Childhood is a time of wishes, desires, dreams of endless possibilities. But for children faced with cancer it is a battle for and with life.. They face it with unflinching courage and an acceptance of their circumstances that humbles us.
Here are some facts about childhood cancer:
Every year 300,000 children all over the world get diagnosed with cancer
Childhood Cancers constitute 3-4% of all cancers
70-90% of childhood cancer is curable because of better response to the treatment and protocols
Unlike the cause of adult Cancers, the causes of most childhood cancers are as yet unknown
In India, it is estimated that nearly 40-50,000 new childhood cancer cases present each year
It is a Cankids estimate that not more than 20000 cases are being diagnosed. Of those that are diagnosed a large percentage come in fairly advanced stages of cancer.
Despite the high cure rates in developed countries, it is estimated that in India 70% children die of cancer due largely to lack of awareness, late detection and late diagnosis, inadequate facilities, the high cost of treatment and the absence of supportive care.
Types Of Childhood Cancer
Leukemias- cancer of the tissues of the body that make the blood cells and the bone marrow. When leukemia strikes, the body makes an abundance of abnormal white cells that do not perform their proper functions. They invade the marrow and crowd out the normal healthy blood cells, making the patient susceptible to infection and bruising.
Lymphomas- cancer which arises in the lymph system, the body’s circulatory network for filtering out impurities. It can arise in the tonsils, thymus, bone, small intestine, spleen, or in lymph glands anywhere in the body. The disease can spread to the central nervous system and the bone marrow.
Brain Tumors-Tumors of the brain and spinal cord are the most common types of solid tumors in children. Some tumors are benign, and some children can be cured by surgery.There has been less dramatic progress in treating brain cancer tumors than most other childhood Twenty percent of all primary brain tumors arise in children younger than age 15, somewhat more malignancies because they are hard to diagnose and treat in boys than girls. There is a peak in incidence between the ages of 5 and 10.
Bone Cancers-The most common bone cancer is osteogenic sarcoma. Bone cancer in children occurs most often during adolescence, 85% of them have tumors on their legs or arms, half of them around the knee.
Neuroblastoma- Found only in children, neuroblastoma arises in the adrenal glands, located in the abdominal area. It attacks very young children. One-fourth of those affected show initial symptoms during the first year of life. Neuroblastoma spreads quickly, and often is discovered only after the disease is widespread. Early stages are curable by surgery alone.
Other Cancers In Children
Wilms’ Tumor- This rapidly-developing tumor of the kidney most often appears in children, usually between the ages of two and four, and is very different from adult kidney cancers. The disease often metastasizes to the lungs, and in the past, the mortality from this cancer was extremely high. However, newer therapies have been very effective in controlling it.
Retinoblastoma- a malignant eye tumor which occurs in young children and shows a hereditary pattern -- accounts for only 2% of the childhood cancer cases. However, it received a great deal of attention when it was the first cancer for which researchers were able to identify the responsible gene.
Rhabdomyosarcoma- The most common soft tissue sarcoma in children, this extremely malignant neoplasm originates in skeletal muscle. Although it can occur in any muscle tissue, it is generally found in the head and neck area (including the eye socket), the genito-urinary tract, or in the extremities. Although rhabdomyosarcoma tends to grow and spread very rapidly, fortunately its symptoms are quite obvious compared to other forms of childhood cancer.
Symptoms Of Childhood Cancer
Continued, unexplained weight loss
Headaches, often with early morning vomiting
Increased swelling or persistent pain in bones, joints, back, or legs
Lump or mass, especially in the abdomen, neck, chest, pelvis, or armpits
Development of excessive bruising, bleeding, or rash
A whitish color behind the pupil, squint or redness in the eye, shrunken or swollen eye
Nausea which persists or vomiting without nausea
Constant tiredness or noticeable paleness
Eye or vision changes which occur suddenly and persist
Recurrent or persistent fevers of unknown origin
Treatment For Childhood Cancer
The treatment of cancer in children can include chemotherapy (the use of medical drugs to kill cancer cells), Radiation(the use of radiant energy to kill cancer cells), and surgery (to remove cancerous cells or tumors). The type of treatment needed depends on the type and severity of cancer and the child's age.
