Facts about cancer in children
- Childhood cancer is curable if diagnosed early and treated appropriately
- It is not infectious and does not spread from one child to the other
- It is not usually inherited through the genes
- Early diagnosis and prompt treatment are essential for good cure rate
- Cancer in children is quite different from that in adults in many ways. Firstly only 3% of all cancers occur in children, secondly they are fast growing but also very sensitive to chemotherapy treatment. Cure is a very realistic and practically achievable goal.
- As the treatment is often long it is very important that extra care is taken at home to ensure treatment discipline and regularity, good hygiene and balanced nutrition.
- The treatment for cancer is somewhat complicated therefore it is advisable to take treatment in an experienced and specialized pediatric cancer unit.
- A child after completing treatment for cancer is normal like any other child can go to school and play etc.
- Although the actual number of children who develop cancer is small, the cure rate is high and the total number of productive life years saved by curing these children is significantly high and therefore the effort in treating them appropriately is all the more worthwhile and fulfilling.
- Warning Signs of Childhood Cancer
- S: Seek: Medical help early for persistent symptoms
- I: Eye: White spot in the eye, new squint, blindness, bulging eyeball
- L: Lump: Abdomen and pelvis, head and neck, limbs, testes, glands
- U: Unexplained: Fever, loss of weight and appetite, pallor, fatigue, easy bruising or bleeding
- A: Aching: Bones, joints, back and easy fractures
- N: Neurological signs: Change in behavior, balance, gait and milestones, headache, enlarging head
Remember – Childhood cancer is curable
FAQ About cancer in children
- What is cancer?
Cancer is the abnormal growth of a cell or group of cells. When a cell starts growing in an uncontrolled way, it leads to cancer.
- What are the possible causes of cancer in children?
Though it is very difficult to pin point the definite cause of cancer, certain substances such as carcinogens have been shown to increase the chances of getting cancer in adults. For instance, people who smoke or chew tobacco are more prone to mouth, throat and lung cancer. Although tremendous amount of research is going on in this field we still do not know the causes of cancer in children.
- What are the common types of cancer in children?
They are very different from those that occur in adults. The common ones are Acute lymphoblastic leukemia, Hodgkin’s lymphoma, Non-Hodgkin’s lymphoma, Wilms’ tumor, retinoblastoma, brain tumors, bone tumors, neuroblastoma, Ewings sarcoma, osteosarcoma etc.
- What are the types of blood cancer in children and what are their symptoms?
There are two types of blood cancer (leukemia) in childrena) ALL (Acute lymphoblastic Leukemia) ( more common)b) AML (Acute Myeloid Leukemia)The symptoms of blood cancer are prolonged fever, weakness, fatigue and lethargy and children may also have other complaints like bone or joint pains, limping gait, bleeding under the skin, swelling of lymph glands in the neck or swollen abdomen (Due to enlarge liver and spleen) and headache.
- What is the treatment of blood cancer and what is its duration?Treatment of blood cancer mainly includes chemotherapy and it lasts about 2-3 yrs. The treatment of AML is quite different from ALL. It consists of about 5-6 months of aggressive chemotherapy and children often need a bone marrow transplant (BMT). Generally in ALL there is no need of BMT.
- What is chemotherapy?Chemotherapy implies treatment with anti cancer drug. Chemotherapy is the backbone of cancer treatment in children. It includes a group of medicines called cytotoxic agents which have the power to kill cancer cells. Most of these are injections while a few are also available as oral medicines.
- Do patients of blood cancer need lifelong blood transfusion?No, after completion of treatment there is no need for blood transfusion.
- What is LP and why it is done?As the chemotherapy drugs do not reach the brain in sufficient amount to kill cancer cells, anti- cancer medicine is injected into the fluid which bathes the brain and the spinal cord called CSF. This procedure is called lumbar puncture (LP). A fine needle is inserted in the middle of the lower back in the space between two lumbar vertebrae (back bone) and the drug is gently injected.
- What are the reasons for the side effects like vomiting, loss of hair, mouth ulcers , anemia, decrease of blood counts, diarrhea, etc. during chemotherapy?Chemotherapy mainly kills cancer cells; it also affects normal dividing cells causing side effects. Many of these are temporary and reversible, once chemotherapy is stopped.
