Cancer In Children

Each cell in our body has an independent system that manages its growth, controls its life duration and its interaction with other cells. When these healthy cells alter and grow unrestricted, and the body is unable to control them, the body is said to be affected by cancer. Every type of cancer has different signs and symptoms, and its treatment depends upon the rate of cell growth and types of cells. It can affect humans of all ages and gender.

What is Cancer?

Cancer is a life-threatening disease that is characterized by the unhindered growth of cells which develop into abnormal size. These cells destroy other cells in the body and over a period, spread to other organs of the human body. The spreading of these cancerous cells is known as metastasis, thus resulting in a serious condition that is difficult to treat. These altered cells go on to form large masses or lumps of tissue that are called tumours. These tumours release function-altering hormones into the body and are capable of interfering with the nervous, digestive and circulatory systems of the body.

The growth of cancer cells in a body weakens the immune system drastically, and the affected person is unable to fight against any other illness he/she is afflicted with. The internal organs and bones are destroyed, and the person loses his/her strength.

Types of Cancer in Kids

There are various types of cancer that can affect children. The following are the most common types of cancer in kids:

• Leukaemia: This is cancer that infects blood and the bone marrow and is one of the most common types of childhood cancer. Acute lymphoblastic leukaemia and acute myeloid leukaemia are two main types of leukaemia which affect children.
• Neuroblastoma: This type of cancer is mostly seen in infants and very young children. It is a cancer of neural crest cells which are specialized nerve cells. It originates in the child’s abdomen and causes swelling and high temperature.
• Brain and spinal cord tumours: This is the second most common type of childhood cancer and accounts for one out of four cases of cancer in children. Spinal cord tumours, however, are less common than brain tumours.
• Lymphoma: This type of cancer begins its journey from lymph nodes and other lymph tissues like the tonsils. The bone marrow and other organs can also get affected by Lymphomas. This type accounts for one out of ten cases of cancer in children. Two types of lymphoma that can infect a child are Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma.
• Liver Cancer: Liver cancers are a rare occurrence in children. There are two types of liver tumours, Hepatoblastomas and hepatic carcinomas.
• Kidney Cancer: This type is also known as Wilms’ tumour or nephroblastoma, and it usually originates in one of the kidneys. Usually, children of 3-4 years of age are affected by cancer of the kidneys, and it rarely strikes kids above the age of six.
• Bone Cancer: This cancer typically affects older children and teenagers but can develop at any age. There are two types of Bone cancer, Osteosarcoma and Ewing’s sarcoma, and together they account for 3 out of every 100 cancers detected.
• Soft tissue sarcoma: This type of cancer can originate from any part or organ of the body like the head, neck, groin, abdomen or the pelvis. Rhabdomyosarcoma is the most common type of Soft tissue sarcoma in kids.
• Germ cell tumour: Germs cells develop into eggs or sperms and are mostly found in testicles and ovaries. On rare occasions, germ cells are also found in other parts of the body.
• Retinoblastoma: This cancer affects the retina lining of the child’s eye and is a rare type (Every 2 out of 100). Children of 2 years or below are most susceptible to it.

Differences Between Adult Cancer and Child Cancer

Cancer types that develop in children are quite different from the ones that develop in adults. Like most adult cancers, childhood cancers cannot be linked to environmental or lifestyle factors. Apart from a few types, most childhood cancers respond in a better manner to specific treatments.

Since children do not suffer from any major health issues that can become worse, they respond to cancer treatment more positively than adults. On the other hand, if cancer needs radiation therapy as a part of its treatment, very young children are more likely to suffer from the side-effects than adults. At the same time, it is important to remember that children respond to chemotherapy in a better manner than adults do as their bodies handle it positively.

How Does Cancer Affect the Children and the Family?

Thanks to advancement in science and medicine, almost 80% of cancer cases in children are treated successfully. However, apart from the physical deterioration of the body and the visible changes, the child and its family are subject to a lot of stress and emotional upheaval.

