents. Over 80% of childhood cancer sufferers who undergo treatment survive the next 5-year period thanks toadvancements in technology.

The most common types of childhood cancers are:

• Blood cancer also called leukemia, commonly AML & ALL - 31% of total childhood cancers
• Brain and CNS tumors - Account for nearly 20% of cases
• Lymphoma - 10% of total childhood cancersNeuroblastoma from the early nerve cells - 7% of cases
• Wilm’s Tumor (Kidney)
• Rhabdomyosarcoma (muscle)
• Retinoblastoma (Back of eye)
• Bone cancer like Osteosarcoma, Ewing's sarcoma.

Key factors for childhood cancers

Unlike adults, lifestyle is not the cause of childhood cancer as it takes a lot of time for the cancer changes to take place. In fact it is the DNA that is the culprit. DNA in each of our cells that makes up our genes sends instructions for nearly everything our cells do.  It also influences our risks of developing certain diseases, including some kinds of cancer. Genes that help cells grow, divide, or stay alive are called Oncogenes. We may get these genes from our parents. It is learnt that most of the genes that cause cancers would be developed during foetal stage or during the first few years of birth. So you do not inherit cancer from your parents but develop them more often. This is called acquired genes.

Can childhood cancers be prevented?

Now here is the bad news. Very rarely can one prevent childhood cancers. Radiation exposure by parents during pregnancy is said to prevent certain types of cancers. Doctors recommend preventive surgery to prevent testicular cancer for an undescended testis in an infant.

Unfortunately there are no screening tests for early detection of childhood cancers.

How do you recognize childhood cancers?

Only the child’s doctor will be able to find out or recognize the cancers. Some of the symptoms they’d look for are:

• Lump or swelling which is unusual
• Unexplained tiredness
• Easy Bruising
• Failure to thrive
• Inability to gain weight
• Loss of vision
• Loss of energy
• Limping
• Frequent headaches
• Unexplained fever

Management of Childhood cancers

Managing someone with a cancer has always been challenging. It is definitely more challenging when the patient is under 14 years of age.

However, a good hospital / cancer setup can make a lot of difference to someone suffering with childhood cancers. A “Good cancer setup” can be defined as ones that have integrated

• Pediatric oncologist who is the primary expert handling childhood cancers
• Oncosurgeon, especially one with the expertise to handle pediatric cancers
• Radiotherapist who is an expert in dealing with radiotherapy
• Palliative care specialist who can handle and treat cancer related pain
• Special nursing staff
• Besides those, a psychologist who can regularly counsel the family. A social worker who can provide social as well as financial support and a nutritionist will add valuable assets to the institute. 

As said earlier, it is a child’s regular pediatrician who will examine the child and order for relevant investigations that will include battery of blood tests, radiological tests including PET CT and bone marrow examination. If diagnosed, treatment is started with chemotherapy drugs that destroy cancer cells. Chemotherapy will be followed by surgery and radiotherapy for suitable cases. Since these cancers are by nature aggressive, response to chemotherapy is generally positive.

It is definitely disturbing to have someone with cancer. However, doctors can make handling the problem much easier with integrated services of multiple, related specialties.