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    The C-word itself is scary. And, when it hits children it can be really bad. There is hope even if it’s fragile. The truth is Cancer occurs in people of all ages and children are no exception. Cancer in children is curable if there is early intervention. Recent studies point out that over three lakh children are diagnosed with cancer all over the world every year. In India, more than 50,000 new childhood cancer cases are detected each year and this is about 20 % of pediatric cancers reported across the globe.  The Population-Based Cancer Registry (PBCR) report 2012-14 reveals that childhood cancer in India accounts for 0.7 % -4.4 % of total cancer diagnoses. This is almost similar to the 0.5 % -5.8 % range shown in the previous PBCR report of 2009-11.  Pediatric cancers may be broadly divided into HEMATOLOGICAL (blood) MALIGNANCY AND SOLID TUMOR MALIGNANCY.  ACUTE LYMPHOBLASTIC LEUKEMIA (ALL), and ACUTE MYELOID LEUKEMIA (AML) are the common types of pediatric cancers.  ALL is a cancer of white blood cells. The abnormal white blood cells, which form in the bone marrow quickly move through the bloodstream and drive out healthy cells. This can cause the chances of infection and other health issues. Lymphoblastic Leukemia affects the B cells and T cells in the immune system. AML is a type of blood cancer, where the bone marrow makes too many immature white blood cells. This is the most common pediatric cancer, and approximately 50% of childhood cancer fall under this category.  Other types of cancers that are common in children include LYMPHOMAS, CHILDREN’S BRAIN, SPINAL CORD TUMORS, NEUROBLASTOMA, WILMS TUMOR, RHABDOMYOSARCOMA, RETINOBLASTOMA, and BONE CANCERS like EWINGS and OSTEOSARCOMA.

    Causes/ Reasons

    The causes of childhood cancers remain unknown. Several studies have shown that changes or mutations in the DNA inside our cells can contribute to the production of cancer cells. Researchers have also found that 5%-10 % of childhood cancers are caused due to genetic factors which can be inherited or acquired.

    Treatment

    Generally, childhood cancer has a better potential for cure compared to similar adult cancers. For example, ALL has an overall recovery rate of 45% –81 % compared to 40-60% in adults. In Amrita Hospital, we have found that the survival rate of ALL is similar to the survival rate prevalent in developed countries. Managing pediatric cancer usually involves a multidisciplinary team.  “We have specialized subunits dealing with various aspects of treatment. These include treatments like cellular therapy (like allogeneic and autologous stem cell transplant), high dose chemotherapy units, Radiotherapy therapies including Radiosurgery (CyberKnife), and Radionuclide therapy (eg MIBG scans). Supportive pediatric specialty and subspecialties of the hospital also help in the management and delivering the best outcome,” says Dr. Nikhil Krishna Haridas; Assistant Professor, and Consultant; Medical Oncology and Hematology; Amrita Hospital.

    Can children with cancer lead healthy lives

    Yes. Early detection and treatment can help children recover from cancer and treatment-related issues. Cancer and its treatments will have a different impact on the growing bodies of children than that of the adult body, and the bodies of children could respond differently to cancer therapy. Long-term side effects may happen even when the disease is in remission and the child has been cancer-free for years. These problems are called late effects.  At least two out of three cancer survivors will develop one late effect at some point. With early diagnosis and proper follow-up care, most late effects can be treated or cured. Common late effects include the following -learning disorders, abnormal bone growth, hearing loss, vision problems, dental problems, lung, liver, kidney, and heart problems. Delayed sexual development and fertility issues. Increased risk of future cancers. Regular follow-up and early recognition of signs and symptoms could mitigate some of the late effects.

    Precautions for Prevention

    BEFORE AND DURING PREGNANCY

    • Adapt behaviors that help to lower cancer risk
    • Avoid alcohol and tobacco
    • Ensure enough physical activity
    • Ensure safe, stable, nurturing relationships and environments for all children and families
    • Reduce exposure to traffic-related air pollution
    • Reduce harmful exposures; avoid exposure to harmful chemicals
    • Restricting exposure to the radiation used during certain medical tests, like CT (computed tomography) scans.
    • Take adequate folic acid during pregnancy

    AFTER CHILDBIRTH AND CHILDCARE

    • Breastfeeding
    • Keep children away from second-hand smoke

    Prevent adverse childhood experiences and trauma Consult your doctor for a detailed medical examination and treatment.