Compared to adult malignancies, environmental factors have not been found to play a major role in childhood cancers. Some of the common factors that increase the risk of childhood cancers are radiation exposure, medical conditions like Down’s syndrome, genetic abnormalities, developmental abnormalities in the womb, and associated infections.

Genetic factors include acquired or inherited mutations causing DNA damage in children. Some of the genetic factors like abnormalities in the Retinoblastoma gene, p53 gene, leads to different malignancies later in childhood. Non-genetic factors include exposure to infections like Epstein Barr virus, problems associated with development while inside the womb, previous radiation exposure, history of chemotherapy increases the risk of childhood cancers.

Most of the childhood cancers symptoms are often noted by parents or relatives. Unusual body swelling or lump, pallor, bruises, unexplained fever and weight loss, headache, vomiting, seizures, eye or visual changes, limping, warrants a visit to the clinician.

Leukaemia’s are usually suspected when a child presents with persistent fever, weight loss, bleeding/bruising, bone pain, hepatosplenomegaly and/or lymphadenopathy. Some of the common investigations done are complete blood panel, peripheral smear, bone marrow examination, and flow cytometry/immunochemistry are done to confirm the diagnosis of leukaemia.

Treatment of childhood cancers, depending on the type of cancer and the site of disease.

Common treatment options for childhood cancers include Systemic therapy (Chemotherapy/Targeted Therapy), Surgery (Complete or partial removal of tumour) and Radiation therapy/proton therapy (Alone or in combination with systemic therapy/Surgery).

The survival rate depends on the type and stage of the disease. Recently, outcomes of treatment in certain tumours can be predicted by using molecular information from the tumours as a tool. Certain childhood tumours when diagnosed early the cure rates can be as high as 95%, and therefore survival in those children is similar to that of a normal population.

The duration of chemotherapy also depends on the stage and type of tumour. The duration depending on the type of tumour ranges between 3 months to 1 year or more in some children. The chemotherapy is administered usually as injections or tablets over a few days to weeks followed by a gap before the next dose.

Some parents think they should not tell a child about an upcoming procedure, especially if it may hurt. But children need clear and honest information. If you tell your child that a procedure will not hurt, and when it does, the child may be surprised and confused. Your child may then expect all procedures to hurt and will not believe you if you say otherwise.

Many children can cope with pain, loud machines, or uncomfortable positions if they know when it will happen and how long it will last. Learning this information ahead of time can help your child share what he or she needs to stay calm during the unpleasant experience. You may want to explain to your child that unpleasant things have to be done to help him or her get better. But remind your child that this procedure is not happening because he or she did anything wrong. A social worker, nurse, child life specialist, or another member of the health care team can help you find the right words to explain the medical procedures to your child.

Side-effects depend on the type and nature of the treatment. Most of the side effects are temporary. Children recover from them a few months after treatment. However, there are some side-effects that can be long-term. With recent advances in the field of medicine and by using sophisticated technology such as Proton therapy, targeted therapy, minimally invasive surgical techniques, etc the long-term side-effects can be minimized.

Side-effects depend on the type and nature of the treatment. Most of the side effects are temporary. Children recover from them a few months after treatment. However, there are some side-effects that can be long-term. With recent advances in the field of medicine and by using sophisticated technology such as Proton therapy, targeted therapy, minimally invasive surgical techniques, etc the long-term side-effects can be minimized.

Unlike many cancers of adults, lifestyle-related risk factors (such as smoking) don't play much of a role in a child’s risk of getting cancer. A few environmental factors, such as radiation exposure, have been linked with an increased risk of some childhood cancers. But in some cases, exposure to radiation might be unavoidable, such as if the child needs radiation therapy to treat another cancer.

During cancer treatment, most families are mainly concerned about the daily aspects of getting through treatment and beating cancer.

It is certainly normal for families to want to put cancer and its treatment behind them and to get back to a life that doesn’t revolve around cancer. But it’s important to realize that close follow-up care is a central part of this process that offers children the best chance for recovery and long-term survival.

Once treatment is finished, the health care team will set up a follow-up schedule. For many years after treatment, children must have regular follow-up exams with the cancer care team. As time goes by, the risk of cancer coming back goes down. Doctor visits might be needed less often, but they are still important because some side effects of treatment might not show up until years later.

Because of major advances in treatment, more children treated for cancer now survive into adulthood. But treatments might affect children’s health later in life, so watching for health effects as they get older has become more of a concern in recent years. The earlier any problems are recognized, the more likely it is they can be treated effectively.

It is true that surviving cancer may shorten life expectancy because of the late side-effects related to treatment. However, these effects can be mitigated by following a lifestyle. Evolving treatment approaches are projected to be associated with improved life expectancy after treatment for paediatric cancer.

Side-effects depend on the type and nature of the treatment. Most of the side effects are temporary. Children recover from them a few months after treatment. However, there are some side-effects that can be long-term. With recent advances in the field of medicine and by using sophisticated technology such as Proton therapy, targeted therapy, minimally invasive surgical techniques, etc the long-term side-effects can be minimized.

Depending on the stage and type of cancer, there is a risk of cancer coming back later. However, in certain childhood tumours when diagnosed early the cure rates can be as high as 95%. Once treatment is finished, the health care team will set up a follow-up schedule. For many years after treatment, it is very important that children have regular follow-up exams with the cancer care team. As time goes by, the risk of cancer coming back goes down.

Cancer and the treatment of it can have serious social and emotional consequences for the child. Children with cancer and survivors of childhood cancer may experience severe anxiety, inhibited and behavioral problems, excessive somatic complaints, intense stress, post-traumatic stress disorder (PTSD), academic difficulties and surrounding frustration, peer relationship difficulties, and worries about the future concerning with the career and relationships. Family members of a child with cancer often suffer various forms of distress about the child’s illness.

Early signs of emotional distress and symptoms of posttraumatic stress require early assessment and intervention to minimize the negative impact on the child and his or her family. APCC has an excellent psychosocial support team constituting psychiatrists, psychologists, counsellors specializing in managing paediatric, teenage and young adult cancer patients.

Late effects of childhood cancer treatment. The treatment of cancer may cause health problems for childhood cancer survivors months or years after successful treatment has ended. Cancer treatments may affect the body's organs, tissues, or bones and may cause health problems later in life. These health problems are called late effects.

Doctors at APCC are studying the late effects caused by cancer treatment. They are working to improve cancer treatments and stop or lessen late effects. While most late effects are not life-threatening, they may cause problems that affect health and quality of life. The cutting edge pencil beam scanning proton therapy used at APCC has shown promising results in preventing/minimizing these late effects and helping children maintain a good quality of life after cancer treatment.

Children treated for cancer miss out on a lot of normal social things. They miss school and are often isolated. Social developmental milestones can be delayed. Receiving cancer treatment as a growing child can have long term impacts on physical and emotional health – especially a developing child. Adolescents who are treated often lose independence at a time that they would normally be establishing independence.

In addition to the many physical late effects that may develop in survivors of childhood cancer, there are also a host of psychosocial issues that may emerge. Long-term educational, social, behavioural and vocational difficulties are all common.

APCC has a comprehensive program “AALAP” for providing comprehensive care to all children, teenagers and young adults with cancer.

APCC has an active clinical research unit whereby our doctors are in a constant endeavour to bring out innovative treatment strategies to minimize side effects if any due to cancer treatment and help children in marinating an active life even after treatment.

In recent years research related to childhood cancers has made tremendous progress. APCC’s paediatric CMT has been actively involved in studying the effect of various treatments in childhood cancer patients.