Name of the portal: ET health world

Brief about the topic: Childhood is the purest form of joy, but many children aren’t fortunate enough because of the deadly disease of ‘cancer’. According to the World Health Organisation (WHO), every year globally an estimated 4,00,000 children and adolescents (0-19 years of age) are diagnosed with cancer. India’s childhood cancer burden is around 20 per cent ie, 75,000 children are diagnosed with cancer every year. In high-income countries, more than 80 per cent of children diagnosed with cancer are cured due to the accessibility of comprehensive services, whereas in low- and middle-income countries (LMICs), less than 30 per cent of children are cured.

The growing advancements in treating childhood cancer have resulted in positive survival rates. However, improving serious health outcomes in survivors remains a challenge. Many studies have noted that childhood cancer survivors are 15 times more likely to have heart failure and eight times more likely to have heart disease than the general population.

So it is important to understand the risk factors associated with childhood cancer and create awareness about the disease.

Questions:

What are the most common types of childhood cancer cases seen in India? What are the survival rates of those?

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. Most Common Childhood Cancer are Blood cancer- Luekemia- Acute Lymphoblastic leukaemia (ALL) or Acute Myeloid Leukemia (AML), Lymphoma,  Neuroblastoma, Ewing Sarcoma, Retinoblastoma, Brain Tumors.
  • Most childhood cancers are very treatable and have a high survival rate. In the west, the survival rate is as high as 90% in some cancers. With a conservative estimate of 70- 80 % survival rate, many survivors are added to population every year.

What are the risk factors associated with childhood cancer? Are childhood cancer survivors at risk of heart disease?

Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.

Risk Factors associated with childhood cancer:

  • Genetics Factors
  • Down’s Syndrome
  • Li-Fraumeni syndrome
  • Inherited immune system problems
  • Ataxia-telangiectasia
  • Wiskott-Aldrich syndrome
  • Bloom syndrome
  • Shwachman-Diamond syndrome
  • Environmental Factors : Environmental risk factors are influences in our surroundings, such as radiation and certain chemicals, that increase the risk of getting diseases such as leukemias.

Childhood cancer survivors are at risk for a range of cardiovascular diseases (CVD) as a consequence of their cancer therapy. Research has proven focused on anthracycline-related heart failure (HF) mostly. Studies have suggested risk of the risks of developement  of Heart Failures, arrhythmias, pericardial disease, valvular disease, and coronary artery disease in a  childhood cancer survivors.

What are the long-term effects of childhood cancer treatment? Is there any risk of cancer recurrence? Please elaborate.

Late effects in childhood cancer survivors may affect the following:

  • Organs, tissues, and body function.
  • Growth and development.
  • Mood, feelings, and actions.
  • Thinking, learning, and memory.
  • Social and psychological adjustment.
  • Risk of second cancers.

There are three important factors that affect the risk of late effects.

Many childhood cancer survivors will have late effects. The risk of late effects depends on factors related to the tumor, treatment, and patient. These include the following:

Tumor-related factors

  • Type of cancer.
  • Where the tumor is in the body.
  • How the tumor affects the way tissues and organs work.

Treatment-related factors

  • Type of surgery.
  • Chemotherapy type, dose, and schedule.
  • Type of radiation therapy, part of the body treated, and dose.
  • Stem cell transplant.
  • Use of two or more types of treatment at the same time.
  • Chronic graft-versus-host disease.

Patient-related factors

  • The child’s sex.
  • Health problems the child had before being diagnosed with cancer.
  • The child’s age and developmental stage when diagnosed and treated.
  • Length of time since diagnosis and treatment.
  • Changes in hormone levels.
  • The ability of healthy tissue affected by cancer treatment to repair itself.
  • Certain changes in the child’s genes.
  • Family history of cancer or other conditions.
  • Socioeconomic status.
  • Health habits.

Childhood cancer survivors have an increased risk of a second cancer later in life.

A different primary cancer that occurs at least two months after cancer treatment ends is called a second cancer. A second cancer may occur months or years after treatment is completed. The type of second cancer that occurs depends in part on the original type of cancer and the cancer treatment. Benign tumors (not cancer) may also occyr. Solid tumor occur almost after 10 years of primary tumor.

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