Paediatric Cancer

Paediatric Cancer

Paediatric cancers are the cancers that occur in children. Most cancers that occur in the paediatric age group are different from those seen in adults. Examples are neuroblastomas, retinoblastomas, leukemias, lymphomas, wilms tumour, and sarcomas. Kids usually respond better to treatment than adults do.

A diagnosis of cancer is upsetting at any age, but especially so when the patient is a minor. This may make the parents wonder if the child will ever lead a normal life again. How will all this affect our family? While only time will give the answer to these questions, here is some important information about the basics of childhood cancers.

Childhood cancers are relatively rare, and statistics suggest that only one child develops 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 natural and understandable, however they may also be combined some misconceptions. Parents are sometimes too distressed to recognize 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 present era 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 fully developed human beings, so when they have a serious illness, they have different demands than adults, and must be treated with utmost care. They need to be treated at a specialised medical centre by professionals trained to deal with such kinds of cases. Kokilaben Dhirubhai Ambani Hospital is the best paediatric cancer treatment hospital in Indore, where paediatric oncologists are responsible for treating childhood tumours like leukaemias, sarcomas, Wilms tumours, and brain and spinal cord tumours. With prompt and effective treatment plans, most children with cancer have successful outcomes of their treatment and lead a healthy life ahead.

Information and support are significant 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 participate in support group meetings where you get a chance to interact with other parents whose children are either being treated for cancer or have completed the treatment.

Paediatric cancers are broadly classified into primary and secondary cancers. Primary cancer is when cancer originates from the place where it is found. Secondary cancers metastasize to the location of cancer in a distant organ. Cancer cells usually 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, weight loss, bleeding, tiredness, joint pain and high fever. Acute leukaemias can grow very fast, hence they require 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, vomiting, severe headaches, 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, tiredness and unexplained weight loss.
  • Wilms tumour
    It constitutes about 5% of all childhood cancers and commonly occurs in children aged 3-4 years. It begins in your kidneys and shows up as a swelling in the abdomen associated with loss of appetite, fever and nausea.
  • 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 can form in places where bones grow quickly, such as the long bones in the arms or legs. Swelling occurs around the bone as a result of the discomfort, which typically gets worse at night or after physical exercise. Young adolescents are the main victims of Ewing sarcoma. It begins in the ribcage, shoulder blades, hip bones, 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.
  • Rhabdomyosarcoma
    These cancers arise from the connective tissues of the body such as fat and muscle. Following are the two most common types of rhabdomyosarcomas seen in children:
  • Embryonal rhabdomyosarcoma (ERMS)
    It is more common in children below the age of 6 and is seen in the neck, head, bladder, and groin area.
  • Alveolar rhabdomyosarcoma (ARMS)
    This cancer affects kids of all ages and is more commonly seen in the legs, arms, and trunk.
  • Retinoblastoma
    It is the cancer that originates in the eye. It constitutes around 2% of all childhood cancers. The cancer generally affects young children, around the age of 2 years. It is usually diagnosed when the doctor notices something unusual around the eyes of the child. For example, the pupil might look pink or white when a light is directed on it, when it normally would appear red in colour. The treatment options for retinoblastoma include surgery, laser therapy, chemotherapy, and radiation therapy. Another option is cryotherapy— a treatment that involves damaging the cancer cells by freezing them.

The symptoms of many childhood cancers are similar to those of childhood injuries or illnesses, making them hard to recognise. However, if you notice any of the below symptoms, you must seek immediate medical care:

  • 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 conducting a series of tests to identify the specific category of cancer. After a diagnosis is established, a series of other tests are performed 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, the oncologist and other specialists hold in-depth counselling sessions with the child's parents. The team takes all the essential steps to ensure that the children are comfortable during the duration of the therapy.

  • Surgery
    If the tumour is surgically resectable, most or all of it is removed by surgery
  • Chemotherapy
    It is the administration of certain specialised drugs to stop the growth of cancer cells or to destroy them. These drugs can be given intravenously, intramuscularly, orally, subcutaneously, or intrathecally. The chemotherapy medications move through the bloodstream, killing cancer cells along the way. Chemotherapy is essentially useful treat diffuse cancers, which is blood cancer or other cancers that have disseminated to other body parts. Chemotherapy may have certain side effects as sometimes they tend to affect the body's healthy cells. 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 frequent sessions at the medical centre, with each session lasting around 10-15 minutes. The overall duration of the treatment 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 may lead to some 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 can be treated and your child will suffer from minimal discomfort. You must closely monitor your child at all times, and inform your doctor in case of any unusual symptoms or side effects. The paediatric oncology team at Kokilaben Dhirubhai Ambani Hospital, Indore has the best paediatric oncologists in Indore. The team is always ready to help the small angels in their treatment journey to relieve all treatable symptoms and alleviate the anxiety of the parents.

Receiving a diagnosis of childhood cancer can be quite scary for the parents. Most of them often don’t know that their kid has the disease until it has progressed to an advanced stage, where the treatment options are limited. If you suspect your child has symptoms suggestive of childhood cancer, you must talk to a healthcare provider and seek medical attention. If you are located in Indore, you can visit the Kokilaben Dhirubhai Ambani Hospital, Indore and get an appointment with an expert who will guide you to the next step.