Recent Advances In Paediatric Oncology Treatment- Transforming Cancer Care in Children

by Dr. Intezar Mehdi, Director and Head of the Department, Senior Consultant – Paediatric Haeamtology Oncology & BMT, HCG Cancer Centre, Bengaluru
 
Cancer, a disorder affecting millions of lives across all age groups, is of 100 different kinds. Paediatric cancer, one of the many kinds of cancer,  refers to the cancer that occurs in children under the age of 18. It is a rare but serious disease that affects thousands of children worldwide each year. While the causes of paediatric cancer are not fully understood, it has been clinically observed that a combination of genetic and environmental factors may play a role albeit in a small percentage of kids.
 
Identifying the causes and signs of paediatric cancer
 
One of the most common causes of paediatric cancer is a genetic mutation. These mutations can occur spontaneously or can be inherited from a parent. Some genetic mutations are known to increase a child's risk of developing certain types of cancer, such as retinoblastoma- a cancer of the eye, Osteosarcoma- a cancer of the bone and neuroblastoma- a cancer that affects the nervous system. Environmental factors, such as exposure to certain chemicals or radiation, may also increase a child's risk of developing cancer.
 
The signs and symptoms of Childhood Cancer can vary depending on the type of cancer and where it is located in the body. Common signs include:
 
●     Unexplained or prolonged Fever or infection that doesn't go away
●     Lump or mass that can be felt in the neck, armpit or groin or abdomen
●     Pallor, or bleeding – external or internal
●     Pain or discomfort especially if it is persistent or progressing
●     Unexplained weight loss
●     Feeling tired or unexplained weakness
●     Persistent early morning headache  associated with vomiting
●     Changes in the skin, such as a new mole or a sore that doesn't heal
 
If a child has any of these symptoms, it is important to see a doctor/Pediatrician for an evaluation to rule out the possibility of cancer.  Earlier the paediatric cancer is diagnosed, the better the chances of a successful treatment and cure.
 
Treating Children with Cancer
 
Treatment for Childhood cancer typically involves a combination of surgery, chemotherapy, radiation therapy, and immunotherapy. Surgery is often used to remove the tumour and nearby lymph nodes and sometimes for diagnosis. Chemotherapy is a type of treatment that uses drugs to kill cancer cells. Radiation therapy uses high-energy rays to kill cancer cells. Immunotherapy is a type of treatment that helps the body's immune system fight cancer. Managing children with Cancer has to follow a Multidisciplinary approach involving multiple specialists trying to give personalized treatment focusing on that particular child. It is also important to have empathetic and holistic approach. In Cancer- first time is the best time for treating the cancer successfully and in Childhood cancer- we have to make sure that not only the child has a successful treatment outcome but also he/she should have a normal growth, development, a normal future and career. Because, child is not only the future for that family, but also for the society and the Nation as a whole. 
 
Recent Advances revolutionising paediatric cancer treatment
 
Advances in paediatric cancer treatment have led to significant improvements in survival rates for children with cancer. Cure rates for children with cancer have improved in the last few decades significantly. Currently, almost 75-80 % of children are expected to be cured completely with the right treatment approach. Now, the focus is moving towards improves the outcomes as well as minimizing the side effects of therapy. Also research at the genetic and molecular levels have lead to targeted therapy and immunotherapy. These recent advances in technology and research have led to more targeted and effective treatments.
 
Precision medicine: One major advance in paediatric cancer treatment is the use of precision medicine. Precision medicine is an approach to treatment that takes into account the specific genetic makeup of a patient's cancer. By identifying the specific mutations that are driving a child's cancer, doctors can select treatments that are more likely to be effective. Targeted therapies, such as those that target the B-Raf or ALK genes, have been developed for children with certain types of cancer, such as Melanoma or Neuroblastoma.
 
Immunotherapy: Another advance in paediatric cancer treatment is the use of immunotherapy. Immunotherapy is a type of treatment that helps the body's immune system fight cancer. One type of immunotherapy, called CAR-T cell therapy, involves taking T cells (a type of white blood cell) from a child's blood, genetically modifying them to target cancer cells, and then infusing them back into the child's bloodstream. This type of therapy has shown promise in treating paediatric leukaemias and lymphomas.
 
Proton Therapy: Another recent advancement in paediatric cancer treatment is the use of proton therapy. Proton therapy is a type of radiation therapy that uses protons, instead of X-rays (Photons), to treat cancer. Because protons can be more precisely targeted to a tumour, they can deliver higher doses of radiation to the cancer while minimising damage to surrounding healthy tissue. This can be especially beneficial for children, whose bodies are still growing and developing.
 
Improved management of side-effects
 
In addition to these advances in treatment, there have also been improvements in the management of side effects. Like, new medications have been developed to manage nausea and vomiting, which are common side effects of chemotherapy. Other advances, such as the use of virtual reality and other forms of distraction therapy, can help children to cope with the stress and anxiety of cancer treatment.
 
Research into paediatric cancer is ongoing and new treatments are being developed all the time. In recent years, scientists have made significant progress in understanding the genetic and molecular changes that drive paediatric cancer. This has led to the development of new drugs and therapies that are more targeted and effective.
 
Advances in paediatric cancer treatment have led to significant improvements in survival rates for children with cancer. Precision medicine, immunotherapy, and proton therapy are among the most promising new treatments. However, there are still many challenges in paediatric cancer treatment and research into paediatric cancer is ongoing. With continued support for research, it is hoped that even more effective treatments for paediatric cancer will be developed in the future.