The burden of childhood cancers is high in low- and middle-income countries where the health system is weak and contributes to cure rates of less than 30 per cent due to significant barriers in early diagnosis, inability to accurately diagnose, poor access to health care facilities, and inability to initiate treatment promptly.
Dr Srikanth Soma, Consultant Surgical Oncologist, SLG Hospitals, said: “In spite of drastic improvement in cancer care services over the past few decades, India continues to have a low success rate when it comes to curing childhood cancers completely. That is because most of the malignancies brought to the notice of doctors are at advanced stages. Lack of awareness, treatment refusal, and financial constraints are among the prime reasons for this delay in seeking right medical care.
“Another major problem is that childhood cancer care services are currently available only at tertiary health centres in major cities, forcing a majority of India to depend on these few centres.”
Dr Narender Kumar Thota, Consultant Medical Oncology & Haemato Oncologist & Stem Cell Bone Marrow Transplant Specialist, KIMS Hospitals, said: “(As many as) 1.6 to 4.8 per cent of all cancer in India is seen in children below 15 years of age and the overall incidence of 38 to 124 per million children, per year, is lower than that in the developed world.
“The considerable inter-regional variation in incidence and mortality rates across India suggests a possible deficiency in ascertainment of cases and death notification, particularly in rural areas. Unlike adult malignancies, childhood cancers do not have a known cause in a majority cases. Only 10 per cent cases are due to genetic reasons. Childhood cancers cannot be prevented nor identified through screening.”
According to Dr Revanth Reddy, Consultant Surgical Oncologist, Aware Gleneagles Global Hospital, financial support through the government-promoted health insurance and holistic support through philanthropic organisations have improved treatment adherence and outcome.
“Moving forward, the focus should be on strengthening the cancer registries for capturing nationwide data, improving awareness of childhood cancer among caregivers and healthcare workers for early recognition and improving accessibility of childhood cancer care services beyond major cities,” he said.
Symptoms of childhood cancers generally include unexplained weight loss, persistent pain in bone, joints or legs, lumps/mass in the abdomen, chest, neck or pelvis, excessive bruising or bleeding, prolonged fatigue, whitish appearance of the pupil etc.
In infants and children less than one year, neuroblastoma appears to be one of the most common cancers while in children between 1-4 years leukemias are common, and in children aged between 9-16 years, bone cancers are common.
Treatment for such cancers would include surgery, chemotherapy, radiotherapy, or a combination depending on the nature of malignancy and its stage of presentation. Doctors say focus should be on improving awareness about childhood cancers and its symptoms among parents and healthcare providers and improving healthcare access to remote areas. India needs to have a policy framework specifically to address childhood cancer care, they added.