Dr Jitendra Pehalajani, Medical Oncologist, HCG Cancer Centre Jaipur highlights the key aspects of childhood cancer
Cancer is a leading cause of death amongst children and adolescents globally. The likelihood of surviving from childhood cancer depends on the type of place they hail from. On analysing, it was observed that approximately 80 per cent of children hailing from high-income countries can be cured of the cancer they are diagnosed with, compared to 50 per cent in children hailing from low-income nations. The reasons behind the difference in survival rates are delay in diagnosis, inability to obtain an accurate diagnosis, inaccessible therapy, abandonment of treatment, death from side effects and avoidable relapse.
Cancer formation in children is difficult to prevent, but is treatable when diagnosed at the initial stage. Based on the diagnosis, the treatment needs to be strategised effectively to reduce the burden of cancer in children. Enhanced and improved outcomes can be expected, with accurate and quality diagnosis, followed by effective evidence-based therapy with tailor made supportive care.
Early diagnosis of cancer
With early diagnosis, cancer is more likely to restrain with effective treatment resulting in a greater probability of survival, less suffering, and often less expensive and intensive treatment. Significant improvements have been witnessed by early detection of cancer and providing awareness of various symptoms diagnosed, with the family members and primary care providers. The diagnosis, it must be noted, needs to be accurate and timely.
When identified early, cancer is more likely to respond to effective treatment and result in a better outcome. It necessitates accurate and rapid clinical evaluation, diagnosis, and staging, as well as access and adherence to appropriate therapy.
Early detection is important in all contexts and improves survival rates for many malignancies. Early and proper diagnostic programmes have been effectively implemented in nations of all income levels, frequently via the coordinated efforts of governments, civil society, and voluntary organisations, with parent groups playing critical roles. Childhood cancer is associated with a variety of warning symptoms, including fever, severe and persistent headaches, bone pain, bleeding from natural orifices, spots on skin and weight loss, all of which can be noticed by families and competent primary care providers.
Cancer screening for childhood malignancies
Screening is not often beneficial for childhood cancer. It can be explored in some limited circumstances in high-risk groups. Some childhood eye tumours can be caused by an inherited mutation. If that mutation or disease is detected in the family of a kid with retinoblastoma, genetic counselling can be provided and siblings can be monitored with regular eye examinations early in life. Only a small percentage of children with cancer inherit from their genetics. There is no high-quality data to support population-based kid screening programmes.
Accurate diagnosis is essential to prescribe appropriate therapy for the type and extent of the disease. Chemotherapy, surgery, and or radiotherapy are common treatments. Specific attention must be paid to the children’s ongoing physical condition, cognitive progress, and nutritional balance, which necessitates the involvement of a multidisciplinary team. Around the world, access to appropriate diagnosis, necessary drugs, pathology, blood products, radiation therapy, technology, and psychosocial and supportive care is variable and inequitable.
Palliative care and cure
Palliative care relieves symptoms caused by cancer and improves the quality of life of patients and their families. However, cure is possible for more than 80 per cent of children with cancer when childhood cancer services are accessible. On the other hand, not all children with cancer can be cured, but relief of suffering is possible for everyone. Paediatric palliative care is considered a core component of comprehensive care, starting when the illness is diagnosed and continuing throughout treatment and care, regardless of whether or not a child receives treatment with curative intent. Children who complete treatment require ongoing care to monitor for cancer recurrence and to manage any possible long-term impact of treatment.
Palliative care programmes can be delivered through community and home-based care, providing pain relief and psychosocial support to patients and their families. Adequate access to oral morphine and other pain medicines should be provided for the treatment of moderate to severe cancer pain, which affects more than 80 per cent of cancer patients in the terminal phase.
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