Incidence of Childhood Cancers in India
- In India, over 60,000 new cases of childhood cancers are diagnosed each year, representing 4-5% of the overall cancer burden.
- Adolescent and young adult cancers (AYA) account for another 5.7% of all cancers.
- Leukemia (blood cancer) is the most common childhood cancer, accounting for 50-75% of childhood cancers.
- Other common pediatric cancers are lymphoma, Wilms tumor (tumor of the kidney), neuroblastoma (adrenal gland tumor), retinoblastoma (eye tumor) and bone and brain tumors.
Signs and Symptoms of Childhood Cancer
Unlike adults, there are no screening tests (breast self-examination/prostate exam) for most childhood cancers. Hence, SIOP (International Society of Pediatric Oncology) has come up with 9 warning signs for childhood cancer, for early detection and treatment. These are not confirmatory signs, but the persistence of these symptoms should warrant a pediatric oncologist evaluation.
These are:
- Pallor or bleeding from the gums.
- A lump or a swelling which is generally painless.
- Any unexplained weight loss/high-grade fever not responding to antibiotics/persistent cough.
- Eye changes – white reflex (when you shine a torch, naturally a red reflex will be seen), presence of white reflex can indicate eye tumor.
This is a screening test for retinoblastoma (eye tumor arising from retina). - Abdominal swelling.
- Headache – severe early morning associated with vomiting.
- Bone pain – more at night.
- Lethargy/Easy fatiguability.
- Dizziness/Loss of balance.
How to Confirm the Diagnosis of Childhood Cancer?
Blood Investigation
Basic investigations like CBC (complete blood count) and peripheral smear can show increased white cell count which can alert us to the possibility of leukemia (blood cancer).
Bone Marrow Aspiration
This is the confirmatory test for leukemia, where 2-3 ml of bone marrow sample is taken and tested for the presence of leukemic blasts.
Biopsy
In the case of solid organ tumor like kidney tumor (Wilms tumor), liver tumor (hepatoblastoma/hepatocellular carcinoma) or adrenal gland (neuroblastoma), a biopsy may be needed for confirmation.
Treatment Options for Childhood Cancer
The treatment options are intravenous chemotherapy, radiotherapy or surgery based on the type and staging of the cancer. Standard risk leukemia when treated early has an 85% survival chance. Childhood cancer when detected and treated early has a good prognosis.
