When the big C hits the little ones
Paediatric cancers occur largely due to a child’s genetic makeup, and acceptance is imperative so the patient can get immediate treatment, writes Kasmiah Mustapha
EACH year, approximately 300,000 children are diagnosed with cancer worldwide. Although childhood cancers are rare, Childhood Cancer International says they are threatening to overtake infectious diseases as one of the highest causes of disease-related mortality in children.
The World Health Organisation states that cancer in children occurs most likely due to the child’s genetic makeup rather than lifestyle or the environment.
The pattern of cancer in childhood differs considerably from those among people of other ages. In general, leukaemia constitutes about a third of all childhood cancers.
The other most common malignancies are lymphomas and tumours of the central nervous system. There are several tumour types that occur almost exclusively in children including neuroblastoma, nephroblastoma, medulloblastoma and retinoblastoma.
Prince Court Medical Centre paediatric haematologist Dr Eni Juraida explains further about childhood cancers.
WHAT ARE THE DIFFERENCES BETWEEN CHILDHOOD AND ADULT CANCERS?
The difference is the type of cancer itself. Childhood cancers sometimes occur as a result of changes in DNA that happen either in the embryo or very early in life.
In the majority of cases there is no single known cause but most childhood cancers are not related to any environmental factors.
Some children who are born with certain syndromes will be at a higher risk of getting cancer. Most children who are diagnosed with cancer often don’t have a family history of cancer.
AS CANCER CAN RESULT FROM GENETIC CHANGES DURING PREGNANCY, WHAT IS YOUR ADVICE?
Honestly, we don’t know who is going to get cancer. There is no specific advice I can provide that will guarantee your child doesn’t get cancer. So I advise women to consistently maintain a healthy lifestyle.
HOW CAN PARENTS DETECT THE SYMPTOMS?
Different cancers present in different ways. The symptoms and signs of cancer can be quite nonspecific. Infections and fevers are common in children. But when the fever is prolonged or keeps recurring it requires further looking into.
Other symptoms include the appearance of abnormal lumps and bumps such as on the limbs that cannot be adequately explained by trauma, and especially if there a progressive increase in the size of the swelling
Leukaemia is a systemic disease so the child can have fever that comes on and off, joint pains or bleeding tendencies — bruises, bleeding nose, bleeding gums. The child may even appear pale.
WHAT IS YOUR ADVICE FOR PARENTS UPON DIAGNOSIS?
The first step is acceptance because if parents are in denial, it is very difficult to move on. We will then discuss treatment options and what to expect during the process, especially the side-effects.
WHAT ARE THE TREATMENTS?
The treatments depend on the type and stage of the cancer. It may be just surgery alone, chemotherapy or a combination of surgery, chemotherapy and radiotherapy.
The diagnosis and treatment of all paediatric cancers come under the purview of the paediatric oncologist. The other malignancies may be managed by the medical oncologist, the radiation oncologist or the various subspecialists such as surgical oncologist, gynae-oncologist or orthooncologist.
WILL THE TREATMENT AFFECT THE CHILD’S DEVELOPMENT AND GROWTH?
All medications have side-effects. Different people react differently to the same type of medication. Although chemotherapy targets the tumour, there will be to some extent effects on normal tissues such as heart, lungs and kidney.
Some drugs have an effect on the brain and nervous system. In boys, some drugs may affect their fertility. The family should be forewarned that this may happen so it doesn’t take them by surprise later on.
WHAT ARE THE RISKS OF THE CANCER RECURRING?
There is always a risk of recurrence for any tumour. If the child remains disease-free for a certain number of years after treatment, then he can be considered as cured.
However, the follow-up is lifelong. In the early days, the followup is to monitor for possible disease recurrence or relapse. Subsequently it is to monitor for late effects of the treatment, any other health issues, as well as the development of second malignancies.
However, despite the challenges, childhood cancers are potentially curable conditions. The treatment is a complex and long process. It also takes a lot out of the parents and the family, emotionally, financially and psychologically. But the outcome for childhood cancers is good.
Most children who are diagnosed with cancer often don’t have a family history of cancer.
Dr Eni Juraida