Does cancer exists in children?

The belief about cancer is that, it only appears in adult people, and old people, like if it was only destined for them, but that is a wrong belief, because cancer can appear in every age in life, there are even types of cancer that appear exclusively in children.
Another wrong belief, is that cancer doesn’t have a cure, that fact it’s not true, a well treated cancer and well diagnosticated in time, before it gets to other organs, has more chances of healing by surgery, chemotherapy, or radiotherapy, whatever the case is.

Another wrong belief, is that cancer doesn’t have a cure, that fact it’s not true, a well treated cancer and well diagnosticated in time, before it gets to other organs, has more chances of healing by surgery, chemotherapy, or radiotherapy, whatever the case is.

What  is cancer in children?

Cancer is the loss of order in tissue or in organs where it develops. All our cells in our bodies have a process, for example, the cell is born, grows, makes the action for what it was made for, and dies in a certain time. Cancer occurs when a certain type of cells break this specific type of functions and starts to grow in a very random way, in a way that the body can’t control it anymore.

All type of cancer, have a certain common pathologic process, when the affected cells grow without control, they acquire forms and random anomalies, they ignore their normal limits in the body, Destroy neighborly cells, in a period of time they can start affecting other tissues and organs in the body.

Why does cancer appear in children?

Because of multiple factors, these are:
Factores genéticos (alteraciones en la información genética).

• Genetic factors (genetic information alterations)
• Environment  factors (pollution, such as lead, dioxid sulfur, dioxid nitrogen, etc.)
• Biologic (bacteria, virus, weed, detergents, solvents, pesticides, heavy metals).
• Quimics (petroleum and other derivatives)
• Physic (radiations)

 

How common is cancer in children?

In Mexico, cancer is the second cause of death in children, followed by other accidents, especially between ages of 5 and 14 years old.

• One of every 650 children develop cancer in the first 15 years of their life.
• Every year around 120 new cases, for every million of minor habitants less than 18 years old are diagnosticated.
• It is in consideration that all over the globe, the tendency for children to have cancer is going in high levels.  

What are the most frecuent types of cancer in children?

There exists a major trend of some variety of cancer according to the age of the child, in order of frequency they are:

-Leukaemia: it is the cancer that affects the marrow and the fabrics that generate the cells of the blood, making a great quantity of abnormal white blood cells that do not realize his functions in suitable form. This appears between 2 and 6 years of age.
-Linfoma: it is a type of cancer that appears in the lymphatic system, the net of traffic of the body that extracts the impurities. There are two varieties: Hodgkin's disease and Not Hodgkin. This appears in general in major children from 5 to 10 years of age. 
-Tumors of the Nervous Central System: Tumors that they find inside the brain

Which are the differences between the cancer in children and the one that appears in adults?

ADULTS

1.- The survival in adults is a minor of 30 %. 
2.- The most common cancers in the adults develop in: Skin, Lung, Colon, Rectum, Breast, Endometrium, Ovary, Prostate.

Próstata.
3.- It depends on the surgery for a good forecast of survival. They are less sensitive to the chemotherapy and radiotherapy.

CHILDRENS

1.- In children, the survival is 70 %.

2.- The cancer develops immediately after mutations (or changes) in the genes of his cells in process of growth.

3.-It's more sensitive to being destroyed by chemotherapy and radiotherapy, does not depend totally of the surgery.

On what does Life hope depend in children?

Nowadays the life hope of the children depends mainly on the following conditions:

• Opportune diagnosis
• Correct diagnosis, where a series of proofs are realized to determine about what type of cancer it really is and to value up to where the disease has spread.
• Treatment with specializing professionals of the health.
• Technical and human infrastructure to develop programs of treatment

Which is the main problem that one presents to diagnose the cancer in children?

The principal problem consists of NOT CONSIDERING that the children could have cancer.
Due to the fact that the infantile cancer, in his initial period, does not have evident symptoms, one might give a late diagnosis.

Another problem to considering is that don't exist sufficient oncologists qualified pediatricians. Therefore it is necessary to be conscious that a percentage about 50 % of children with cancer does not receive medical specializing attention.

Why in most cases does treatment begin in late form?

The infantile cancer can demonstrate to the beginning with a very "subtle" symptoms, for what his diagnosis can be difficult.

That's why it is important that the parents come to the periodic reviews of the child with the pediatrician and that they are attentive to any sign of alarm that indicates that his son is sick. The ignorance of the reasons of the cancer in the infancy does that many symptoms of the disease are misinterpreted as infantile common ailments.

Before the suspicion of cancer, the specialists must realize a series of proofs to determine about what type of cancer is and to see if the disease has spread

How can parents realize that their children have symptoms of cancer?

The different kinds of cancers have signs, symptoms, treatments and different forecasts; the parents can notice some symptoms or signs without an apparent reason exist for them, since they are:

• Fever
• Widespread pallor
• Abundant perspiration. 
• Loss of weight.
• Loss of appetite that is associated with a condition of little activity.
• Decay (that does not want to play).
• Fatigue or easy and constant weariness.
• Mass or masses (little boll, bundle) located in neck, armpits, thorax, abdomen or extremities.
• Easy bled by mouth, nose and anus.
• Appearances of bruise on skin.
• Constant pain in legs that there causes disability to walk (especially in teenagers).

There exist specialists of children's cancer?

Yes, there exist specialists dedicated to the exclusive treatment of the cancer in children.

