PAEDIATRIC ONCOLOGY

Pediatric Oncology

Cancer in childhood is uncommon. Out of 10,000 normal children, one will develop cancer during their childhood. The initial diagnosis can be traumatic and stressful for the child and his/her parents. 

Cancer can infiltrate any part of the body- the most commonly affected are bones, blood and, muscles other cancers seen in the very young children (embryonal cancer)

As of today, more than 80% of children with cancer are curable, depending upon diagnosis of the type of cancer. 

Paediatric oncologists are responsible for treating all malignant conditions among children like leukaemia, bone cancers, Wilms tumour, brain and spinal cord tumours among several others. With timely, appropriate and complete treatment, the majority of children with cancer get cured and can lead their lives peacefully.

 

MOST COMMON TYPES OF CHILDHOOD CANCER

  • Primary Cancer and Secondary Cancer - 

“Primary Cancer” is where cancer started. 

In case some cells break away from the primary cancer site and settle in another part of the body, this cancer is then known as “Secondary Cancer” or metastases. 

The cancer cells can spread locally by entering the bloodstream or lymphatic system. However, secondary cancers comprise the same type of cells as primary cancer.

  • Leukaemia 

It is detectable in the blood and bone marrow. This cancer accounts for one-third of all childhood cancers. The common cancers found in children are Acute Lymphocytic Leukemia (ALL) and Acute Myeloid Leukemia (AML). These cancers can cause fatigue, weight loss, bleeding, joint pain and high fever. As acute leukaemias tend to grow fast, they need immediate medical intervention (chemotherapy).

  • Brain and Spinal Cord Tumors - 

The second most common cancer in children is the brain and central nervous system tumours, that account for a quarter of all childhood cancers. They commonly occur in lower parts of the brain like cerebellum or brain stem. Most common symptoms seen are dizziness, double vision, severe headache, vomiting, and, difficulty in walking or holding things.

  • Lymphomas 

They originate in lymph nodes and lymph tissues and can also affect bone marrow as well as other organs. The most common symptoms are swollen lymph nodes under neck and armpit, excessive weight loss, and fatigue. 2 types of lymphoma that can occur both in children and adults are:

  • Hodgkin Lymphoma- Hodgkin lymphoma(HL)

 This type of lymphoma in which cancer originates from a specific type of white blood cells called lymphocytes. Symptoms may include fever, night sweats, and weight loss. Often there will be non-painful enlarged lymph nodes in the neck, under the arm, or in the groin. Those affected may feel tired or be itchy. 

  • Non-Hodgkin Lymphoma-

Non-Hodgkin's lymphoma is cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body. In non-Hodgkin's lymphoma, tumours develop from lymphocytes — a type of white blood cell.

  • Wilms tumour - 

This tumour accounts for 5% of childhood cancers and is frequently evident in children ageing 3-4 years. It usually starts in one or both kidneys, causing swelling or lump in the abdomen with symptoms like loss of appetite, nausea and fever.

  • Neuroblastoma 

This cancer develops in infants and young children. It accounts for about 6% of childhood cancers, neuroblastomas can begin anywhere but begins in the abdomen and may also cause severe bone pain and fever.

  • Bone Cancers -

 About 3% of childhood cancers are bone cancers that occur in older children and teenagers (though they can develop at any age). 

Receiving a cancer diagnosis can be devastating, and explaining that diagnosis to a child adds yet another layer of stress, fear and anxiety to an already difficult situation.

Depending on their age, children may not fully understand what cancer is, but they are perceptive. They can sense when something is wrong, and this can result in fear, confusion, anxiety and even self-blame.

1. Explain the diagnosis in terms they can understand.

Use simple words, phrases and examples to explain your cancer diagnosis.

2. If you need help finding the right words, seek advice from your doctors and care team.

Before talking to your children, it can be helpful to seek guidance from your doctors, psychologists, social workers or teachers about how to have difficult yet effective conversations with children.

3. Keep them informed.

A cancer journey can take many unexpected twists and turns. Keep children up-to-date so they don’t feel left out or isolated.

"Being a two-time survivor myself, I strongly advise keeping the children in the loop with a simple but honest explanation of your circumstances. I was treated at City of Hope in 2004 for leukemia, and was in isolation much of the time. I mistakenly thought that my youngest son, who was 13 at the time, should be shielded from the unpleasant aspects of my disease and recovery," a Facebook user wrote.

4. When explaining a cancer diagnosis, be truthful.

Several members of our community emphasized the need for adults to be transparent with children when it comes to breaking the news about a cancer diagnosis. While it’s tempting to hide the truth to spare their feelings, it’s best to keep them in the loop.

5. Answer their questions and provide comfort.

It’s natural for children to become upset or afraid during a close adult’s illness. Answer their questions to help them process what is happening, and show them love and affection to calm their fears.

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