CHILDHOOD CANCER AWARENESS MONTH

Cancer occurs in people of all ages including children. Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can then spread to other areas of the body.¹

Although this is common for both adults and children, childhood cancers may behave very differently from adult cancers. There are differences in the types of cancers that children tend to get, as well as how they are treated. Adult cancers majorly originate in organs whereas childhood cancers involve tissues. However, cancer is curable if detected early and treated effectively.^{2, 3}

Every year, over 3 lakh children are diagnosed with Cancer all over the world. In India, nearly more than 50,000 new childhood cancer cases occur every year.³

The most common cancers of children are:⁴

• Leukemia (cancers of the bone marrow and blood)
• Brain and spinal cord tumors
• Wilms tumor (Cancer in the kidney)
• Lymphoma (including both Hodgkin and non-Hodgkin)
• Rhabdomyosarcoma (cancer develops in any of the skeletal muscles)
• Bone cancer

Childhood cancer symptoms and signs:

Adults can observe the signs and symptoms of cancer in their bodies. However, in children, it is difficult to understand and observe any signs and symptoms^. A variety of the signs or symptoms are listed below using an acronym (CHILDCANCER):³

• Continued, weight loss
• Headaches with morning vomiting
• Increased swelling or persistent pain in the bones
• Lump or mass, especially in the abdomen and other parts
• Development of excessive bruising, bleeding/rash
• Constant infections
• A whitish color behind the pupil
• Nausea that persists or vomiting without nausea
• Constant tiredness
• Eye or vision changes that occur suddenly
• Recurring fevers of unknown origin

Risk factors for childhood cancer:

Childhood cancers do not have a known cause.

Lifestyle and environmental factors –Generally, these cancers are not strongly linked to lifestyle or environmental risk factors. But, a few environmental factors, such as radiation exposure, and some parental exposures such as smoking might increase a child’s risk of certain cancers.²

Changes in genes – DNA is the chemical that makes up genes. DNA can be a medium to transfer diseases from parent to child (inherited).In contrast, this kind of gene mutation can happen at any time in life and is called an acquired mutation. Studies show that 5-10 % of childhood cancers are caused due to genetic factors which can be inherited or acquired.^{3, 5}

Complications:

Childhood cancer has potential late effects including anxiety, depression, fear, hormonal problems, and breathing problems because of various therapies. Also, cancer therapy can cause complications ranging from impaired growth and development, cognitive deficits and psychosocial issues, heart or lung problems, gastrointestinal problems, and secondary malignancies.^{1, 3}

Treatment for Childhood cancer:⁶

There are main common types of treatments used for childhood cancer are as follows-

• Surgery– It is the process of removal of the tumor, either cancerous or non-cancerous and some surrounding healthy tissue during an operation.
  
  
• Medication-based therapies- It is the use of medication to eradicate cancer cells throughout the body. Systemic therapies are usually prescribed by a pediatric oncologist. Chemotherapy and immunotherapy are common ways to give systemic therapies including an intravenous tube placed into a vein using a needle or in a pill or capsule that is swallowed orally.
  
  
• Radiation therapy– It is the process of removing cancer cells using high-energy x-ray particles. Doctors frequently aim to prevent or reduce the use of radiation therapy in this age group whenever feasible since healthy organs and tissues in the radiation field are susceptible to harm and secondary malignancies, especially in young children. External-beam radiation which is delivered from a machine outside the body is the most used kind of radiation therapy. Internal radiation therapy, also known as brachytherapy, is used when radiation therapy is administered via implants.
  
  
• Bone marrow/stem cell transplantation– A bone marrow transplant is a medical procedure in which cancerous bone marrow is replaced by highly specialized hematopoietic stem cells.

Prevention:⁷

Cancer Prevention and Control factors from before birth through early childhood may affect a person’s chance of getting cancer. For lowering the chances of childhood cancer with some key lifestyle choices:

Encouraging Behaviors –

Getting enough folic acid during pregnancy, and enough physical activity during childhood can lower the cancer risk. Also, ensure safe, stable, nurturing relationships and environments for all children and families.

Reducing Harmful Exposures –

• Skip alcohol and tobacco use during pregnancy.
  
  
• Keeping children away from secondhand smoke.
  
  
• Feed them a healthy diet with lots of fiber, fruits, and vegetables.
  
  
• Avoid exposure to chemicals that can cause cancer.
  
  
• Learning about the family’s history of exposure to diethylstilbestrol (DES).
  
  
• Preventing adverse childhood experiences.
  
  
• Limiting the amount of radiation used during certain medical tests, like CT (computed tomography) scans.
  
  

The month of September is celebrated as Childhood Cancer Awareness Month, with events occurring all around the country.⁸ Childhood Cancer Awareness Month encourages by a variety of advocacy organizations, brings people together to share stories, and pushes continued efforts to improve the lives of children.

References:

1. Childhood Cancer: Introduction. Available at: https://www.cancer.net/cancer-types/childhood-cancer/introduction. Assessed on 17^th August 2022.
2. What Are the Differences Between Cancers in Adults and Children?, Available at:https://www.cancer.org/cancer/cancer-in-children/differences-adults-children.html, Assessed on 17^th August 2022.
3. Introduction to Childhood Cancer, Indian Cancer Society, Available at: https://www.indiancancersociety.org/cancer-information/childhood-cancer.aspx, Assessed on 17^th August 2022.
4. Types of Cancer that Develop in Children. Available at: https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html. Assessed on 17^th August 2022.
5. Risk Factors and Causes of Childhood Cancer, Available at:https://www.cancer.org/cancer/cancer-in-children/risk-factors-and-causes.html, Assessed on 17^th August 2022.
6. Childhood Cancer: Types of Treatment. Available at: https://www.cancer.net/cancer-types/childhood-cancer/types-treatment. Assessed on 3^rd September 2022.
7. Cancer Prevention during Early Life. Available at: https://www.cdc.gov/cancer/dcpc/prevention/childhood.htm#. Assessed on 17^th August 2022.
8. September is Childhood Cancer Awareness Month. Available at: https://www.cancer.gov/pediatric-adult-rare-tumor/news/upcoming-events/childhoodcancerawarenessmonth#. Assessed on 17^th August 2022.