Cancer is the main cause of death in children and adolescents (0-19). This is mainly in high-income countries. At the same time their survival rate is 80% in them, whereas in low-income groups the survival rate is only 15 to 40%, the reason here is delay in diagnosis, consulting after advanced stage, stopping the treatment mid-way and may be because of side effects and no proper knowledge of taking care of the diseased children.
CAUSES OF CANCER IN CHILDREN:
Cancer can start in people of all ages, unlike in adults there is no definite cause for in children. The cause can be because of the lifestyle our children lead today or environmental exposure.
- Some chronic infections—HIV, Epstein-Barr virus and malaria can be the causes.
- If not vaccinated against hepatitis B, children can develop liver cancer,
- Human Papillomavirus vaccine to be taken to prevent cervical cancer.
- Some genetic factors are also the cause.
- Some cancers are inherited like eye cancers in children.
RISK FACTORS OF CHILDHOOD CANCER:
A risk factor means the chances of getting a disease such as cancer. The risk factors are:
- Lifestyle and environmental—being overweight, no proper exercise, eating an unhealthy diet, may not affect children that much. Environmental risk can be due to exposure to radiation in childhood. Exposure to parental smoking.
- Cancers can be caused by DNA changes.
- Some children inherit DNA changes from parents and increase the risk of developing cancer among children.
WAYS TO IMPROVE CHILDHOOD CANCERS:
- We can reduce the burden of cancer in children as we cannot prevent it.
- Correct diagnosis at the right time.
- Correct treatment.
- Care to be taken thoroughly.
Three things to be kept in mind—
- Families and caretakers must have an awareness of the symptoms.
- Accurate and timely diagnosis and to know the stage and spread of the cancer.
- Correct and prompt treatment.
A correct diagnosis always helps to administer the right treatment. If childhood cancer services are available 80% of the children can survive. Children also need a dedicated multi-disciplinary team, a good diet, continuous family attention.
- Treatment methods include Surgery, Chemotherapy or Radiotherapy.
- Pharmacological treatment—inexpensive GENERIC MEDICATIONS that are listed by WHO (27 cytotoxic agents, 5 targeted therapies, and 4 hormone treatments).
- After treatment children need to be monitored for cancer recurrence and to manage long-term impact of treatment.
PEDIATRIC PALLIATIVE CARE:
- This care decreases the symptoms caused by cancer and improves the life of the patients and their children.
- It is not possible to cure all the children affected with cancer but can relief of suffering for everyone can be possible.
- Palliative care starts from diagnosis, treatment to care, whether the patient can be cured or not.
- Palliative care programs are held through community and at home also.
- This provides relief to the child and family.
- Oral morphine is given for treatment of moderate and severe cancer pain, for more than 80% at the beginning stage.
W.H.O. RESPONSE TO CHILD CANCER:
WHO launched a program The Global Initiative for Childhood Cancer and provided leadership and technical assistance to world governments to build childhood cancer program. The goal was to achieve 60% survival globally by 2030 of children suffering with cancer. The initiatives taken up were. The initiatives taken up were:
- Countries should follow best practices in childhood cancer and,
- Prioritization of childhood cancer at the global, regional and national levels.
- The CURE ALL framework is helping by sharing expertise between countries and partners.
WHO and The International Agency for Research on Cancer (IARC) in collaboration with The International Atomic Energy (IAEA) and UN organizations are helping the world countries:
- Support governments to develop high-quality cancer centers and regional satellites for perfect diagnosis and effective treatment for childhood cancer.
- To develop standards and tools to guide and to plan for best results in palliative care and treatment.
- To improve to get essential medicines and technologies at affordable amount.
- To support governments to help families of children with cancer from getting into financial problems and social isolation as a result of cancer care.
CYTOTOXIC MEDICINES FOR CHILDREN WITH CANCER:
The International Society of Pediatric Oncology (SIOP) has proposed a list of anti neo plastic drugs for low and middle income countries that should be available. 18 essential and 8 ancillary anti neo plastic medicines list (NEMLs) or national reimbursable medicines lists (NRMLs) of 135 countries were extracted.
Targeted therapy is a cancer treatment where drugs are used to target specific genes and proteins that involve the growth and survival cancer cells, like blood vessel cells.
Targeted therapy is administered along with Chemotherapy and other treatments. Targeted therapy does different things to the cancer cells they target:
- Block or turn off signals of the cancer cells that grow and divide.
- Do not allow the cells to live longer than normal.
They destroy the cancer cells.
There are many different types of targeted therapy, but the most common types are Monoclonal antibodies or Small-Molecule drugs.
Along with Targeted Therapy most of them also need Surgery, Chemotherapy, Radiation Therapy or Hormone Therapy.
COMMON CHILDHOOD CANCERS:
Among children the most common cancers are:
- Central Nervous System Tumors,
- Kidney tumors,
- Malignant Bone Tumors.
Among these LEUKEMIAS, the cancer of the bone marrow and blood are the most common childhood cancers.
The rarest childhood cancers are:
- Hepatoblastoma—develops in children under five years old.
- Hepatocellular Carcinoma or HCC—develops in older children
- Liver Cancer –Primary, effects the liver 0r Secondary, which has spread from another part of the body.
Childhood Cancer is always scary, but the good news is that now many childhood cancers, about 80% of them are curable. Children are generally treated at specialized cancer centers. At these centers a team of doctors like Pediatricians, Surgeons, Oncologists, and Radiation Oncologists work as a team to ensure the best treatment for every child. Parents also involve themselves at every stage of diagnosis and treatment.