Though the cancer in children is rare and it accounts for a small percentage (4-5%) of all cancers, the childhood cancer incidence is on the rise. In India around 50,000 new cases of cancer in children are diagnosed every year. Fortunately, a lot of progress has been made in the treatment of childhood cancer in recent decades. With better diagnostic tools and newer treatment modalities, more and more children with cancer are becoming long term survivors.
Almost more than 80% of children with cancer can get cured if they are diagnosed on time and receive appropriate treatment. Though the outcome is very good, the treatment itself is intense and lengthy, continuing for at least 6 months to 2 years depending on the type and stage of cancer. During the treatment period the child misses out on regular activities, like going to school, playing with friends, visiting places, etc. Sometimes the kids have to travel to faraway places for better treatment, away from the comfort and warmth of their siblings and family. Moreover, the treatment also has some kind of implications on the physical appearance like hair loss, weight loss, surgical scar etc.
I would like emphasise here that the story doesn’t end with winning the battle against cancer, the war is far from over. The so called survivors then have to deal with issues related to the treatment or the disease depending on the type of cancer and intensity of the treatment. So along with survivorship there comes psychosocial, emotional, physical hardship. Hence it’s pertinent for us to focus on survivorship related issues to help these little ones (specially the adolescent age group) resume their normal life as quickly as possible and yes, with proper counselling many of them are now leading a life as normal as their peers.
At a time when the developed nations are focusing in care of survivors, reducing long term toxicities of treatment with treatment tailoring for low risk diseases, in India, we are still struggling to achieve a good cure rate. Many children still succumb to this disease due to multiple factors like lack of awareness, delayed diagnosis, lack of access to appropriate cancer care, treatment abandonment due to social or financial issues. Though we have good tertiary care centers for childhood cancer care in India, unfortunately most of them confined to metropolitan cities. For us it’s time to spread awareness about this malady in children and to focus on improving the outcome. We should be able to improve the outcomes if we can focus on:
It’s germane for us to realize that children are not small adults, they need special care. Management should not only be limited to treating the disease, it should be a holistic approach involving the management of the treatment related toxicities, the psycho-social aspects and nutritional aspects.
Cancer in children is biologically different from cancers in adult. The types of cancer generally seen in children are more aggressive, they grow faster but respond well to treatment. Childhood cancers have a better cure rate than adult cancers.