The long-term side effects of treatments are a cause for concern. This is because children’s bodies are still growing. For instance, young children are likely to be affected by radiation therapy.
Childhood cancers are different from adult cancers in many ways, including the fact that childhood cancers are usually not caused due to lifestyle or environmental risk factors, and only a small proportion of childhood cancers are caused due to DNA changes inherited from parents. In most cases, childhood cancers respond better to certain treatments, probably because of the differences between childhood and adult cancers, and the fact that children usually get more intense treatments.
Unlike adults, children do not have too many comorbidities, and hence, respond better to treatment.
However, long-term side effects of treatments are a cause for concern. This is because children’s bodies are still growing. For instance, extremely young children are likely to be affected by radiation therapy.
How childhood cancer treatments differ from those of adult cancers
Childhood cancer patients are treated at paediatric cancer centres where health specialists are aware of the differences between adult and childhood cancers, and psychologists who support and educate the family are present.
Surgery, radiation therapy, and chemotherapy are the three main types of childhood cancer treatments. In some cases, a child with cancer is given high-dose chemotherapy, followed by stem cell transplants.
Some advancements in childhood cancer treatment include immunotherapy and targeted therapy drugs.
Most childhood cancers respond well to chemotherapy because this works best against fast-growing cancers. Compared to adult bodies, children’s bodies are able to better recover from higher doses of chemotherapy.
“Overall, children tolerate anti-cancer treatment better than adults, leading to better outcomes and cure rates. But they have a higher potential for long-term toxicities. These include growth and developmental disturbance, mental changes, cognitive impact, dysfunction of organs such as the heart, liver, and kidney, hearing and hormone problems later in life, and secondary cancers. They do suffer from short-term harsh effects but recover faster than adults. To minimise adverse effects in very young children, drug doses are generally reduced and/or calculated in a different manner than in adults,” Dr Prashant Mehta, Senior Consultant, Department of Medical Oncology and BMT, Amrita Hospital, Faridabad, told ABP Live.
Not only do children respond better to chemotherapy and have better tolerance compared to adults, but the cure rates are also better.
“More than 80 per cent of children recover from cancer, while less than 60 per cent of adults recover from cancer. Childhood cancers are treated more aggressively than adult cancers,” said Dr Pavithran K, Professor & HoD of Medical Oncology and Haematology, Amrita Hospital, Kochi.
Side effects of childhood cancer treatments, and how to prevent them
Radiation therapy can lead to serious side effects in children, and hence, radiation doses should be limited.
Dr Pavithran said that radiation is not given to children under three years of age to prevent side effects on the developing brain. “Long-term follow-ups and monitoring are needed for cancer survivors as they are likely to develop various delayed side effects such as effects on the heart, endocrinopathy, infertility, and secondary malignancies.”
Monitoring will allow healthcare professionals to detect the side effects early or prevent them.
According to Dr Mehta, radiation therapy is avoided in extremely young children to prevent growth disturbances. He also said that children who suffer from cancer suffer from severe psychological impact. Their sexual health is also affected, and education may be hindered.
“Adequate counselling and support can help minimise some of these issues. Data from Tata Memorial Hospital, Mumbai, showed that 62.4 per cent of survivors had mild or no late adverse effects, while about 21 per cent had severe late effects,” said Dr Mehta.
Childhood cancer patients receive different types of treatment, depending on various factors.
“Paediatric oncology teams tailor treatment plans to the child’s age, size, and overall health to reduce the impact on developing organs and tissues. They also employ supportive therapies and medications to manage side effects effectively. Despite potential challenges, the focus is on achieving the best possible outcomes while preserving the child’s long-term health,” said Dr Vikas Talreja, Consultant Medical Oncology, Regency Hospital.
It is important for childhood cancer treatments to focus on long-term cure as well as a normal and healthy transition from childhood to adulthood.
“Majority of childhood cancers are treated under the umbrella of established national and international guidelines using multiple modalities like surgery, chemotherapy and radiation therapy. In using these treatment modalities there is a focus on preserving fertility, bone growth, vision, and cardiac function, depending on the location of tumours,” said Dr Vineeta Goel, Head and Director, Department of Radiation Oncology, Fortis Hospital Shalimar Bagh.
Therefore, children with cancers respond better to treatments than adults with cancers, but the former should not receive radiation therapy if they are very young. Also, after treatment, health specialists must focus on the long-term effects, ensure that the cancer does not come back, administer therapies to prevent side effects, and provide psychological support to the patients and their families.