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Paediatric Cancer

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A diagnosis of cancer is heartbreaking at any age, but especially so when the patient is a minor. In such a condition, it is natural for parents to have questions like, who will treat my child? Will my child be ever able to have a normal life again? How will all this affect our family? While there is no suitable answer to all these questions, we have prepared this information to provide a starting point for parents to understand the basics of childhood cancers.

Childhood cancers are relatively rare, with only one child developing cancer globally out of 10,000 normal children. The initial diagnosis of cancer can be shocking and stressful for the child and his parents. These emotions are quite natural and understandable, but they are also combined with a lack of information as well as some misconceptions. Parents are sometimes too distressed to realise that most childhood cancers are treatable and completely curable.

Childhood cancers can affect any body part, more commonly the bones, blood, and muscles. Leukemias, lymphomas, sarcomas, and embryonal cancers are some commonly seen childhood cancers. In the current times of advanced technology and due to the developments in the medical field, more than 80% of childhood cancers are completely treatable. Some childhood cancers like lymphoblastic leukaemia and wilms tumour have a more than 90% cure rate. Some cancers like Hodgkin's disease and germ cell tumours even have more than a 95% cure rate.

Children are not mature human beings, so when they suffer from a serious illness, their needs differ from adults, which require them to be treated accordingly. They need to be treated at a specialized medical centre by professionals trained to deal with such kinds of cases. Kokilaben Dhirubhai Ambani Hospital is the best Paediatric Cancer treatment hospital in Navi Mumbai, where paediatric oncologists are responsible for treating childhood tumours like leukaemias, sarcomas, wilms tumours, and brain and spinal cord tumours. With timely, appropriate and efficient treatment plans, most children with cancer get cured completely and get a chance to lead peaceful and fulfilled lives.

Information and support are important parts of the process that helps parents cope with the distressing situation. As parents, the more you know about the type of cancer your child is suffering from and its treatment options, the less confused and anxious you will feel. You can also try attending support group meetings where you get a chance to meet other parents whose children are either being treated for different types of cancers or have completed the treatment.

Paediatric cancers can be broadly classified into primary and secondary cancers. Primary cancer is when cancer originates from the place where it is found. Secondary cancers metastasise to the location of cancer in a distant organ. Cancer cells can spread from one organ to another either through the bloodstream or the lymphatic system.

  • Leukaemia
    It is the malignancy of the blood and bone marrow. It is a common type of childhood cancer, accounting for about one-third of all childhood cancers. It further has variants like Acute Lymphocytic Leukemia (ALL) and Acute Myeloid Leukemia (AML). These cancers lead to generalised weakness, tiredness, weight loss, bleeding, joint pain and high fever. Acute leukaemias can grow very fast, so they need timely medical intervention in the form of chemotherapy.
  • Tumours of the brain and the spinal cord
    These are the second most common cancers in children, accounting for a quarter of all the cases. They commonly originate from lower parts of the brain like the cerebellum or the brain stem. They cause symptoms like light-headedness, double vision, severe headaches, vomiting, and difficulty walking or balancing.
  • Lymphomas
    They originate from the lymph nodes and lymph tissues. They can sometimes involve the bone marrow and other organs as well. Their most common symptoms include enlarged lymph nodes under the neck and the armpits, unexplained weight loss, and tiredness.
  • Wilms tumour
    It constitutes about 5% of all childhood cancers and commonly occurs in children aged 3-4 years. It begins in the kidneys and presents as a swelling in the abdomen associated with loss of appetite, nausea and fever.
  • Neuroblastoma
    They occur in infants and young children and account for about 6% of all childhood cancers. Neuroblastomas can begin anywhere but using start in the abdomen.
  • Bone Cancers
    They constitute about l - 3% of all childhood cancers. The most common variants are osteosarcoma and Ewing's sarcoma. Osteosarcomas occur in the areas of rapid bone development like the long bones in arms or legs. The pain usually worsens at night or while doing physical activity, leading to swelling around the bone. Ewing sarcoma occurs mostly in young teenagers. It starts in the hip bones, ribs, shoulder bladders, or leg bones.
  • Hodgkin Lymphoma
    Type of cancer affecting the lymphatic system, part of the body's germ fighting mechanism.
  • Non-Hodgkin Lymphoma
    It is a cancer that results in production of abnormal lymphocytes in the body. Lymphocytes are an important component of the body's immune system.

The symptoms of many cancers in children are similar to those of childhood injuries or illnesses, making them hard to recognize. However, the persistence of the below-mentioned symptoms requires immediate intervention:

  • A lump or swelling in the abdomen
  • Unexplained fatigue
  • Easy bruising or bleeding
  • Continuous pain in a body part like bones, joints, back
  • Limping
  • Unexplained persistent fever or illness
  • Frequent headaches associated with vomiting
  • Difficulty in walking or balancing
  • Sudden eye or vision changes including a white spot in the eye, new squint, new blindness, bulging eyeball
  • Unexplained weight loss

Paediatric oncologists diagnose childhood cancers by running tests to identify the specific category of cancer. After a diagnosis is established, a series of other tests are run to determine the cancer stage and the extent of its spread. Following are some of the most common investigations done:

  • Blood and Urine Tests
  • Imaging in the form of ultrasound, MRI, CT scan, or PET CT scan
  • Bone Marrow examination and lumbar puncture
  • Biopsy

Getting the diagnosis is very important to ensure the appropriate treatment of cancer. Once the diagnosis is confirmed, detailed counselling sessions are held by the oncologist and the other members of the cancer team for the child's parents. The team ensures that all children are comfortable and pain-free throughout the course of the treatment.

  • Surgery
    If the tumour is surgically resectable, most or all of it is removed by surgery
  • Chemotherapy
    It is the administration of certain specialized drugs to stop the growth of cancer cells or to destroy them. These drugs can be given intravenously, orally, intramuscularly, subcutaneously, or intrathecally. The chemotherapy drugs travel across the bloodstream, destroying the cancer cells as they go. Therefore, chemotherapy is useful to treat diffuse cancers, that is, blood cancers or other cancers that have disseminated to other body parts. Chemotherapy has side effects as sometimes they tend to affect the body's healthy cells. So, it is given in a few sessions or cycles to allow the healthy cells to recover.
  • Radiotherapy
    This treatment modality uses high energy beams from X-rays or protons to destroy the cancer cells. It is given in daily sessions at the medical centre or hospital, with each session lasting around 10-15 minutes. The overall duration of the tumour depends on the type of tumour and may extend from 2-6 weeks.
  • Bone Marrow Transplantation
    This medical procedure aims at replacing the damaged bone marrow cells with healthy cells. It is useful in certain types of recurrent cancers.

As the treatment of childhood cancers is quite strong and sometimes aggressive, it can sometimes give rise to certain side effects. Some children may experience only some of these side effects. They include:

  • Tiredness and fatigue
  • Aches and pains all over the body, including the jaw and the legs.
  • Decreased appetite
  • Nausea and vomiting
  • Diarrhoea
  • Sores and ulcers in the mouth or throat
  • Constipation
  • Hair loss
  • Low white blood cell counts (leukopenia) with or without infection
  • Anaemia

Please note that most of these side effects are treatable, so your child does not need to tolerate them. You must monitor your child carefully at all times, and if you notice any symptoms or side effects, you must report them to the oncology team immediately so that they can help you. The paediatric oncology team at Kokilaben Dhirubhai Ambani Hospital which comprises the best Paediatric Oncologists in Navi Mumbai is always ready to help the small angels in their treatment journey to relieve all treatable symptoms and alleviate the anxiety of the parents.