Childhood cancer is not as uncommon as it may seem. There are approximately 5 lakh children are diagnosed with cancer annually worldwide, and around 10% are from India. So around 50000 new cancer cases are diagnosed in India every year. This figure might be the tip of the iceberg, as many patients remain undiagnosed in a remote part of India due to a lack of diagnostic facilities.
The most common cancer in children is Acute Leukemia, called Blood Cancer in normal language. Other cancers seen in children are brain tumors, Neuroblastoma, Wilms’ Tumor (Kidney Cancer), Lymphoma, Rhabdomyosarcoma (Cancer of Muscle), Retinoblastoma (Cancer of the Eye), Hepatoblastoma (Liver Cancer), Bone and other soft tissue tumors, etc.
While >80% of children with cancer in high-income countries now achieve long-term survival, it is not a good outcome in India. Today, cancer is the 8th most common cause of death in children. Many factors are responsible for lower survival rates in India such as coming to the hospital late when there is already advanced disease with complications, lack of right information-social support-financial constraints leading to treatment abandonment, etc. Lots of improvement is possible and achieved when the children present to the pediatric cancer specialist at the right time, they get the right treatment from the right team.
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Traditionally, there are 3 main types of treatment strategies to treat cancer.
- Chemotherapy: Cancer cells are dividing more rapidly than other normal cells of the body. Those medicines that can target rapidly dividing cells and don’t allow them to divide are used to kill cancer cells. They are called chemotherapy. Chemotherapy is the mainstay for the majority of cancers. Chemotherapy medicines are given orally, in veins, in muscles, or in the spinal canal according to the type of the medicine.
- Surgery: The tumor has to be taken out of the body through surgery. Generally, a few cycles of chemotherapy are given before surgery to decrease the size and vascularity of the tumor, so that it can be taken out easily and with fewer complications.
- Radiotherapy: High energy beam of radiation can be given focally to the tumor area to kill those very small-sized tumor masses that cannot be seen with the eye and hence are left behind after surgery. Radiotherapy reduces the rate of cancer coming back. In some cancers like some brain tumors, radiotherapy is the cornerstone of the treatment.
Also, Read About Radiation Therapy for Breast Cancer
With advancements in science, the armamentarium of cancer specialists has much more to offer for better results.
- The cancer treatment protocols have become more refined so that we can chemotherapy with better results with fewer side effects
- In cancers, robotic surgery does a better job to remove almost all tumors, with minimum blood loss and quicker recovery.
- Advanced radiotherapy modalities like gamma knife, proton beam, etc can now tackle difficult-to-treat tumors with many vital structures around them and give better outcomes.
- Bone Marrow Transplant is a sophisticated treatment that aims to replace the patient’s bone marrow and immune system with normal functioning marrow. We can now treat and cure many patients with relapsed or refractory cancers, for which the other conventional treatment cannot yield a cure.
- Targeted medicines are now developed for many cancers. They are the medicines that target the proteins or genes which make cancer cells grow, divide and spread. As scientists know more about the DNA and proteins of cancer cells, more and more targeted therapies are being developed.
- Immunotherapy taps the capabilities of the body’s immune system to fight against cancers. Immunotherapy educates the immune system to recognize and attack specific cancers. The immune system is precise so that it is possible to target the cancer cells while sparing the other healthy cells entirely.
Cancer treatment is very complicated with many intricacies. It is an evolving science with many new updates coming every day. In India, a complete plethora of cancer treatments are not available in every hospital, but fortunately, the situation is changing today. A multidisciplinary team consisting of a pediatric cancer specialist, pediatric cancer surgeon, pediatric intensivist, radiotherapist, trained nursing staff, and nutritionist, gives a child a fighting chance against cancer. A few hospitals such as ours have all modalities to give treatment such as Targeted therapy, Immunotherapy, and Bone Marrow Transplant. With timely treatment with the most recent advances, the survival result at par with the Western world is achievable.