Chemotherapy : Chemotherapy is medication which is used as a complementary tool to eliminate remaining cancer cells in the body. A child or teen is usually given the chemotherapy drugs intravenously (through a vein) or orally (by mouth). Some forms of chemotherapy can be given intrathecally, or into the spinal fluid. The drugs enter the bloodstream and work to kill cancer cells. The duration of chemotherapy treatment and type of drugs that are used depend on the type of cancer the child has and his or her response to the drugs. Every child's treatment differs, so a child may receive daily, weekly, or monthly chemotherapy treatments. The doctor may also recommend cycles of treatment, which allow the child's body to rest between periods of chemotherapy treatment.
Radiation : A child who receives radiation therapy is treated with a stream of high-energy particles or waves that destroy or damage cancer cells in parts of the body to which the cancer has spread . Many types of childhood cancer are treated with radiation in conjunction with chemotherapy or surgery.
Surgery : In children with osteosarcoma and other solid tumors that haven't spread to other parts of the body, surgery can often effectively remove cancer when used in combination with chemotherapy and/or radiation.
Bone Marrow Transplants: Bone marrow is a spongy tissue inside certain bones of the body that produces blood cells. If a child has a type of cancer that affects the function of blood cells, a bone marrow transplant (in conjunction with chemotherapy to kill the defective cells) may allow new, healthy cells to grow. Bone marrow transplant is also sometimes used to treat cancer that does not involve blood cells because it allows doctors to use higher doses of chemotherapy than would otherwise be tolerated.
Targeted therapies : In recent years, new drugs that target specific parts of cancer cells have been developed. These targeted drugs work differently from standard chemotherapy drugs.They sometimes work when chemo drugs don’t, and they often have different (and less severe) side effects. For instance, drugs such as imatinib (Gleevec) and dasatinib (Sprycel) specifically attack cells that have the Philadelphia chromosome (a shortened chromosome 22 that results from a translocation with chromosome 9). Nearly all children with chronic myeloid leukemia (CML) have this abnormal chromosome in their leukemia cells. These drugs are very effective at controlling the leukemia for long periods of time in most of these children, although it’s not yet clear if the drugs can help cure CML.
Duration and Cost Of Treatment
The duration of the treatment depends on the cancer. Varying from leukemia treatment for 2 1⁄2 years, PNET and Osteosarcoma over 1 year, to Retinoblastoma over 6-12 months, AML over 4 -5 months
If the child relapses during or after treatment, the treatment cycles may be repeated.
If a bone marrow transplant (BMT) is indicated, the BMT itself takes about one month.
Chronic Cancers can be treated for several years
Costs differ from cancer to cancer, and centre to centre. For many childhood cancers the cost of treatment alone can be prohibitive. Even at a Government Hospital, the cost of drugs alone, for leukemia, can be as high as Rs 3 lakhs. For an ALL BMT it can be as high as Rs 5 lakhs
CanKids has a very large medical assistance program. Between 2004 and 2013, 11,200 children have been assisted for treatment, drugs, investigations, surgeries, supportive care, and BMTs, through our Adopt a Child program, from our various Medical Assistance Funds, and from our Palliative Care Fund to the tune of Rs 7.50 crores.
Carpe Diem - Seize The Day
These children are an inspiration in their ability to put aside their pain and sorrow and make the best of whatever life has to offer. We have much to learn from them-They deserve the best. The best possible treatment (to deal with the illness), care (support with social and psychological impact of the illness) and assistance to reintegrate back into the society.
As per United Nations Article 24: Children have the right to good quality health care, clean water, nutritious food and a clean environment so that they will stay healthy.Richer countries should help poorer countries achieve this.