Pediatric Cancer

Pediatric Cancer

Childhood cancer is a mixed bag of various tumors and the approach to these tumors is unlike that in adults. Majority of the tumors are seen in less than 5 years of age, and often present in advanced stages. The incidence of pediatric tumors is less in our country than that in the western world. It is not that we are staying in a country where these tumors are less but are because many go unreported. Many times for girl child with a tumor the family opts out of treatment. There is unknown fear for example kidney being removed from the body, or fertility being affected or leading of normal life later on. With current evidence even with a single functioning, a kidney can have a normal life or fertility issues can be discussed and are sortable. These inhibitions/fear need to clear off as being cured of a tumor and surviving is utmost important than dying of cancer.

 

Except for limited centers well acquainted in managing them, there are places where they are not even reported. Many times symptoms are non-specific, small children unable to describe discomfort and unaware family members delay diagnosis. Even if the family is counseled about cancer they might opt out of treatment because of lack of awareness, losing hope and not getting treatment for cancer, insufficient finances for a long duration of treatment or getting into a non-medical form of treatment.

There has been a tremendous improvement in the overall survival of these patients that is clearly seen again in the western world. The tumor registries, awareness of primary physicians, larger clinical trials and the availability of treatment is robust. The awareness is important if as these pediatric tumors are curable if detected early and optimally treated. It makes a difference if the treating physician is aware of these tumors and diagnostic facilities available. The most common symptom is abnormal mass (lump) felt in the body. It can be in the abdomen, chest, neck, arms or legs, in most cases it will not be associated with any pain. Other symptoms are presently based on the tumor, site, and metastasis if any.

The key to success lies in early detection, adequate required treatment and close follow up. One should remember that if we know of about it, detect early the child is cured of cancer. Not all tumors have bad outcomes, most of them are treatment responsive be it surgery, chemotherapy or radiotherapy. It important to have complete evaluation and staging of the disease so that the effective treatment can be provided.

As the pediatric age group is different for adults so is the tumors presenting in this age group. These tumors have different treatment requirements and better managed in a team where pediatric oncologist and pediatric surgeons trained in operating pediatric tumors are available if possible radiation oncologist as well. Most of the pediatric surgical oncology procedures major surgeries as tumors have no boundaries to limit their invasion and generally, post-surgical recovery is good. The chemotherapy is also planned so as to have more benefit and less of toxicity. With the improvement in surgical technique, chemotherapy, intensive care, and postoperative rehabilitation the outcomes have improved. The five-year survival reaches 95-100% in these tumors.

NH-SRCC Children's Hospital,

Haji Ali, Mumbai, India

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