Cure close at hand

CANCER in kids It is a sad affair. However, early detection and timely treatment can ensure total cure in paediatric cancers, assures Dr Chandragauda

Though cancer is undeniably a much-dreaded disease, continuous advancements in medical
sciences have enabled the medical fraternity to not only tame the ailment, but also cure the
patients, provided they are diagnosed early and put under treatment. The going, however, gets tougher when cancer is detected in a child. In order to ensure that cancer in a child is detected early, parents must look for symptoms like prolonged fever, bone pain, swelling in body, blood in urine, stools and glands or lump in abdomen. A child with any of these symptoms should be taken to a doctor for check-up. If cancer is detected at an early stage, the disease can be effectively cured.

The causes

Most paediatric cancers belong to the leukaemia category and are found in a child in the age group of a few months to 16 years. Almost 70 percent of cases are cured, though treatment is prolonged. Causes of most childhood cancers are not known. About five percent of all cancers in children are caused by an inherited mutation – a genetic mutation that can be passed from parents to their children.

Inherited mutations associated with certain familial syndromes such as Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, Fanconi anaemia syndrome, Noonan syndrome and Von Hippel-Lindau syndrome also increase the risk of childhood cancer. Genetic mutations that cause cancer can also arise during the development of a foetus in the womb.

Most cancers in children, like those in adults, are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer. However, environmental causes of childhood cancer have been difficult to identify, partly because cancer in children is rare, and partly because it is difficult to determine what children might have been exposed to early in their development.

The types

There are certain common types of paediatric cancers:

n Leukaemia is the cancer of bone marrow and blood. It is the most common childhood cancer and accounts for about 30 percent of all cancers in children.

n Brain and central nervous system tumours are the second-most common cancer in children, making up about 26 percent of childhood cancers.

n Neuroblastoma starts in early forms of nerve cells found in a developing embryo or a foetus. About six percent of childhood cancers are neuroblastoma.

n Wilms’ tumour, also called nephroblastoma, starts in one, and sometimes in both kidneys.

n Lymphoma cancers start in certain cells of the immune system called
lymphocytes.

n Rhabdomyosarcoma starts in cells that normally develop into skeletal
muscles.

n Retinoblastoma is a cancer of the eye. It accounts for about two percent of childhood cancers.

n Bone cancers occur most often in older children and teenagers, but they can develop at any age. They account for about three percent of childhood cancers.

Risk & hope factors

Different cancers have different risk
factors. Lifestyle-related risk factors play a major role in many types of cancer in adults. A few environmental factors, such as radiation exposure, have been linked with some types of childhood cancers. Studies have also suggested that certain parental exposures such as smoking, might increase a child’s risk of certain cancers. So far, most childhood cancers have not been shown to have outside causes. Also, in recent years, scientists have made great progress in understanding how certain changes in our DNA can cause cells to become cancerous.

So where does the silver lining lie for young cancer patients? Less than five percent of children in India suffer from cancer. Cancer in children is highly curable with the help of chemotherapy and combined modality, as is done in the treatment of soft tissue tumours, surgery and radiation. Since cancers of children are highly sensitive to chemotherapy, most of cancers are cured. Similarly, the tolerance in kids for chemo treatment is high and lastly, the secondary genetic abnormalities are very rare.

According to the Indian Council of Medical Research (ICMR), the number of new cancer cases and cancer related deaths was approximately 10.78 lakh and 4.78 lakh respectively during 2013-14.

However, the increase in the number of cases may be attributed to the ageing population, unhealthy lifestyles, use of tobacco and tobacco products, unhealthy diet, better diagnostic facilities and so on.

The Central government in 2013-14 approved a scheme for enhancing the tertiary care cancer facilities in the country. There is a proposal for setting up a National Cancer Institute at Jhajjar, Haryana, and the development of a second campus of Chittaranjan National Cancer Institute, Kolkata.

And lastly...
n If diagnosed initially, most paediatric cancers are curable.
n Treatment lasts from six months to three years.
n Treatment cost remains in the range of sixty thousand to five lakh rupees.

(The writer is consultant, Medical
Oncology, BLK Super Speciality Hospital, New Delhi)