Although modern-day treatments are highly effective, medicines, radiation and chemotherapy can leave their mark on the child. Most common side effects caused are hair loss, a feeling of tiredness, loss of appetite and lethargy. Due to a long duration of stay at the hospital, the child could miss school classes, friends and family life. Since they miss classes, they are unable to catch up with rest of the students for school work.

Cancer and the treatment that follows leave the kids tired and they may not want to indulge in any other activity. Some children are diagnosed with anxiety or depression and display symptoms of being withdrawn.

Since cancer treatments last for months or years, parents of afflicted children are unable to focus on their career or social life. They may need to reschedule their work timings and at times take long breaks from work to accommodate their kid’s treatment etc. Like the affected child, the immediate family goes through major emotional upheavals and is sure to need support and help from the hospital staff, doctors and social workers. Enrolling at a cancer support group is also a sensible thing to do.

It is important to for the child’s parents and siblings to learn to deal efficiently with this difficult phase of detection of cancer and its treatment to provide much-needed emotional support to the affected child.

Causes of Cancer in Children

The following are the probable causes and risk factors associated with cancer in children:

• Exposure To Radiation: If a child is exposed to radiation at a very young age, he or she is at a greater risk of developing cancer than those who weren’t. The unfortunate children living in Japan at the time of the atomic bombing and those who were born around that time are examples of this cause. Children treated with radiation are at a higher risk of developing another cancer within their bodies. However, if radiotherapy wasn’t a part of their treatment, this risk is minimal.
• Genetic Causes: If a child is detected with certain inherited conditions at the time of birth, it increases the risk of developing specific kinds of cancers in them. For example, babies detected of Down’s syndrome are 20 times more likely, than those without it, to develop leukaemia.
• Contact With Infections: One common infection that can strike young children is EBV or Epstein Barr virus. It is known to cause infectious mononucleosis or glandular fever in teenage kids but does not display any specific symptoms. EBV can become a causal factor for the growth of certain types of cancer especially lymphoma, but this happens in extremely rare cases.
• Complications In The Womb: The growth of some childhood cancers begins while the baby is in the mother’s womb. Wilms’ tumour, which is a type of kidney cancer,  and retinoblastoma, which is retinal cancer, are common examples. Here, the cells in the baby’s body that develop early during pregnancy remain underdeveloped. When they do not develop as desired and remain immature, they develop into cancer cells.

Signs & Symptoms of Childhood Cancer

The symptoms of childhood cancer depend on the following factors:

• Type of cancer
• The part of the child’s body affected
• If cancer has spread to the rest of the body

These symptoms are caused by external conditions that are not necessarily related to cancer, but occasionally, can act as pointers to indicate cancer. The symptoms are as follows:

• Loss of appetite or inexplicable weight loss
• Vomiting without a specific reason
• Fever or sweating
• Unexplained lumps in the body
• Feeling of fatigue
• Regular infection or flu
• Constant headaches
• Persistent backaches that occur while the body is at rest
• Swelling of glands
• Bruising, bleeding or rash on the body
• Seizures or fits
• Behavioural changes
• Changes in vision
• Changes in eye shape or size
• Blood in urine (indication of bladder or kidney cancer)
• Abdominal swelling and pain
• Pain in bones, back, legs or arms

Diagnosis

Doctors use various tests to diagnose cancer and its causes. Tests like imaging, also confirm if cancer has spread to other parts of the body (metastasis). Another important function of diagnostic tests is to decide which treatments will be the ideal for the specific case. Mostly, a biopsy is probably the only assured method of determining if the child is afflicted with cancer. However, a doctor may resort to other tests if a biopsy is not possible for some reason.

