Childhood Cancers
Childhood cancers are rare, but remain a leading cause of death in children below 15 years. In India, it is estimated that about 40,000 cases are reported each year. However, recent advances offer hope for childhood cancers. Many childhood cancers have a 5-year or more survival rate of about 80-85%, although these rates vary depending on the specific type of cancer.
Unlike adult cancer, childhood cancers are unlikely to be associated with lifestyle or environmental factors, except childhood acute lymphatic leukemia (blood cancer). A higher incidence was recorded in areas where background radioactivity was higher in the ground. Sometimes, changes in the child’s genes pass from a parent and carry a risk for an inherited type of early childhood cancer.
Many cancers in children are found early, either by a vigilant paediatrician or concerned parents. However, early symptoms mimic more common childhood illnesses or injuries making them easier to be overlooked. It is essential to consult a healthcare professional if any of the following symptoms persist: an unusual lump or swelling, easy bruising, limping or bleeding, looking unusually pale with loss of appetite, energy and weight loss, persistent fever, headaches associated with vomiting, or sudden vision changes.
Childhood cancers can affect various parts of the body including blood, brain, bone and organs. Leukemias for nearly 30% of all childhood cancers with acute lymphocytic leukemia (ALL) and acute myeloid leukemia (AML) being the most common types. Brain and spinal cord tumors rank as the second most common childhood cancers. Neuroblastomas originate in early forms of nerve cells found in a developing fetus and make up about 6% of childhood cancers. Wilms tumor, also called nephroblastoma, starts in one, or rarely, both kidneys, typically found in children 3 to 4 years old, with fewer cases in older children. Lymphomas begin in the lymph nodes or in other lymph tissues, causing swelling under the skin in the neck, armpit, or groin. The 2 main types of lymphomas are Hodgkin lymphoma and non-Hodgkin lymphoma. Rhabdomyosarcoma accounts for about 3% of childhood cancers, while retinoblastoma, a rare cancer of the eye accounts for about 2% of childhood cancers, usually occurring in children around the age of two, and infrequently in children older than six years. Primary bone cancers, such asosteosarcoma and Ewing sarcoma, are most common in older children and teens, but they can develop at any age. They represent about 3% of childhood cancers.
Early identification of childhood cancer results in not only greater probability of survival, but the cancer is more likely to respond to effective treatment. Early treatment also leads to less suffering, is less expensive and less intensive. Treatment is based mainly on the type and stage (extent) of the disease at diagnosis and options include surgery and chemotherapy administered by medical professionals specializing in treating children with cancer (pediatric oncologists). Radiation treatment is kept in reserve and used in childhood cancers if surgery is not possible or there is residual disease after surgery. Some cancers require bone marrow transplants or innovative therapies such as targeted therapy and immunotherapy. It is possible that some children with cancer, with parental consent, may be advised to participate in a clinical trial testing for newer drugs. To minimize the side -effects of treatment multi-modality treatment is recommended along with active physiotherapy and social/emotional rehabilitation of children to make it possible for them to integrate in normal life after treatment.
Upon completion of treatment, regular follow-up visits with the treatment team are vital. Over time, the risk of the cancer returning is reduced considerably. It is notable that with ongoing research and new frontiers exploring saving lives of children with cancer, more children are surviving into adulthood offering renewed hope to families facing the challenge of childhood cancers.