Healing touch

Children with cancer are like candles who accept the possibility that they are in danger of being extinguished by a gust of wind from nowhere and yet, as they flicker and dance to remain alive. Their brilliance challenges the darkness and dazzles many who surround them. Pediatric cancer is on the rise. But the good news is improvement in cancer diagnoses and more screening results in early detection and better treatment, thus giving little ones an improved chance at a normal life.

Dr Purvi Kadakia Kutty, M.D. Pediatrics, FNB Pediatric Hematology & Oncology is a trusted Navi Mumbai based-consultant in Pediatric Hematology & Oncology. “I understand how frightening it is to have your child diagnosed with a serious illness. Every parent or caregiver is upset and uncertain in that moment — and it goes without saying that they want the best, most up-to-date care for their child. My team offers compassionate and world-class care for children and teens with cancer and blood disorders,” said Dr Purvi Kutty.

The team of highly skilled specialists provides comprehensive care and innovative treatments to pediatric and young adult patients with blood disorders or cancer. “Every patient and their family are at the center of all we do. We care for your child through every phase of illness and recovery, from evaluation, diagnosis, and treatment to survivorship care. Our team of specialists works together to enable rapid assessment of your child’s condition and a timely start to therapy as well as excellent follow-up care,” adds Dr Purvi Kutty.

When age acts on patients

When treating an 80 plus-year-old with cancer, doctors are not thinking about getting that person 40 years of survival. Instead, they focus on prolonging their life and ensuring quality of life by managing side effects and symptoms.

Whereas, among children with cancer, doctors focus on curing this deadly disease and to restore a lifelong health for little ones. For a child who’s treated at age 3, the goal is to give them 70 or 80 more years of life. So, the whole mindset is different. The long-term side effects of treatment are much more in children than in adults. In addition to hopefully having a long lifetime ahead of them, a child’s body is growing and developing. So, the consequences of giving brain radiation, for instance, to a 3-year-old compared with a 50-year-old are dramatically different.

On the positive side, children’s organs—their heart, their lungs, their kidneys—are healthy to start with, and so they may actually be able to tolerate more intensive treatment.

Awareness is the key

With an increase in awareness about cancer as a disease and the hope that most cancers are curable. An analysis of figures reveals that cancer cases are more prevalent in the age group of 2-8 years and most common is acute lymphoblastic leukemia (blood cancer). Nearly 40 per cent of all cancer cases are of acute lymphatic leukemia, which is so far the commonest childhood cancer. Besides this cases of solid tumour such as Wilms tumour (cancer of the kidney’s), Hodgkin’s disease and non-Hodgkins lymphoma (cancer of lymphnodes) are also being commonly reported.

Overall survival rate in childhood cancers is 80 % approx, thanks to the efforts of a team of doctors and advanced state-of-art, diagnosing such cases and providing comprehensive care to children afflicted with cancer during the last few years.

Lookout for symptoms

Most common symptoms of children suffering from leukemia is prolonged fever lasting more than two weeks, anemia and skin bleeds. However, Hodgkin’s disease classically manifests as a progressive, painless enlargement of one group of lymph nodes. And tumors in the abdomen are marked by lumps in the abdomen.

Dr Purvi Kutty pointed out that early recognition and rapid diagnosis is essential to improve survival. Hence it is important to make the parents alert about the early recognition of the disease. They should then refer early to a specialist for preventing delay in management. The treatment of blood cancer is mostly chemotherapy and lasts about 2 years. For the first three months, it is very intensive and parents are either advised to stay in the hospital or a place close by so that they can come back as soon as possible.

However, later it is administered once in 4-6 weeks. Cranial radiotherapy is given in such cases where the aim is to prevent the disease from progressing to the central nervous system. In case of other solid tumors, it is a multi modality treatment with a judicious combination of chemotherapy, surgery and radiotherapy, if needed. And the treatment normally lasts for 6 months to one year. The investigations are aimed at establishing the diagnosis and also at determining promptly the extent of the disease.

Ray of hope
Doctors attending on these patients believe that if cancer does not re-occur 2-3 years after completion of therapy, it is unlikely to recur again, and patients can be deemed to be cured. However, even after the treatment is stopped patients must come up for regular follow-ups at the intervals of 2-3 months. There are many support groups for parents and children who are dealing with this challenging situation.