While selecting the right diagnostic test to diagnose childhood cancer, the doctor will consider the following factors:

• The child’s age and his medical condition
• The cancer type suspected from initial diagnosis
• Signs and symptoms shown
• Results from previous tests

Apart from a detailed physical examination, the one or more of the following diagnostic tests could be used to detect childhood cancer:

• Biopsy: This involves the removal of a tiny portion of tissue from the affected person’s body, which is later examined under a microscope. A biopsy is known to provide a positive diagnosis whereas other tests may only suggest the presence of cancer. To carry out the procedure properly, imaging is used to guide the biopsy. The type of biopsy is decided by where the cancer is located and imaging is of great help here. A pathologist, who is a specialist in the evaluation of tissues, cells and organs, then analyses the sample tissue.
• Blood Tests: These tests are carried out to measure the presence of various cell types in the child’s body. Certain types of cancer can be detected by checking the high or low levels of certain cells.
• Lumbar Puncture: Also known as a spinal tap, the lumbar puncture involves taking the cerebral spinal fluid (CSF) sample using a needle. It shows the presence of cancer cells or tumour markers. CSF is the fluid flowing around the spinal cord and brain while tumour markers abnormal amounts of substances found in tissues, blood and urine. The child’s lower back is numbed with the use of local anaesthetics.
• Bone Marrow Aspiration And Biopsy: This combines the two procedures which are carried out together for the examination of bone marrow found inside large bones. The bone marrow is a spongy tissue that is solid and liquid in parts. Using bone marrow aspiration, the liquid is sucked out through a needle while biopsy takes out a sample of the solid portion. These samples are then sent to a pathologist for further study and observation.
• Computed Tomography: Commonly known as CT or CAT scan, this method uses x-rays taken from different angles which helps in creating a 3D image of the insides of the body. A cross-sectional view using these images is then created to detect any abnormalities.
• Magnetic Resonance Imaging (MRI): An MRI uses magnetic fields instead of x-rays to create detailed images of the body. The patient’s body is often injected with a dye to obtain a clearer image of a tumour and its size.

Treatment

Your doctor will decide upon the line of treatment after considering factors like stage and type of cancer, health conditions and expected side effects. The common treatment options for childhood cancer are listed below:

• Chemotherapy: This line of treatment includes the use of drugs to destroy childhood cancer cells and seeks to terminate the cancer cells from growing further. The drug is generally given through an Intravenous tube or a pill or capsule.
• Surgery: Surgery involves the removal of the infected area (a tumour) and surrounding areas through a surgical procedure and is conducted by a surgical oncologist. After removal, doctors suggest chemo or radiation to eliminate the cancer completely.
• Radiation Therapy: This treatment uses potent x-rays and photons to destroy cancer cells and is carried out by a radiation oncologist. Since other organs and tissues can be affected by radiation, doctors generally avoid radiation as much as possible.

Apart from the above, immunotherapy and bone marrow transplantation are also used to stop the spread of cancerous cells.

Late and Long-Term Effects of Cancer Treatment

Evaluating the effects of cancer treatments, in the long run, is important while deciding on the path to follow. Surgery, where spleen removal is involved, can cause risk of infections. The emotional impact of losing a body part is also huge and can cause depression. Chemotherapy and radiation therapy can cause heart-related problems and hypertension. The lungs and the endocrine systems are also affected due to chemotherapy and radiotherapy.

Coping With Childhood Cancer

Here are a few tips on how to cope with blood cancer in kids:

• Seek support from family, friends, social workers and counsellors
• Learn strategies to overcome stress and depression
• Talk with other parents of cancer-stricken children
• Involve the child in decision-making
• Find strength through religious beliefs and practice meditation
• Give vent to feelings of anger or sadness when alone
  

When a child is detected with cancer, it can cause extreme emotional upheavals with the family. The feeling of shock and disbelief hits the parents and is often followed by bouts of anger and fear. The process of diagnosis, followed by a long-drawn treatment can take its toll on the child and immediate family. The facts mentioned above can give you a clear picture of what to expect and ways to tide over this difficult process.