50,000 cases detected every year

It is commonly assumed that cancer is a disease affecting adults, but lately more and more children are being diagnosed with cancer every year. In Hyderabad, in 2017 according to the hospital-based cancer registry 5 percent of all cancer patients are children. This percentage has doubled in the last 10 years.

In India every year there are close to 50,000 new cases of childhood cancer. Among childhood cancers leukemia (a form of blood cancer) has the highest incidence. Survival rates of childhood cancer are high and around 80% in developed countries but in India it is only 30%!!

In adults, lifestyle-related risk factors, play a major role in many types of cancer. But lifestyle factors and environmental exposure usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers.

Pediatric cancers if given proper treatment have a very good prognosis as compared to adult cancers. But the problem is that in most cases the symptoms are ignored by parents and also sometimes doctors do not suspect cancer, so the diagnosis gets delayed. Even after diagnosis, parents, particularly those in small cities or rural areas are clueless where to go for treatment.

Treatment costs are very high and there are few government hospitals catering to a huge load of childhood cancer. Unlike adult cancers, there are no widely recommended screening tests to look for cancer in children who are not at increased risk.

It is important for parents to know that cancer in children is not common, but it’s important to have your child checked by a pediatrician if they have unusual signs or symptoms that are persistent or recurrent, such as:

• An unusual lump or swelling
• Increasing or sudden paleness and loss of energy
• Easy bruising or bleeding
• An ongoing pain in one area of the body like bones, joints, back
• Limping or easy fractures
• Unexplained fever or illness that is prolonged
• Frequent headaches (often with vomiting), change in behavior, balance, gait, enlarging head
• Sudden eye or vision changes, new squint, bulging of eyeball
• Sudden unexplained weight loss

Diagnosis of Leukemia

Most of the signs and symptoms of childhood leukemia are more likely to have other causes, such as infections. Still, it’s important to let your child’s doctor know about such symptoms right away so that the cause can be found and treated, if needed. Exams and tests will be done to determine the cause of the symptoms.

If leukemia is found, further tests will be needed to find out what type it is and decide how it should be treated. It’s important to diagnose childhood leukemia as early as possible and to determine what type of leukemia it is so that treatment can be tailored to provide the best chance of success.

Tests for leukemia

If the doctor thinks your child might have leukemia, samples of your child’s blood and bone marrow will need to be checked to be sure of the diagnosis. Your child’s doctor may refer you to a pediatric oncologist, a doctor who specializes in childhood cancers (including leukemias), to have some of these tests done. If leukemia is found, other body tissue and cell samples may also be taken to help guide treatment.

Blood tests, Bone marrow aspiration and biopsy, Lumbar puncture (spinal tap) and Lymph node biopsy.

In India, the diagnosis and treatment of childhood cancer needs to be strengthened and be more accessible all over the country. There is need for more dedicated cancer hospitals and awareness of the general public regarding childhood cancer.

(The writer is a Consultant Pediatrician at KIMS Cuddles, Kondapur)

By Dr Preethi Sharma