Pediatric Oncology
What is Pediatric Oncology?
Medical specialty dealing with oncology and the diagnosis/treatment of children called Oncology For Children. The treatment of childhood cancers differs both in nature and behaviour from that of adults, owing to oncology for children is an individual approach just like child. In India, the importance of pediatric oncology grows with the growing number of diagnosed cancer cases every year especially in children.
Similarly, the child oncology specialists work to improve the quality of age-appropriate care for children to address the physical and emotional requirements of the children. Pediatric cancer, unlike cancers in the adults that are usually breast/Occupational/lifestyle-related, is primarily due to a genetic mutation.Delays in diagnosis and shortage of specialty care are the main problem-specific challenges for Pediatric Oncology in India, usually located in the rural areas. The child oncology (specialty) needs an army of oncologists, surgeons, counselors for complete care.
10 Facts About Childhood Cancer in India
Prevalence:
Childhood cancers account for nearly 4% of all cancer cases in India, according to the National Cancer Registry Program. Pediatric oncology is important to address this growing problem.
Incidence Rates
: The age-standardized incidence rate of childhood cancer is highest in metropolitan cities (108 per million), followed by urban (86 per million) and rural (53 per million) areas. These variations indicate inequities in oncology for children.
Common Forms
: Lymphomas, leukemia, and brain tumors are among the most prevalent cancers among children. Children’ oncology focuses on these to improve outcomes.
Underdiagnosis
: There are fewer facilities for diagnosis in rural areas, hence underdiagnosis occurs. This affects the effectiveness of oncology for children in these regions.
Survival Rates
: Survival rates are slightly lower in India than in high-income countries due to delayed diagnosis and socioeconomic factors. Oncology for children is designed to bridge this gap.
Specialized Care
: There are specialized pediatric oncology units in only 41.6% of the public sector tertiary hospitals. Pediatric Oncology is more available in private and NGO-managed hospitals.
Treatment Access
: Referral for specialized treatments like immunotherapy or bone marrow transplant is limited. Children’s oncology seeks to enhance such services.
Research Efforts
: The Indian Pediatric Oncology Group (InPOG) has enrolled over 16,000 children in clinical trials since 2015 to encourage pediatric oncology.
Socioeconomic Challenges
: Financial constraints and lack of information about cancer result in delayed diagnosis. Children’s oncology seeks to overcome these through cancer awareness programs.
Policy Gaps
: There is no specific policy for childhood cancer in India. Oncology for children advocates for policies to ensure timely access to care.
Most Common Cancers for Children in India
The most prevalent cancers in Indian children are leukemia, lymphoma, and central nervous system (CNS) tumors. They are the most dominant among oncology for children due to their prevalence and complexity.
Leukemia
In India, leukemia and more specifically acute lymphoblastic leukemia (ALL), are the leading cause of paediatric cancer by number. So around 25.4 % of Pediatric cancer. It is that leukemia make up the majority of cases that pediatric oncology centers treat because it involves the bone marrow and blood and needs aggressive treatment modalities like chemotherapy. Unlike in high income countries, where the incidence is low as a part of other inherited conditions or regressed by underreporting or absence of number of diagnostic centers leukemia is common. This is the reason why the challenge is not less for oncology in children — delayed diagnosis leads to delayed stages. The Indian groups focusing on pediatric leukemia, Indian Pediatric Oncology group (IPOG) are in the process of developing protocol-based treatment protocols with an aim of modifying the outcome in these patients.
Lymphoma
Hodgkin’s twenty first (21) and non-Hodgkin’s lymphoma is the second most frequent cancer {6.6% non-Hodgkin’s & 6.4% of all lymphomas in children (0-14 years). Some instances Pediatric oncology can use Chemotherapy, radiation and stem cell transplantation to treat Lymphoma.
The solution to this problem in India was a rarity of skilled pediatric oncologists, only 10 % of cancer centers had one by 1988 but it has increased a little. Poor incarceration for patients with lymphoma because services in children’s oncology have no rural access. This will help in early diagnosis through awareness programs like the PromOTE-Pediatric campaign.
Central Nervous System (CNS) Tumors
CNS tumors, such as brain and spinal cord tumors, are less common but challenging given the need for advanced imaging and surgical technique. They account for about 15.9% of cancer in children. Children’s oncology is faced with CNS tumors because of limited access to MRI and CT scans in state hospitals, particularly the second level. In India, underdiagnosis of CNS tumors is a huge issue because technical skills to diagnose them correctly are present. Treatment can involve surgery, radiation, and chemotherapy but is not equitable, especially in rural areas.
Challenges and the Way Forward
Oncology for children in India has many challenges. More than 50% of medical schools do not have facilities or knowledge to treat children with cancer. Infrastructural gaps, including restricted access to immunophenotyping, cytogenetics, or oncology-trained nurses, hinder proper care. Socioeconomic determinants of poor poverty levels and poor awareness result in late diagnosis, lowering survival rates.
Improvement is seen in the face of these odds. Dedicated pediatric oncology units, beginning with Tata Memorial Hospital on of the best cancer hospitals in 1985, have enhanced outcomes over the last four decades. Programs such as the Indian Pediatric Oncology Initiative™ and the National Training Program in Practical Pediatric Oncology are strengthening data collection and training for clinicians.
To improve oncology for children, India needs a national policy for children with cancer. This would grant universal access to early diagnosis and treatment. Strengthening cancer registries, sensitization of medical personnel, and availability of specialized care beyond urban areas are integral steps. Multigroup research through organizations like InPOG is crucial for the development of treatments in India to adapt to India’s unique challenges. By closing these gaps, oncology for children can transform the treatment of childhood cancer, bringing hope to tens of thousands of children and their families.
FAQ
What is pediatric oncology?
Pediatric oncology is a medical specialty focused on diagnosing and treating cancer in children, addressing their physical and emotional needs.
What are the most common childhood cancers in India?
Leukemia, lymphoma, and central nervous system tumors are the most common childhood cancers in India.
Why is diagnosing childhood cancer in India challenging?
Limited diagnostic facilities, especially in rural areas, and delays in diagnosis create challenges for pediatric oncology.
How prevalent is childhood cancer in India?
Childhood cancer accounts for about 4% of all cancer cases in India.
What is the incidence rate of childhood cancer in India?
The incidence rate is 108 per million in metropolitan cities, 86 per million in urban areas, and 53 per million in rural areas.
What treatments are used in pediatric oncology?
Treatments include chemotherapy, radiation, surgery, and in some cases, immunotherapy or bone marrow transplants.
Why are survival rates lower in India?
Delayed diagnosis and socioeconomic factors contribute to lower survival rates compared to high-income countries.
How available are specialized pediatric oncology units?
Only 41.6% of public tertiary hospitals in India have specialized pediatric oncology units.
How can pediatric oncology in India be improved?
A national policy, increased access to early diagnosis, and expanded specialized centers are essential for improvement.
