Udupi: Coordinated Efforts can Cure Children's Blood Cancer
Divvy Kant Upadhyay, Manipal
Daijiworld News Network - Udupi (GA)
Udupi, May 20: Cancer in children is a major cause of mortality and may be more common than generally perceived. But however scary the disease may sound, it is important to know that today in a large number of cases it is curable. Estimates indicate nearly 70,000 children in India suffer from some form of cancer. The most common is leukemia- or blood cancer and 75 – 80 percent of that is in the form of ‘A L L’ – Acute Lymphoblastic Leukemia. If this condition were to be diagnosed when India got her Independence, it would generally be equated to a death sentence for the little one. But today, thanks to early diagnosis and combined supportive care, a whopping 70-80 percent of children suffering from ‘ALL’ can be cured of the disease. Children with a form of kidney tumour like Willm’s tumour have 90 percent chances of being cured.
Vice-chancellor of Manipal University Dr Raj P Warrier is a trained Children’s cancer specialist and has been in the field for nearly three decades now, having spent almost all of that time in USA. Dr Warrier feels care for children with cancer in India needs to be coordinated and comprehensive multi-disciplinary care is the need of the hour. “We need to have comprehensive care with National protocols for specific cancers similar to the collaborative study groups such as Children’s Oncolgy Group in the USA or SIOP in Europe,” says Dr Warrier.
He emphasizes on the multi-pronged approach for treatment. “It’s a team effort that helps bring in the best results – we need a paediatrician, oncologist, ped-surgeon, data manager, basic science researcher and of course a skilled and dedicated nursing team to supervise the chemotherapy (medicines), psychosocial and family supports groups and long term follow-up plans. It doesn’t stop there – "we need a good blood bank, well-equipped labs in microbiology, pathology and radiology to help in the accurate diagnostic and prognostic staging of the disease." Dr Warrier sums it up by stressing that children with cancer need to be treated at tertiary care centers where all of these facilities are available.
“We do have a shortage of ‘Fellowship trained’- Pediatric Hemato-oncologists” says Dr Warrier who is part of a group of doctors who are working to change the scenario for the treatment of children’s blood cancer in India. The Hematology - oncology chapter of the Indian Academy of Paediatrics (IAP-PHO ) is trying to form a collaborative study group called IPog. The group would like to coordinate and standardize treatment protocols across different centres in the country. AIIMS, Sir Gangaram Hospital and Rajiv Gandhi Inst in Delhi, Wadia Children’s Hospital and the famed Tata Cancer Inst in Mumbai, the Manipal University hospitals and other hospitals across the country have evinced interest to make national protocols a reality soon. Six medical institutes across India are also offering Fellowship of the National Board (FNB) in Paeadiatric Hematolgy Oncology with Manipal University being one of them.
One of the biggest challenges of treating children’s blood cancer is the cost and affordability of the newer drugs. Incase medicines do not work and the child suffers from a relapse, then Bone Marrow Transplantation is a good option but it comes with its own challenges of finding a perfect donor and the need for intensive post transplant care . “A national registry of donors based on HLA-typing as well as cord-blood banks are essential for India” says a concerned Dr Warrier. He agrees that some wonder-drugs like Gleevac or Rituxan are expensive and unaffordable for the poor patients. In most cities the Chief Minister’s funds, the NGOs and several support groups come forward to help. The Manipal Foundation which is the charitable arm of the Manipal Group has a unique scheme. Any money donated for a cause is matched by an equal grant from the foundation and can be used for specific cases like Children’s cancer treatment or free heart surgeries.
There seems to be hope for Children suffering from Cancer as Peds - oncolgy groups across the country are "tailoring" treatment options to suit the specific types of cancer in children to obtain the best results while minimizing side-effects and long term complications.
What is Leukemia?
Leukemia means "white blood". The word indicates an unexpected, unwarranted and uncontrollable increase in the number of white blood cells in the blood or the bone marrow(the site where blood cells are formed).In simple words the non-functional cells simply forget to die and keep on increasing in number by multiplying.
These immature cells which are useless to us, crowd up in the marrow and take up the space actually meant for very crucial and useful normal stem cells. Eventually this abnormal proliferation leads to a scarcity of cells that are needed for normal functioning .
Early suspicious signs like unexplained pallor (paleness), bleeding, fever, weight loss or persistent infection requires a checkup by your family doctor who can refer the case to a specialist if needed. Improvements in diagnostic modalities, rational use of drugs with combination therapy and improved supportive care have made majority of pediatric cancers curable.