Dr Vasudha N R is a paediatric oncologist currently practicing at Cytecare Hospital, Bengaluru. She trained at the Great Ormond Street Hospital for Children in London, UK. In this post, Dr Vasudha answers FAQs on childhood cancers; blood cancer and brain tumours. 

Can children treated for childhood cancers lead a normal life?

Children treated for blood cancer can definitely lead a normal life. We have lots of blood cancer survivors who are doing well in their adult lives. With some brain tumours, radiation may form an integral part of the treatment. This might lead to some effects like a drop in IQ, but with early intervention, we find that these children can also go on to have equal career and educational opportunities as their peers. 

What are the warning signs (symptoms) of blood cancer in children?

As the haemoglobin levels drop, the child may show abnormal paleness or increased tiredness. Bluish or greenish discolouration on their hands and feet, or small pinpoint-like red spots over the body, persistent bleeding from nose are also symptoms to consider. When the white blood cells are affected, the child is more susceptible to infections. The child might keep suffering from flues or more serious infections, which do not subside. Boney pains are also a common symptom, and so are enlargement of lymph nodes in the neck, armpits or groin region.

Does Bone Marrow Transplant cure blood cancer?

An advantage of bone marrow transplant is that the reinfused donor stem cells mount up an immune response against the residual leukemia cells. This is called the graft versus leukemia effect. This is how the bone marrow transplant works to cure blood cancer. However, bone marrow transplant is not always successful. There are a few scenarios where, unfortunately, even after a bone marrow transplant, the disease tends to relapse.

What are the treatment options for childhood cancer in India?

Chemotherapy is usually used to treat childhood cancers. If required, surgery and radiation therapy may also be used. Very often, it is a combination of these three modalities. Of late, we are starting to use immunotherapy to treat leukemias and lymphomas.

What are the cure rates of Leukemia in children?

The cure rates of childhood cancers are much better than those of adult cancers. In the 1960s, the cure rate was about 4%. Today, it is about 85% for childhood lyphoblastic leukemia.

What are the cure rates for Medulloblastoma and Glioma tumours?

Generally, for standard risk medulloblastoma, the cure rates are about 60 to 70% . And for the high risk medulloblastoma the cure rates are only about 40 to 50%. The survival rates for children for low grade gliomas are as high as 90% for ten years.

What is the duration of treatment for blood cancer in children?

For acute lymphoblastic leukemia, there would be six to eight months of protocol directed therapy, followed by two years of maintenance therapy. The first six to eight months are intensive where you will be expected to visit the hospital frequently. Maintenance therapy comprises of oral medications.

For acute myeloid leukemia, four cycles of chemotherapy are given over a period of six to eight months. This is quite an intensive treatment, and often, for acute myeloid leukemia, a child may have to be hospitalised for the entire duration of treatment.

What are the late effects of childhood cancer and how can it be managed?

The late effects of childhood cancer may include cardiovascular, musculo-skelital, reproductive and endocrine-ralated problems. It is important for the child to receive life-long, focused follow-up, to monitor such effects, and remedy them in time.

What is your advice for caregivers of childhood cancer patients?

Firstly, the treatment protocol suggested by your oncologist should be strictly adhered to. Secondly, it is important to prevent infections in the child, and for this hygiene has to be maintained at all times. Thirdly, the side-effects of chemotherapy like oral ulcers must be identified and treated in time. Lastly, the psychological toll of the treatment on the child must be addressed.