Over four lakh children are detected with cancer every year in the world and in India the reported cases are around 50,000. As the number of such cases is increasing, with survival rates in developing and underdeveloped countries falling, WHO in 2018 announced a Global Initiative for Childhood Cancer. Manas Kalra, a senior paediatric oncologist at New Delhi’s Ganga Ram Hospital, spoke to Amit Anand Choudhary on precautionary measures that need to be taken:
Childhood cancers are more amenable to treatment and have better cure rates as compared to adult cancers. The types of cancers seen in adults and children are also different. While children more often suffer from blood cancers, lymphomas and brain tumours; solid tumours like breast, prostate, lung, oral, stomach and intestine cancers commonly afflict adults. Children tolerate chemotherapy much better than adults and have fewer side effects. Like they say, every child has a superhero inside him. They don’t worry about the outcomes, appearance, finances and future. This robust attitude positively impacts their outcome.
What are the reasons for cancer at an early age?
Little is known about the cause of cancer and even less is known about how to prevent cancer. With intensive research in cancer we are gaining expertise in treatment, but still need to understand its cause and ways of prevention. In simple terms, cancer happens because the repair mechanism of the body gets disturbed. Aberrations happen in our cell machinery which the body fails to repair and this ultimately leads to uncontrolled division of cells.
This disease in children spreads like a wildfire in the body and reaches an advanced stage in just a few weeks. What are the symptoms which could be a signal for parents to seek timely medical consultation?
One should suspect malignancy if fever persists beyond 1-2 weeks and after all the basic tests for infections and common illnesses have come out to be negative. Often these children are treated for typhoid or TB without adequate evidence.
Other common symptoms are bone pains and lump felt anywhere in the body – commonly in the belly, neck or bones. These lumps are generally painless and keep growing in size. In some children it can present with back pain, paleness of skin, bruises and unexplained weight loss, recent onset of squint, and white reflex in the pupil or protrusion of eyes. Brain tumours can present with recurrent headaches, vomiting or disturbance in balance and gait.
What are the chances of recovery in case of childhood cancer? When can a child be declared cancer free? Also, is the treatment available in smaller cities?
Thirty-forty years ago, not more than 20% children survived cancer. The diagnosis of cancer was considered a death sentence. Not anymore. Childhood tumours have set the modern day paradigm for cure of cancer. Acute lymphoblastic leukemia – the commonest blood cancer in children – can be cured in 80% of the cases with modern chemotherapy which lasts a period of 2-2.5 years. The time period varies with the type of cancer, ranging from 4 months to 2-3 years. There are chances of relapse in the first 5 years from the diagnosis, after which we consider the patient cured. With access to chemotherapy, pathology labs, radiation oncology and blood banks – treatment is now available in many second tier cities as well.
How is life after cancer for children? Can they lead a normal life after treatment?
Treatment for childhood cancer is challenging but children are very resilient and recover quite soon. Hair loss, skin and nail changes are temporary and revert back once the treatment finishes. Most childhood cancers are cured and many children live an almost normal life after completion of therapy. Late effects of cancer treatment are more common after treatment of brain and bone tumours. With newer technologies of radiation, non-mutilating surgeries and advances such as targeted therapy/ immunotherapy, even these late effects are being minimised. Life is not about how fast you run or how high you climb, it’s about how well you bounce back!
The treatment cost is high and may be unaffordable to many. What options are available to get financial assistance?
No doubt chemotherapy drugs, radiation, surgery used in the treatment are costly, but there are many support systems available to help parents to get financial aid. There are government funding facilities both from the PM’s and CM’s relief fund for children suffering from cancer. Many NGOs are doing a commendable job in helping such children by providing assistance with drugs, access to expensive investigations and even financial support to survive through this difficult journey.
Views expressed above are the author’s own.
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