More than 50,000 new cases of childhood cancer occur each year in India, adding to the existing burden of the disease. The most common cancers in children are blood cancers, such as leukemia, which account for about 30 percent of childhood cancers. These cancers are more prevalent among children between the ages of 2 and 6.
Brain and spinal cord tumors are the second most common cancers, accounting for 26 percent, followed by neuroblastoma (cancer of nerve cells), bone cancer, retinoblastomas (cancer of the eye), lymphomas, liver cancer, and kidney cancer. The success rate of cancer treatment in children has significantly improved over the past four decades, rising from 20-30 percent to 80-90 percent. After treatment, most children are able to live normal lives. It is a remarkable success story.
However, the biggest challenge facing India today is the late diagnosis of cancers, which severely affects the treatment and cure rate of the disease.
Epidemiology
According to the World Health Organisation ( WHO), only 30 percent of children in low- and middle-income countries are cured of cancer, compared to 80 percent in developed nations. Unlike cancer in adults, the majority of childhood cancers do not have a known cause. Numerous studies have sought to identify the causes of childhood cancer, but unlike in adults very few cancers in children are caused by environmental or lifestyle factors. Current data suggests that about 10 percent of all children with cancer have a predisposition due to genetic factors.
Symptoms
The common symptoms of these cancers are frequent fever or headache, paleness, loss of energy, unexplained weight loss, sudden bleeding, or bruising. Solid tumors such as neuroblastoma can lead to lump formation in the abdominal area, a mass under the skin that isn’t tender when touched; besides, abdominal pain and changes in bowel habits such as diarrhea or constipation are among the other symptoms.
In cases of brain tumors, children often complain of morning nausea with forceful vomiting, sudden loss of vision, headaches, lethargy, and drowsiness. Macroencephaly (enlarged head) in infants whose skull bones are not completely fused, seizures are also not so uncommon symptoms. Kidney cancers commonly present as lump and/or pain abdomen. At times it might be associated with blood in urine. While these cancers can all be diagnosed by an observant doctor, the challenge lies in getting these children to the right facility at the right time. The frustration and sadness of losing a patient who could have been saved with timely treatment is enormous.
Treatment
Cancer treatment is more than surgery, chemotherapy, radiation therapy, or Bone Marrow Transplant. It must be a holistic approach that begins with timely diagnosis. When identified early, cancer is more likely to respond to less intense treatment, increasing the chances of survival. It is also less expensive. Equally important is counseling parents so that they do not lose hope. Often, the mention of the word “cancer” can devastate parents, leaving them feeling hopeless. Of course, the treatment must be precise. The type and stage of cancer, as well as the age of the child, determine the course of treatment. If treatment is successful, the chances of which are ever-increasing, we just need to handle side effects and ensure the child gets good nutrition. And, in most cases, the child can lead a cancer-free life.
(Dr Naresh Purohit is Epidemiologist And Advisor- National Cancer Control Programme. The views and opinion expressed in this article are those of the author)
