Cancer is predominantly a disease of old age. But there are a few unfortunate children who have to deal with the ordeal of fighting cancer. The common pediatric cancers are Acute Lymphocytic Leukemia (ALL), brain tumors (medulloblastoma and gliomas), retinoblastoma, neuroblastoma, Wilms tumor, osteosarcoma and ewings sarcoma.
Why children suffer from cancer is not completely known. There are no definitive etiolgical factors associated. Cancer is a genetic disease and few genetic conditions are associated with increased risk of pediatric cancer, they are Li Fraumeni syndrome, Fanconi's anemia, Blooms syndrome, Downs' syndrome, neurofibromatosis etc.
In last 50 years significant advacements have been made in the treatment of childhood cancer bringing the mortality down by half. Today around 80% of children with cancer can be expected to be cured but for the aim is to find cure for 100% without short term or long term toxicity.
There have been advancements in surgery, radiotherapy and chemotherapy but long term survivors of childhood cancer are at increased risk of second malignancy because of treatment ith radiation and certain types of chemotherapeutic agents. The sword of Damocles is always hanging for them! Also they can have stunted growth both mental and physical becuase of disease and treatment. The newer targeted therapies considered less toxic need to be used with caution in children and preferably in a clinical trial, according to a paper in Lancet.Lancet.
Better understanding of childhood cancers, better therapeutic agents, better trial design, long term data, mandates greater scientific rigor and research. All fields of science from technology, genetics, clinical trials, data management, growth and development research need special focus and thrust to eliminate cancer.
As i recollect the few pediatric patients i have treated, i recollect two happy stories, one with Nasopharyngeal cancer and other with Craniopharyngioma, but numerous kids in front of whom i was helpless and was defeated. Metastatic retinoblastoma (cute 6 year old girl), metastatic Ewing's sarcoma (young 15 year old boy), a kid with Medulloblastoma. They all remind me to become a better and scientific person.
References:
1. http://www.cancer.gov/cancertopics/factsheet/Sites-Types/childhood
2. http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2812%2970530-2/fulltext
3. http://www.hopau.org/uploads/flash/lessons/lsn38/2010_Boot_Camp_Koontz_Pediatrics_Appendix_2.PDF
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