Cancer in Children: Awareness Must to Facilitate Early Diagnosis
Do children get cancer? Unfortunately, the answer to this question is yes. But it is a rare occurrence. According to the National Cancer Registry programme, cancers occurring in children in the 0-14 age group accounts for 0.7 to 3.7% of all cancer reported in all age groups in India. Due to the rare nature of this disease in children, awareness regarding this condition needs to be improved to facilitate early diagnosis. Hence, the month of September is celebrated as Childhood Cancer Awareness month all over the world.
The definitive cause of cancer in children is largely unknown. We do know that the genetics of the patient has a role in the occurrence of cancer. However, less than 10% of patients have a significant family history of cancer. In the absence of strong causative factors, there are no real steps which can be taken for cancer prevention in children unlike in adults where lifestyle modification may be of help.
The common symptoms associated with pediatric cancer are:
- Pallor, bruising or bleeding, general bone pain
- Lumps or swelling – especially if painless and without fever or other signs of infection
- Unexplained weight loss or fever, persistent cough or shortness of breath, sweating at night
- Eye changes – white pupil, new onset squint, visual loss, bruising or swelling around the eye(s)
- Abdominal swelling
- Headaches, especially if unusually persistent or severe, vomiting (especially early morning or worsening over days)
- Limb or bone pain, swelling without trauma or signs of infection
- If a parent or physician notes any of these symptoms, the child needs to be investigated further.
Leukemias (also known as blood cancers) are the most common type of pediatric cancers. Of the leukemias, acute lymphoblastic leukemia is the most frequently seen. Children may also be affected by solid tumors, most commonly brain tumors. Other solid tumors seen in children include neuroblastoma, Wilm’s tumor of the kidney and rhabdomyosarcoma. Bone tumors such as Ewing sarcoma and osteosarcoma are also seen in children. However, many of the common adult cancers such as breast and gastrointestinal tumors do not occur in children.
The common treatments available today include chemotherapy, surgery, radiation therapy, immunotherapy and stem cell transplant. Depending on the type of cancer, these treatments may be given singly or in various combinations. Each patient’s treatment plan will be tailored based on the type of cancer and the stage of the disease at presentation.
Generally, children cope with cancer treatment a lot better than adults. They usually do not have any underlying co morbidities that adults may have like hypertension or diabetes. They tolerate chemotherapy a lot better. They also do not usually suffer from the depression that an adult may face on receiving a diagnosis of cancer. The parents on the other hand do need help to cope. Most cancer centers have in-house counsellors and dieticians apart from oncologists and nurses to help in the day-to-day all-round care of our young charges. The physical and mental health of the child is to be nurtured during the treatment and special emphasis has to be given to nutrition to complement the young one’s growth.
Overall pediatric cancer has a much better survival as compared to adult cancers with an approximate survival of 60 to 70%. The survival rate varies with the type of cancer and the stage of the tumor at the time of diagnosis. The survival rate in a country like India also depends on the availability of lab facilities, drug availability, abandonment of treatment and the presence of effective supportive care. Nowadays with the various Government schemes and NGOs providing both financial and supportive aid, more children are able to complete treatment and hence have better survival.
Children who are on chemotherapy for cancer treatment have poor immunity and are at high risk for infections. Parents should take great care in maintaining the child’s personal hygiene. Bathing regularly and washing mouth to maintain oral hygiene after meals is a must. Meals should be prepared and stored hygienically. A child on chemotherapy should be given freshly prepared nutritious food with plenty of added protein. Avoid junk food and eating out. Avoid taking the child to crowded areas or large functions where crowds are expected like weddings. Restrict visitors as much as possible. This is of great importance during the present coronavirus pandemic too. If either parent develops a cold, they should distance themselves from the child and use a mask if they have cough or sneezing.
Children are very resilient. Most children are active and playful even during their chemotherapy. Only infections affect their cheerful demeanor. Whether they can continue school depends on the intensity of the chemotherapy they are receiving and their risk for contracting infections from their school fellows. Patients with leukemias usually miss out on one year of school.
KIMSHealth Cancer Centre offers all the 3 major cancer treatment modalities – chemotherapy, surgery and radiotherapy. With respect to children with cancer, we have trained oncology nursing care, counsellors and nutritionists for the all-round care of the child. We have facilities for central line insertion and care and all invasive procedures are done with the help of short anesthesia to limit any discomfort to our patients as much as possible. All cancer surgeries are performed by a team of pediatric surgeons and surgical oncologists. We have highly experienced radiation oncologists with state-of-the-art equipment for radiotherapy. The treatment plan of every patient is discussed and approved by a multi-disciplinary tumor board.
A very important aspect of cancer care is supportive care. We are able to provide excellent supportive care to these patients in the form of dedicated oncology nursing, pediatric intensivists, an exceptional pediatric ICU with support from Infectious Diseases specialists for care of infections. We have a well-equipped blood bank to deal with any transfusion requirements. The major pediatric subspecialities are well represented in KIMS, Thiruvananthapuram including neonatology, pediatric cardiology, pediatric neurology, pediatric endocrinology etc.
The successful treatment of cancer involves a team effort and we have a superb team of trained professionals to help our patients through their treatment.