Childhood cancer is a growing problem

Yesterday, we had reported on the number of cancer incidences in India, according to the data released by the National Cancer Registry Program.  The scares, however, don’t end there. Childhood cancer is relatively infrequent in India, with the existing data suggesting that a small percentage of overall cancers are in children.

However, the numbers are still alarming, particularly since the medical infrastructure in India doesn’t seem to be prepared to deal with the problem in its present proportions.

At 860, or 4.4 per cent of overall cancer cases in its region, Delhi reported the highest number of cancer incidences for children of the age group 0-14 years among all population-based cancer registries in India.

Delhi was followed by Aurangabad (3.4%) and Manipur (2.7%), excluding Imphal West.

Here’s one major cause for concern: in 2013, only one out of 10 cancer-affected children in India receive complete therapy. This was mainly due to poor supportive care and inadequate infrastructure, according to an Oncology series on The Lancet, as reported by the Indian Express. The numbers are not likely to have improved in the past three years.

More than 50 children, aged from 1 month to 14 years, in India die every day due to cancer, highlighted a study published in the Journal of Global Oncology.  The report mentioned that though treatment is available free of cost in a number of public health facilities, but overcrowding and long waiting times makes it very difficult for children to receive timely and quality care.

The report also highlighted that dearth of medical data in low and middle-income countries like India hampers efforts to place childhood cancer on public health agenda and hinders framing and implementation of national strategies to counter the disease.

Leukemia and lymphoma

Leukaemia is the predominant form of childhood cancer in both boys and girls. Known commonly as cancer in one’s blood, it starts in early blood-forming cells found in the bone marrow. Most often, leukemia is a cancer of the white blood cells, but some leukemias start in other blood cell types. Existing research has not come to any conclusion about whether environmental factors play a part in its incidence.

The Hospital Based Registry Data (HBCR) data shows that in all, except Regional Cancer Centre in Thiruvananthapuram, the second most common cancer in boys was lymphoma. Lymphoma refers to cancers that originate in the body’s lymphatic tissues. In Regional Cancer Centre, central nervous system (CNS) tumours are the second most common followed by lymphoma. Among girls, there are variations. Tumours of the CNS, bone, soft-tissue sarcomas and retinoblastoma are other types of cancer in childhood that seem to be growing in incidence.

Delhi’s worrying statistics

Among all population based cancer registries, Delhi reported the highest incidence rate per million – for boys and girls – among all PBCRs in India.

In a column for Huffington Post, Urvashi Prasad, a public health expert, who has worked with the Michael & Susan Dell Foundation, outlined three major steps regarding combating childhood cancer, which need to be taken in India.

Firstly, diagnosis and treatment services need to be more accessible to families all over the country. Currently, a number of the major cancer hospitals (or those that have the requisite facilities) are concentrated in big cities. This means limited access for those who live in rural areas, which only compounds the distress and anxiety. Secondly, a child coping with cancer needs physical, mental and emotional support. Simply treatment, which is often very long, painful and traumatizing, is not enough. Particularly in case of children, it’s important to ensure parents are able to provide the necessary emotional support.

Finally, even once the cancer is in remission, it’s vital to monitor a child’s health closely to avoid a relapse. The taxing cancer treatment weakens the body’s immunity, which in turn leaves children (and adults) susceptible to infections. “If the chance of recovery in childhood cancer is 80 per cent, then lack of nutrition reduces this chance to a mere 25 per cent,” said Dr Brijesh Arora, of Tata Memorial Hospital in Mumbai.

Earlier this year, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) reported that India accounts for 20 per cent of all childhood cancer in the world. In comparison to this figure, there just isn’t enough by way of medical professionals and facilities to treat the numbers, particularly outside cities. Even within cities and suburban areas, cancer treatment is expensive and difficult for the lower middle class and poor to afford. Add social stigma, and the situation becomes all the more dire. This is why the cure rates for childhood cancers are so abysmally low at 30 per cent in India.

But childhood cancer is a real and growing problem. Particularly because it affects our young, it’s imperative that more initiatives like Freedom from Cancer and Relief Research Foundation, Cankids Kidscan and Cuddles Foundation, which work with children who have cancer, are supported.

However, it will take more than campaigns organised by NGOs and public donations to combat cancer in India. The interventions that are necessary require a collaboration between private enterprises and governmental policies. So far, that hasn’t happened.