February 15 is observed globally as the International Childhood Cancer Day (ICCD). As per reports, cancers occurring in children in the 0-14 age group accounts for 0.7 to 3.7% of all cancer reported in all age groups in India. Dr Shwetha Seetharam, Associate Consultant – Paediatric Oncology, KIMSHealth Cancer Centre, answers a few questions on childhood cancer here.
Is it common for children to get cancer?
The common question that I hear is “do children get cancer?”. The answer, unfortunately, is yes. But it is rare. According to reports, cancers occurring in children in the 0-14 age group accounts for 0.7 to 3.7% of all cancer reported in all age groups in India.
How can we prevent cancer in children?
The cause of cancer in children is largely unknown. What we can say for sure, is that it has to do with the genetic makeup of the patient. In less than 5% of cases, it may be familial. In the absence of strong causative factors, there are no real steps which can be taken for cancer prevention in children unlike in adults.
What are the symptoms? How can one check?
The common symptoms associated with pediatric cancer are:
- Pallor, bruising or bleeding, general bone pain
- Lumps or swelling – especially if painless and without fever or other signs of infection
- Unexplained weight loss or fever, persistent cough or shortness of breath, sweating at night
- Eye changes – white pupil, new onset squint, visual loss, bruising or swelling around the eye(s)
- Abdominal swelling
- Headaches, especially if unusually persistent or severe, vomiting (especially early morning or worsening over days)
- Limb or bone pain, swelling without trauma or signs of infection
If a parent or physician notes any of these symptoms, the child needs further investigations.
What are the common cancers seen in children?
Leukemias (also known as blood cancers) are the most common type of pediatric cancers.
Of the leukemias, acute lymphoblastic leukemia is the most frequently seen. Children may also be affected by solid tumors, most commonly brain tumors. Other solid tumors seen in children include neuroblastoma, Wilm’s tumor of the kidney and rhabdomyosarcoma. Bone tumors such as Ewing sarcoma and osteosarcoma are also seen in children. However, many of the common adult cancers such as breast and gastrointestinal tumors do not occur in children
What are the various treatment options available today?
The common treatments available today include chemotherapy, surgery, radiation therapy, immunotherapy and stem cell transplant. Depending on the type of cancer, these treatments may be given singly or in various combinations. All patients may not require all these treatment options.
Are there any services to help the child cope with the ailment?
Generally, children cope with cancer treatment a lot better than adults. They usually do not have any underlying co morbidities that adults may have like hypertension or diabetes. They tolerate chemotherapy a lot better. They also do not usually suffer from the depression that an adult may face on receiving a diagnosis of cancer. The parents on the other hand do need help to cope. Most cancer centers have in-house counsellors and dieticians apart from oncologists and nurses to help in the day-to-day all-round care of our young charges. The physical and mental health of the child is to be nurtured during the treatment and special emphasis has to be given to nutrition to complement the young one’s growth.
What is the survival rate in pediatric cancer?
Overall pediatric cancer has a much better survival as compared to adult cancers with an approximate survival of 60 to 70%. The survival rate varies with the type of cancer and the stage of the tumor at the time of diagnosis. The survival rate in a country like India also depends on the availability of lab facilities, drug availability, abandonment of treatment and the presence of effective supportive care. Nowadays with the various Government schemes and NGOs providing both financial and supportive aid, more children are able to complete treatment and hence have better survival.
Do children with cancer have significant risk of serious infection? How can we prevent it?
Children who are on chemotherapy for cancer treatment have poor immunity and are at high risk for infections. Parents should take great care in maintaining the child’s personal hygiene including oral hygiene. Bathing regularly and washing mouth after feeds is a must. Care should be taken during food preparation. A child on chemotherapy should be given freshly prepared nutritious food. Avoid junk food and eating out. Avoid taking the child to crowded areas or large functions where crowds are expected like weddings. Restrict visitors as much as possible. This is of great importance during the present coronavirus pandemic too. If either parent develops a cold, they should distance themselves from the child and use a mask if they have cough or sneezing.
Will a child with cancer still feel & act like a child, be able to play and go to school?
Children are very resilient. Most children are active and playful even during their chemotherapy. Only infections affect their cheerful demeanor. Whether they can continue school depends on the intensity of the chemotherapy they are receiving and their risk for contracting infections from their school fellows. Patients with leukemias usually miss out on one year of school.
What are the treatment options available at KIMSHealth Cancer Centre?
KIMSHealth Cancer Centre offers all the 3 major cancer treatment modalities – chemotherapy, surgery and radiotherapy. With respect to children with cancer, we have trained oncology nursing care, counsellors and nutritionists for the all-round care of the child. We have facilities for central line insertion and care and all invasive procedures are done with the help of short anesthesia to limit any discomfort to our patients as much as possible. All cancer surgeries are performed by a team of pediatric surgeons and surgical oncologists. We have highly experienced radiation oncologists with state-of-the-art equipment for radiotherapy.
A very important aspect of cancer care is supportive care. We are able to provide excellent supportive care to these patients in the form of dedicated oncology nursing, pediatric intensivists, an exceptional pediatric ICU with support from Infectious Diseases specialists for care of infections. We have a well-equipped blood bank to deal with any transfusion requirements. Most of the major pediatric subspecialities are well represented in KIMSHealth, Thiruvananthapuram including neonatology, pediatric cardiology, pediatric neurology, pediatric endocrinology etc.