Childhood Cancers: Reviewing Attitudes towards It
POPULAR media may not reflect this reality, but childhood cancers are highly treatable - so treatable, in fact, that most childhood cancers have a 50% to 60% cure rate.
Of course, the stage of detection and type of cancer influence the cure rate, but due to progressively improved cancer management strategies and modern medicine, the numbers keep getting better and better.
Common childhood cancers
Dr Chan Lee Lee, consultant paediatrician and paediatric haematologist at Subang Jaya Medical Centre, shares, "The most common childhood cancer is acute leukaemia, which accounts for at least a third of all cases, followed by brain tumours, lymphoma and a smattering of rare cancers such as cancers of the bone, soft tissue, liver, kidney and eyes.
"Overall, the most common form of leukaemia in children - acute lymphoblastic leukaemia - has an 80% to 90% cure rate. Some types of lymphoma and cancers of the kidney have good cure rates of around 90% as well."
According to Dr Chan, there is less emphasis placed on paediatric cancer research compared with adult cancer in the country, because the percentage of paediatric cancer cases is very small compared to a lot of adult-onset cancers.
Promoting childhood cancer awareness
"When raising awareness, we are hoping that parents come in early and seek treatment instead of opting for alternative therapy. We hope that we can educate the population on the importance of medical advances and therapy that provide children with immediate help and keep the cancer in check," says Dr Chan.
She asserts that knowing cancer can also occur in children is important. Parents and guardians should know how to recognise symptoms, especially if they are persistent, and bring their children to the right medical professional to diagnose and treat them.
"I think it is also important to highlight the fact that cancers in children are so treatable. The fears parents have about chemotherapy are always carried over from what they see in adults but, on the whole, I find that children tolerate chemotherapy very well. Parents should not be wary and should opt for tried and tested methods," she adds.
After the cancer diagnosis
The process does not end at the diagnosis. Treatment and surveillance investigations are ongoing and, according to Dr Chan, children usually adjust better to treatment than adults while the parents or caregivers continue to worry.
She mentions that caregivers should seek emotional support in the form of survivor meetings or cancer support groups.
Dr Chan shares that when a new patient is admitted into her care, the nurses match the new family to another so that both patients and caregivers may find companionship in each other to ease the treatment journey.
The innovations in cancer treatment
Cancer management uses a combination of treatment methods. A good treatment plan and team consists of medical professionals from a variety of disciplines such as paediatric oncology, radiation oncology, oncology imaging, nuclear medicine and surgeons.
When it comes to treatment, not much has changed over the years. What has changed, however, is the quality and precision of treatment.
"Chemotherapy, surgery and radiotherapy are the three main modalities employed in cancer treatment and have remained so for a long time," says Dr Yap Beng Khiong, consultant clinical oncologist at SJMC.
"A patient's cancer treatment is now managed by a multidisciplinary team who are all specialists in a field of oncology and are dedicated to coming up with and maintaining a working treatment plan for the patient."
He adds that cancer management strategies should not be limited to medical decisions. Organising patient and caregiver support groups for different types of cancer could contribute to the general well-being and emotional health of both groups, as encouragement and peer support are essential.
"In support groups, patients and their caregivers can share their individual struggles and realise that they are not alone," says Dr Yap.
Cancer awareness to change the misconceptions
In addition, public awareness activities could help destigmatise the fight against cancer. By taking part in public lectures and awareness activities, oncologists can help the public approach cancer and cancer treatment with hope instead of despair.
Dr Yap asserts, "We cannot implement the policy but we can influence the policymakers. We try to tell the public what's going on, but they have to ask themselves some questions - when to go for treatment, how they want to go for treatment and how much they want to detect cancer early.
"Our country's cancer infrastructure can be improved further. Everyone can play a role. We can educate the public on what services are available and what should be available, so everyone has a choice in what they do about it."
Every cancer patient is different
CANCER management services involve treating each patient as an individual, due to the vast diversity in cancer typology and how cancer develops in each person.
As every treatment centre may provide different approaches and services to cancer management, patients should research and explore their options before undergoing treatment.
According to Dr Yap Beng Khiong, consultant oncologist at Subang Jaya Medical Centre, a good centre should preferably have a wide range of facilities for diagnosis and treatment, manned by multidisciplinary teams to support patients' treatment plans.
"It is important to realise that cancer treatment has to be delivered in a timely manner rather than have the patient shuttled around from hospital to hospital due to the lack of necessary facilities," says Dr Yap.
Cancer treatment services and specialties
The three main branches of cancer management are medical oncology, surgical oncology and radiation oncology. A good treatment centre should have well-equipped facilities in these three areas.
This discipline involves using a combination of chemotherapy, hormonal therapy, biological therapy and targeted therapy that is tailored to each cancer patient to treat their disease.
Surgeons specialising in cancer management contribute to a patient's treatment plan when it involves removing tumours or cancerous tissue.
Radiation oncology is applied as curative treatment for cancer. It is also used palliatively to relieve symptoms for patients in advanced stages of cancer.
In addition to a solid background in the aforementioned cancer treatment areas, here are some other services that could positively impact cancer management.
Experts in this area are involved in the diagnosis, treatment and prevention of blood diseases and cancer as well as research.
Haematology-oncology includes diseases such as anaemia, haemophilia, sickle cell disease, thalassaemia, leukaemia and lymphoma in adults and children.
Stem cell transplantation
Stem cell transplants can be used to treat cancer. Stem cell transplants are most often used for cancers affecting the blood or immune system, such as leukaemia, lymphoma and multiple myeloma.
This specialised and comprehensive laboratory service plays a crucial role in supporting patient care by providing accurate, timely diagnoses, which in turn contribute to positive therapeutic implications.
This medical specialty involves the application of radioactive substances in the diagnosis and treatment of diseases.
A branch of radiology, interventional oncology deals with the diagnosis and treatment of cancer and cancer-related problems using targeted, minimally invasive procedures performed under image guidance.
Biopsies, which involve removing body tissues to screen for presence or extent of a disease, are part of a technique employed under interventional oncology.
An important aspect of multidisciplinary management of cancer, oncologic imaging applications include early screening for cancer, diagnosing and staging of cancer, treatment planning, tumour response monitoring and cancer recurrence.