Cancer can occur in all age groups; children no exception, but childhood cancer is treatable

Dr. Pankaj Abrol

Cancer occurs in all age groups, and children are no exception. This is in contrast to the general belief that malignancy is a disease of adults and old age.

Every year over 3 lakh children are diagnosed with cancer around the world. This figure includes more than 50, 000 children per year in India. The silver lining is that by and large childhood cancer is treatable if detected in time and managed at the right or proper place. The prognosis is so good that in many childhood cancers cure rate is more than 90%.

To have good results, early diagnosis is important. If the diagnosis is late, the results may not be good. Every parent wants to know about symptoms of childhood cancer for early diagnosis. They want to know how these symptoms are different, compared to symptoms in other common diseases/infections. These symptoms may mimic other clinical conditions. These are as given below:

  1. Continued/unexplained weight loss
  2. Headache, especially if early in the morning with/without vomiting
  3. Swelling/pain in bones/joints/back/limbs
  4. Whitish appearance/white reflex in pupils of eyes
  5. Unexplained fever,  when the infections have been excluded
  6. Unexplained anemia with/without abnormal blood counts
  7. Enlarged cervical/axillary lymph nodes
  8. Lump in abdomen
  9. Excessive bruising or bleeding

Risk factors

  1. Genetic factors
  2. Environmental factors – Exposure to drugs like chloramphenicol and other marrow suppressants, radiation, viral infections like Epstein-Barr virus etc.

Common childhood cancers:

  1. Hematolymphoid cancers which include Leukemia (blood cancer), Lymphomas (Hodgkin and Non-Hodgkin)
  2. CNS cancers like Medulloblastoma, other brain tumors
  3. Wilms tumor
  4. Neuroblastoma
  5. Retinoblastoma
  6. Bone tumors  – Osteosarcoma, Ewing’s tumor

Treatment: For all cancers there are 3 modalities of treatment. These are:

  1. Chemotherapy
  2. Surgery
  3. Radiation

Type of treatment depends on the type of childhood cancer. Childhood cancers like leukemia and lymphoma are essentially treated with chemotherapy. Some patients may require radiation. Solid tumors like Wilms tumor may require only surgery in the beginning.

Tumors like Wilms tumor, neuroblastoma, bone tumors, brain tumors may require all 3 modalities as per their respective protocols.

Whenever any of suggestive symptoms/indications are there, one should take the child to a pediatrician who can refer the child to a pediatric oncologist who will be in a position to diagnose and treat the child.

Childhood cancers like acute leukemia, Lymphoma especially Hodgkin lymphoma, Wilms tumor (tumor arising from kidney) in early stages have very good prognosis. With cure rate reaching more than 90% in many childhood cancers, time is not far off, when cure rate for childhood cancers may reach cure rate of infections.

We should go with the key messages as below:

  1. Childhood cancer is not uncommon.
  2. Childhood cancer is treatable with the high possibility of permanent cure.
  3. At the earliest suspicion, the child should be taken to a pediatric oncologist.
  4. Key of the success lies in treatment of childhood cancer by right person and at the right time.

In SGT Medical college hospital, we have facilities to treat childhood cancer.

(The author is Professor and Head of Pediatrics Department in SGT Medical College, Hospital and Research Institute, SGT University, Gurugram)

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