Cancer among children a worry

Although cancer is usually perceived as an adult’s disease, depending on the geographic location, two to 10 per cent of cancers happen in children. According to WHO reports, nearly 3 lakh children get diagnosed with cancer every year. It is estimated that in 2020, around 50, 000 children under the age of 15 years will be affected by cancer.

At present, as children form a substantial proportion of the population, India has the high childhood cancer burden but the survival rate is still less than optimal. This is mainly due to the lack of access to high quality care. Developed countries on the other hand have survival rates as high as 70 to 80 per cent, and up to 90 per cent in some cancers. Cancer in children is different from that in adults. They tolerate treatment better and respond to it more efficiently than adults thereby achieving better results. In most cases of childhood cancer, no cause is found. In some, cancer can be due to genetic causes. Environmental factors like radiation, chemical carcinogens can lead to cancer.

The most common form of cancer in children is leukaemia. Most frequent signs include spots on body, fever, sore throat, loss of energy, pale look and bone pains. They can be limping or crying excessively on handling, because of bone pains. The doctor might notice swollen glands in the neck or liver and spleen might be bigger. Suspicion is confirmed by a simple blood test and sometimes bone marrow test may be required.

Lymphomas are the second most common cancer among children in India. These children may have unexplained fever, weight loss, loss of appetite and glands might become big in neck, armpits and groin. Similar enlarged lymph glands may be found in chest and abdomen on investigation.

Tumours of brain and spinal cord are the next common group. Children might have early morning headache, repeated vomiting, fits and visual problems like squint. The diagnosis is usually made on a MRI scan of head and spine. Children are also affected by other forms of cancer like bone cancers, cancer of kidneys, liver and retina of eye.

Most of these are treated with chemotherapy to kill cancer cells. Some might need surgery, and a minority of them may need radiotherapy. In some high risk cancers or in those that have spread or relapsed, bone marrow transplantation may be required. According to the type of cancer, a combination of modalities may be used. With the right treatment, 70 to 80 per cent of children get cured and lead near normal lives.

(The author is consultant, Paediatric Haematology, Oncology & BMT, Aster CMI Hospital)