Understanding chilcren with cancer

CEBU, Philippines - When a child in the family is diagnosed with cancer, it becomes a burden for the other family members as well. Their daily lives change. At home, cancer is a word no one wants to hear.

Children with cancer also dream of the same things that healthy children long for, like climbing monkey bars, playing ship captains, or going to school.

However, such things are hard to do for those brave little warriors battling the cancer monster. Unfortunately for some, the fight with cancer does not end in treatment or cure, but in death.

It is painful to see children confined at cancer wards fighting for their lives in what is often a losing battle. It is upon parents and immediate guardians to ensure that the little patients’ fear and pain are replaced with compassion, empathy, and assurance.

Compared to cancers in adults, childhood cancers tend to occur in different parts of the body. They look different under the microscope and respond differently to treatment. 

The website www.cancer.gov said that of the twelve major types of childhood cancers, leukemias (blood cell cancers) and cancers of the brain and the central nervous system account for more than half of new cases reported.

About one-third of childhood cancers are leukemia, with acute lymphoblastic leukemia (ALL), also known as “childhood leukemia,” as the most common, usually occurring between two and eight years old.

For the past 15 years in Metro Cebu, 64 children on average are diagnosed with cancer each year and the incidence of cancer affecting children has been increasing, with a five-year average increase of 36 percent, based on the Ramon Aboitiz Foundation Inc. - Eduardo J. Aboitiz Cancer Center’s (RAFI-EJACC) Metro Cebu Population Cancer Registry.

The cancer registry also shows that six in every ten children with cancer in Metro Cebu have been diagnosed before the age of ten. Annually, 38 children die of cancer in Metro Cebu, with 60 percent of these cases happening before their tenth birthday.

Brain and nervous system cancers are the second most common cancers in children and the most common solid tumor cancer in childhood (21 percent of childhood cancers). The most common brain tumors are called gliomas, which occur mostly in children from 0 to 15 years old.

Childhood cancers can occur suddenly, without early symptoms, but fortunately have a high rate of cure. A few conditions, such as Down syndrome, other specific chromosomal and genetic abnormalities, and ionizing radiation exposures, explain a small percentage of cases.

One of the hardest parts in dealing with children with cancer is how to ease their psychological and emotional pain. A strong support system in the family, with friends, and among children with cancer can help the child understand what is going on.

When the child asks, “Why did I get cancer?” or “Why me?” parents should emphasize that cancer is neither his fault nor a contagious disease. A child with cancer often worries how his friends will react if they see his physical changes, such as hair loss.

The question, “Are you going to die?” needs to be answered—even if it’s not asked. Parents need to explain common misconceptions and give the child a balanced point of view that cancer can be cured.

If a close relative died from cancer in the past, the child must be made to understand that each person responds differently to treatments. That just because his Uncle died of cancer does not mean he too will have the same fate.

Some of the psycho-social supports that health professionals give are education, counseling, and behavioral interventions to help manage the stress, depression, fear, and anxiety of cancer-stricken children and their families. These are ways to build trust and establish connectedness among affected members.

Cancer and its current treatments may affect the child’s appetite for and tolerance to food. Children need to get proper nutrients to help them feel better and stronger before, during, and after treatments.

Children with cancer need carbohydrates, fat, protein, water, minerals, and vitamins. A dietitian can help parents to understand their child’s needs and develop an eating plan. A child’s baseline nutritional status (Is he underweight? Overweight?), age, activity levels, treatment plan, and current medication are used to plot a nutrition plan. 

The good news is that three quarters of children diagnosed with cancer can now be cured. Children who survive five years from diagnosis are generally considered to be cured.

Within the overall survival rate, there are some cancers that have a better outlook.“Retinoblastoma, gonadal germ cell tumors, and Hodgkin’s disease all have five-year survival rates above 90 percent.

But there are a number of cancers that have lower rates of survival, including acute myeloid leukemia (65 percent), bone tumors (64 percent), and neuroblastoma (59 percent).

Although there are studies that identified factors that increase risk among adults, there is still no exact basis on what causes childhood cancers. Known factors that increase the risk among children include inherited medical condition, exposure to infections, and exposure to radiation, but most children with cancer do not have any of these factors.

Though there are advancements in cancer management, there is still a lot of research to be done to find out more about the disease. Children, the most vulnerable to pain, need adults to guide and support them during this life-changing phase.

The Children's Cancer and Leukemia Group (CCLG) have a booklet called A Parent’s Guide to Children’s Cancers – For parents and carers, which provides helpful information about childhood cancers and treatments. (FREEMAN)

Sources: http://www.childrenwithcancer.org.uk/childhood-cancer

http://www.cancerresearchuk.org/cancer-help/about-cancer/cancer-questions/childrens-cancers

www.cancer.org