- When does the hair starts grow back after chemotherapy?Generally hair growth starts 3-6 months after cessation of chemotherapy.
- What is PICC line and why is it inserted?PICC line (peripherally inserted central venous catheter) is a central catheter which can be easily introduced through a peripheral vein in the arm. The tip of this tube lies inside the central vein deep inside the chest. It can be kept in place for up to 6 months.Cancer treatment is quite prolonged, requiring frequent blood tests and repeated injections to administer medication, blood and intravenous fluids. Hence to avoid multiple painful skin pricks, central line is placed in a large vein of the body for safe and pain free treatment.
- How common is cancer in children?
Although cancer in children is rare, it is an important cause of death by disease after infancy among children. In India, it is estimated that about 50,000 children and adolescents ages 0 to 19 years will be diagnosed with cancer each year.
- What are the common types of cancers in children? Are they similar to cancers in adults?
Cancers in children are quite different from those in children. The most common types of cancer diagnosed in children and adolescents are leukemia, brain and central nervous system tumors, lymphoma, rhabdomyosarcoma, neuroblastoma, Wilms tumor, bone cancer, and gonadal (testicular and ovarian) germ cell tumors. These often fast growing and respond well to chemotherapy treatment. Cancer is far more common in adults, and nearly 8 lakh cases are diagnosed in India every year. Adult cancers include breast cancer, cervix cancer, lung cancers, prostate cancers, these are epithelial cancers and do not usually occur in children. The outcome of adult cancers is also not as good as it is in children.
- What are the possible causes of cancer in children?
By and large, the causes of most childhood cancers are not known. Most cancers in children, like those in adults, are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer. In adults, these gene mutations are often the result of exposure to environmental factors, such as cigarette smoke, chewing tobacco, and ultraviolet radiation from the sun. However, environmental causes of childhood cancer have been difficult to identify, partly because cancer in children is rare, and partly because it is difficult to determine what children might have been exposed to early in their development. Hence, although tremendous amount of research is going on in this field we still do not know the exact cause of cancer in children.
- Can cancer be inherited from parents?
By and large cancer occurs due to a chance mutation and is NOT inherited. Having said that, we know that 5% of of all cancers in children are caused by an inherited mutation (a genetic mutation that can be passed from parents to their children). For example, 25 to 30 percent of cases of retinoblastoma, a cancer of the eye that develops mainly in children, are caused by an inherited mutation in a gene called RB1 (7). However, retinoblastoma accounts for only about 3 percent of all cancers in children. Inherited mutations associated with certain familial syndromes, such as Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, Fanconi anemia syndrome, Noonan syndrome, and von Hippel-Lindau syndrome, also increase the risk of childhood cancer.
- What is the chance of cure and survival for children with cancer?
The overall outlook for children with cancer has improved greatly over the last 30 years. Internationally most cancers have very good cure rates, for example in the USA in 2004-2010, more than 80 percent of children diagnosed with cancer at age < 18 years survived for more than 5 years. In India too, the past 10 years have seen tremendous advancement in cancer therapy. With early diagnosis and proper treatment these results are achievable in our country as well.
- Where should children with cancer get treated?
Children who have cancer are often treated at a children’s cancer centre, which is a hospital or a unit within a hospital that specializes in diagnosing and treating children and adolescents who have cancer. Most children’s cancer centers treat patients up to 18 years of age. The health professionals at these centers have specific training and expertise to provide comprehensive care for children, adolescents, and their families.
- What does cancer treatment involve and why do we need a specialist/ specialized centre?
Cancer treatment is usually multi-modality, and may involve chemotherapy, surgery and or radiotherapy in various combinations. These are all very specialized treatments requiring special equipments, infrastructure and expertise. The exact treatment in each individual case depends on the type of cancer and its stage and often on where it is located (for solid tumors).
- How can we screen for cancer in children and can cancer be prevented in children?
Early diagnosis is possible but usually screening is reserved cancers in adults (eg. Paps smear for cancer cervix and mammography for breast cancer).
- What are early signs of childhood cancer?
- What are the precautions to be taken for children undergoing cancer treatment?
- What is the treatment of blood cancer and what is its duration?