Cancer In Children

Only accidents claim more lives among children than cancer. These cancers are very malignant and, unless treated early, preferably by a team of consultants in a large centre specialising in childhood cancer, are rapidly fatal.

The more frequent childhood cancers include Wilms’ tumour, neuroblastoma, Ewing’s sarcoma, rhabdomyosarcoma, osteogenic sarcoma and, of course, acute lymphoblastic leukaemia.

All three forms of treatment, surgery, radiotherapy and chemotherapy, are employed, singly or in combination, and great advances have been made in the management of the disease.

One of the reasons why such treatment is best carried out in large centres is the availability of adequate equipment and the presence of medical staff specially trained to select the most effective combination of treatments currently used. Another reason is the expertise of the nursing staff in providing sympathetic psychological support for grieving parents and relatives faced with the possibility of their children actually dying.

There are two fundamental differences between cancers in adults and those occurring in children. First, only a few organs in the body are affected by childhood cancer and these are not usually the ones involving cancer in adults. Second, more than 90 per cent of childhood cancers are sarcomas, whereas in adults carcinomas are much more common.

The sarcomas usually grow with great speed and metastasise widely to other parts of the body quite early. Without prompt treatment survival tends to be short; over half these children die of the disease.

However, the reason why many forms of childhood cancer can be cured, springs from the fact that they consist of rapidly growing tumour cells which respond to anti-cancer drugs as well as being sensitive to damage by radiation.

Adjuvant chemotherapy, that is drug treatment for assumed but unproven micro-metastases after surgery or radiotherapy, has greatly increased the cure rate in Wilms’ tumour, osteogenic sarcoma, Ewing’s sarcoma and rhabdomyosarcoma, something so far not achieved in cancers occurring in adults.

Coping With Childhood Cancer

There probably is no situation more agonising for parents to face than the prospect of a child dying of cancer. Other children in the family may also find it difficult to handle the child’s illness emotionally, sometimes more so than the sick child.

As a direct result, divorces are common among parents of these children, and brothers and sisters frequently resent the attention the parents give to the sick child at their expense. In addition, the family may also have to face economic hardship as a result of the child’s illness, if one parent has had to give up a job to nurse him. No family can cope with a financial crisis and such psychological difficulties at the same time without support from outside.

Medical centres routinely treating children offer many services to help the family to cope with this stressful situation. In particular they set up discussion groups between parents so that an exchange of views of common problems can take place and fears about the death of their child can be shared. The mere fact that other parents have to face similar problems is very consoling. Similarly children in hospital can discuss their illness with other children. It helps them face their disease and encourages them to talk about it with their parents without having to be afraid of upsetting them. It is so much easier when neither parents nor the child need to hide their fear of death from each other. Above all, what is most important is for parents to ensure that the child continues to feel part of the family.