To assure that the children should receive the treatment, therapeutic support and rehabilitation achieving this way a survival and quality of ideal life, it is imperative to realize a teamwork that incorporates the knowledge of the following specialists:

1.-Pediatrician.
2.-Oncologist pediatrician.
3.-Hematólogo pediatrician.
4.-Surgeon Oncologic pediatrician.
5.-Radiooncólogo pediatrician.
6.-Orthopedist pediatrician.
7.-Pediatrician intensives.
8.-Odontopediatras.
9.-Specialists in rehabilitation.
10.-Paediatric Nursing.
11.-Social workers.
12.-Psicooncólogos.
13.-Tanatólogos, among others.

Which is the treatment for children's cancer?

The treatment can include:

• Chemotherapy (use of medicines to destroy the cancerous cells).
• Radiotherapy (use of radiations to destroy to the cancerous cells).
• Surgery (to extirpate the cancerous cells or tumors).

In each case it will depend on the kind of cancer, the widespread thing that is and the age of the child.

Which are the effects or the complications of the treatment of the cancer in children?

The medicines of the chemotherapy that are in use for the treatment of the cancer in children are very strong. They destroy the cancerous cells, but they are not selective and can concern other normal cells what causes effects visible and associated with the cancer like: loss of  hair, eyebrows, eyelashes, injuries in the mouth, among others. 

In spite of the fact that a great advance exists in the treatment of the cancer still lacking much for doing to find medicines that are selective in the treatment of the cancer and try to reduce in major measure the effects.

Why is the Integral treatment important in the patients with cancer?

Because it allows to promote the quality of the child's life and involve the family in his process of integration. There must exist a biological vision, psychological and social vision for the patients' attention with cancer, specially the pediatric patients.
Therefore, it is important that the family sees as an opportunity to join the diverse skills of alternative treatment and receive accompaniment. With it there exists the probability of reducing the physical pain during the treatment and the emotional affection that carries the presence of the disease in a member of the family.

Which are some of the skills of alternative treatment in which it can inform to the family with a child with cancer?

These are only some skills that can develop with support and participation of voluntary work:

• Laughtherapy
• Musictherapy
• Domiciliary accompaniment
• Hospitable accompaniment
• Art therapy
• Individual therapy
• Group therapy
• Support groups
• Smell therapy
• Cromotherapy

What factors are considered to be to determine the cost of the treatment?

The cost of attention in the child with cancer is raised, and we must evaluate it in the context of the following aspects:
FIRST: Which is the socioeconomic level of the parents of the children with cancer? The 74 % of children with cancer in Mexico has a socioeconomic low level, that is to say in hospitals of the sector health does not have the aptitude to pay the consultation of review.

SECOND: How much time lasts the treatment, how much time goes to be in the hospital and especially how much cost the day of hospitalization and what is what includes the cost. The cost for day of hospitalized patient goes of $ 25,000.00 pesos to 30,000.00 $ pesos in the public sector, the cost in the private sector is still major.
These costs represent laboratory, image studies (X-ray photographies, ultrasound, tomography, surgery and radiotherapy.

THIRD: The presence of complications derived from the treatment, already be for the use of chemotherapy and / or radiotherapy or surgery.

• The average of stay inside a hospital of a child with cancer is 12 days, but the stay can go of 1 day even more than 30 days.
  
   
• The duration of the treatment in general is 6 to 36 months, space during which one administers the chemotherapy every day, weekly, every 3 weeks, according to the type of cancer.
  
   
• The costs before mentioned DO NOT INCLUDE THE COMPLICATIONS, which often they present in the treatment of the child with cancer and which are secondary in the majority of the occasions for the toxic effects of the medicines (bled, infections, immunosuppretion, etc). These complications can take the patient to the unit of intensive care and the costs of the treatment to rise so much.
  
   
• To put it in simple words, a complication in the treatment of the child with cancer breaks and throws for the floors any estimation of costs.

Bibliografía.

• Acceso a la población Baja Californiana, Infantil y Adolescente a tratamiento contra el cáncer. Salud B C, 2005;3;10:18.
• Compendio del registro histopatológico de neoplasias en México. Morbilidad regionalización 1993-1996 y Mortalidad tendencias 1985-1995. México: Secretaria de Salud, Dirección General de Epidemiología; 1998.
• Miller BA, Ries LAG, Hanker BF, et al eds. SEER cancer statistics review; 1973-1990. NIH publication no.93-2789. Bethesda; National Cancer Institute; 1993.
• Compendio de registro histopatológico de neoplasias en México. Morbilidad trienio 1993-1995 y Mortalidad tendencias 1990-1994. México: Secretaria de Salud, Dirección General de Epidemiología; 1997.
• Magrath I, Shad A, Epelman S, et al. Pediatric Oncology in countries with limited resources. En: Pizzo Ph A, poplack DG, eds. Principles and Practice of Pediatric Oncology. Third edition. Philadelphia: Lippincott-Raven Publc;1997, p 1395.

Bibliografía electrónica:

 

Robin E. Miller, MD. Cáncer infantil, www.KidsHealth.org, Nemours Center for Children's Health Media Nemours Foundation, junio 2007.
López-Ibor, Blanca, DR. Cáncer Infantil. www.elmundo.es/salud  Mundinteractivos, S.A, 2005.

AGRADECIMIENTO ESPECIAL

AL DR. JUAN CARLOS DUARTE VALENCIA, Cirujano Oncólogo Pediatra, por su amor a los niñ@s con cáncer, expresado a través del tiempo y, dedicación para la integración de este material.

A EDUARDO SAAVEDRA, Caricaturista y Lic. en Comunicación por su disposición y noble corazón al servicio de los niñ@s con cáncer, mediante la creación de las imágenes que apoyan a este material.

A VERÓNICA ÁVILA, Lic. en Comunicación, por su valiosa disposición y gran apoyo en la redacción y corrección de estilo del presente manual.

FUNDACION CASTRO-LIMON, A.C.

Centro Oncológico Pediátrico de Baja California, A.C.