They maintain that parents should have a positive attitude towards this disease as towards other diseases. They should also stop shopping for alternate systems of medicine and instead make a concerted effort with a systematic therapy for achieving a cure. Besides drugs, they should also give psychological support to their children.

The cost of treatment particularly for treating blood cancer is expensive but the hospital authorities and certain NGOs who are working for the cause of such children do provide some financial assistance for the treatment of such cases both in terms of their stay in the hospital and the drugs.

Things to know

1. Cancer is not rare: Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think.
2. Curing cancer and preventing cancer aren’t the same thing: We do have a cure for the majority of childhood cancers – nearly 80 percent of children diagnosed with cancer will survive. However, the treatments stink. About 20 percent of children still die from cancer or from the effects of their treatment.
3. Drugs will have side effects: One can only deal with these side effects as it comes.
4. Keep prevention in mind: Put sunscreen on yourself and your children. Teach them about the dangers of tobacco and excessive habits (i.e., food, alcohol, stress). Take care of yourself and teach your children how to take care of themselves. These are preventative measures.

5. Vaccines save lives: The human papilloma virus (HPV) vaccine works to prevent cervical and head and neck cancers later in life.

Hard facts

It can be uncomfortable to see children going through therapy. It’s terrifying. But turning a blind eye will not decrease the chance that someone you love will be diagnosed with cancer. In fact, 1 in 3 people will develop cancer in their lifetime and 1 in 285 children will develop cancer before the age of 18. Ignoring the facts will not make them go away.

Each individual child’s likelihood of survival will vary depending on factors unique to them, including the type of cancer they have. Pediatric cancer treatments like radiation and chemotherapy can be truly life-saving, but are also physically and emotionally difficult. As a parent, it’s helpful to have clear expectations about what your child’s treatment will entail so that you can help them (and yourself) feel more comfortable and prepared.

Childhood cancers can be difficult to recognize early on and childhood cancer is not routinely screened for. That said, we encourage you to trust your instincts as a caregiver and never hesitate to talk to a health care provider if you have concerns about your child’s health.

Some possible signs and symptoms of pediatric cancer include:

• Unusual lumps, bumps, or swollen areas
• Unusual limping
• Persistent pain in one area of the body
• Easy bruising or bleeding
• Decreased energy
• Unusual paleness
• Unexplained or recurring fever or illness
• Recurring headaches, sometimes with vomiting
• Sudden or unusual changes in vision
• Unexplained weight loss

Protect your child  

Most pediatric cancers are not preventable and do not have any underlying cause. Even so, there are things you can do that may reduce your child’s risk and improve their overall health. This includes:

• Getting enough folic acid during pregnancy to boost brain development
• Avoiding exposure to toxins like alcohol and tobacco during pregnancy
• Protecting your children from excess sun exposure (use sunscreen, hats, sunglasses and lightly layered clothing)
• Ensuring your children are physically active, maintain a healthy weight and eat a balanced diet with plenty of whole foods
• Doing what you can to reduce your child’s exposure to environmental toxins, including secondhand smoke and pollution
• Creating a safe, supportive and stable home environment
• Keeping up with routine well child care with your child’s pediatrician
• Getting your child vaccinated for HPV, which prevents cancer developing as an adult

Seek support

As a parent or caregiver of a child with cancer, please know that you will not handle this situation alone. In fact, we know from years of research that family members of children with cancer often experience increased rates of psychological, physical and social challenges, ranging from depression to marital problems.

About hundreds of children (between birth and 14 years of age) develop childhood cancer every year. The outlook for these children has improved enormously.  Now many of them will become long-term survivors who are cured of their disease. This was very different 20 to 30 years ago, when most children with cancer did not survive.

Cure rates have for the most part improved by the use of multiple treatment modalities (chemotherapy, surgery and sometimes radiation therapy), better supportive care and through therapy intensification (using higher total doses of chemotherapy over a shorter period of time). But still more needs to be done. Some children are still not in that lucky 80%. Childhood cancer is the leading natural cause of death in children aged 1 to 14 years and the impact of this disease on children and their families is enormous. Look for early detection and start treatment at the earliest.