OVERVIEWPaediatric oncology is a medical speciality focused on the diagnosis and treatment of childhood cancers, with experts who specialise in treating infants, children, teenagers, and adolescents. Childhood cancers are a complex group of diseases and treating them requires highly specialised care. Over the past few decades, significant advancements have been made in paediatric oncology research and treatment, leading to improved outcomes for young cancer patients. According to estimates, globally, around 80–85% of childhood cancers can be treated successfully.
Types
Cancer in children is rare but not unusual, and it differs biologically from the cancers diagnosed in adults. The most common types of paediatric cancers include:
Leukaemia
Leukaemia is a type of blood cancer that affects the body's ability to fight infections and comprises about 1/3rd of all childhood cancers. Common types of leukaemia are acute/chronic lymphoblastic leukaemia and acute/chronic myeloid leukaemia.
Lymphoma
Lymphoma is a cancer of the lymphatic system in children and has two main types: Non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. With early diagnosis and advanced treatment options, the survival rates for Hodgkin’s lymphoma stand at 90%.
CNS Tumour
CNS tumours in children occur when brain or spinal cord cells mutate and form a mass. They can be benign or malignant, and common types include medulloblastomas, gliomas, and germ cell tumours.
Neuroblastoma
Neuroblastoma is a rare cancer affecting children under five years of age that develops in nerve tissues. Neuroblastomas are treatable and have a good prognosis.
Bone Tumors
Paediatric bone tumours are rare and responsible for only 3-4% of all childhood cancer cases. Bone tumours can be treated with early diagnosis and appropriate management by a multidisciplinary team.
Retinoblastoma
Retinoblastoma is a type of eye cancer, and it is diagnosed in children under the age of 5. Early diagnosis is the key, as 9 out of 10 children can be treated with a positive outcome.
Hepatic Tumours
Liver tumours in children can be benign or malignant. An MDT approach involving hepatic surgeons and paediatric oncologists is required for appropriate treatment planning.
Soft Tissue Sarcoma
Paediatric soft tissue sarcoma forms in the body's soft tissues, often presenting as painless lumps or inflammation. Early diagnosis and an MDT approach are crucial for effective treatment.
Wilms Tumour
Wilms tumour is a common childhood cancer that starts in the kidneys. This condition can be managed effectively, and most children have a good prognosis.
Management of Paediatric Cancers
HCG's multidisciplinary team of world-class doctors provides patient-centric and compassionate care, hands-on treatment, and round-the-clock support to families of children affected by cancer. We use leading-edge diagnostic and treatment approaches to diagnose, treat, and manage cancer in paediatric patients.
Diagnosis of Paediatric Cancers
We use multiple tests to detect and diagnose cancer in paediatric tests. These tests help our paediatric oncologists zero in on the final diagnosis, staging, and hence the specific type of treatment plan for ensuring a positive outcome:
Physical Examination and Medical History Assessment:
Involves understanding the signs and symptoms experienced by the patient and assessing their medical history for specific health conditions.
Bone Marrow Aspiration:
Involves examining the sample of bone marrow for the presence of cancerous cells.
Lumbar Puncture:
Involves examining the cerebrospinal fluid for the presence of cancer cells.
Extensive Blood Work:
Involves testing the blood for the presence of cancer cells.
Biopsy:
Involves examining the tissue sample from the suspected area for the presence of cancer cells.
Imaging Tests:
Imaging tests, such as PET-CT scans, MRI scans, X-ray scans, and ultrasound scans, help in the disease staging, understanding the tumour parameters, namely the size, exact location, and grade, and planning the treatment.
Treatment for Paediatric Cancers
The treatment options while caring for paediatric patients depend upon various factors, including the child's age, type of cancer, stage of the disease, immunity, underlying reasons like genetic inheritance, etc.
Some cancers are treated with chemotherapy alone, like the majority of leukaemias (ALL and AML) and many types of lymphomas. In some cases, immunotherapy may be recommended for a better treatment response.
Bone marrow or haematopoietic stem cell transplantation may be recommended for leukaemias/lymphomas or many solid tumours. BMT is also a curative option for many non-oncological benign haematological problems, namely thalassaemia, aplastic anaemia, and many immunodeficiency syndromes.
Surgery is also recommended for the management of paediatric cancers, and it involves the removal of the tumour with a small portion of healthy tissue that surrounds it, the nearby lymph nodes, or the organ affected by cancer, depending on the type, stage, and location of the cancer. Cancers of the brain, liver, bones, kidneys, and eyes often demand surgery.
Radiation therapy is an essential treatment modality for many paediatric cancers. It involves using high-energy radiation to destroy cancer cells and shrink tumours. Destroying tumours through precise radiation delivery helps minimise side effects and reduces the risk of long-term complications in children.
Regular check-ups with doctors, intake of nutritional food, and emotional support from family, friends, and loved ones will help the child recover at a faster rate.
