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Understanding Bone Cancer In Children: Causes And Treatment Options
Bone cancer in children, though rare, is a serious condition that requires immediate attention. Understanding the factors that contribute to its development and the available treatment options is crucial for parents, caregivers, and medical professionals. According to National Centre for Disease Informatics and Research, childhood cancers (0-14 years of age) comprise 4% of all reported cancers in the ICMR-NCDIR's national cancer registry programme. This article delves into the various causes of bone cancer in children and explores the treatment avenues that offer hope and healing with expertise of Dr Sirisha Rani, Pediatric Hematologist & Oncologist, Rainbow Children's Hospital, Banjara Hills, Hyderabad.
Types of Bone Cancer in ChildrenBone cancer in children primarily manifests in two forms: osteosarcoma and Ewing sarcoma. Osteosarcoma is the most common type, typically affecting the long bones such as the arms and legs. Ewing sarcoma, on the other hand, can occur in any bone but is often found in the pelvis, thigh, and chest wall. Both types require distinct approaches to treatment and management. As per a media report, In India, the incidence of childhood cancer, including bone cancer, is estimated to be between 38 to 124 per million children per year.
Genetic Factors"Genetic factors play a significant role in the development of bone cancer in children. Certain hereditary syndromes, such as Li-Fraumeni syndrome and hereditary retinoblastoma, increase the risk of developing osteosarcoma. Additionally, genetic mutations that occur spontaneously can also lead to the onset of bone cancer. Understanding these genetic predispositions helps in early detection and personalized treatment plans," shares Dr Rani.
Also Read: Ewing's Sarcoma: Understanding The Rare Bone Cancer Affecting Mainly Children
Environmental FactorsEnvironmental factors, though less common, can contribute to the development of bone cancer in children. Exposure to high doses of radiation, either from previous cancer treatments or environmental sources, has been linked to an increased risk. Similarly, exposure to certain chemicals, such as those found in industrial settings, may also play a role. While these factors are not as prevalent, they highlight the importance of a safe and healthy environment for children.
Symptoms and DiagnosisRecognizing the symptoms of bone cancer early can significantly improve treatment outcomes. According to Dr Rani, "Common symptoms of bone cancer include persistent bone pain, swelling, and fractures that occur without significant trauma. Diagnostic procedures such as X-rays, MRI scans, and biopsies are essential in confirming the presence of bone cancer and determining its type and stage. Early and accurate diagnosis is key to effective treatment."
Also Read: Parita Dholakia's Life Experience of Living with Osteogenesis Imperfecta aka Brittle Bone Disease
Treatment Options for Bone Cancer in ChildrenTreatment for bone cancer in children involves a combination of approaches tailored to the individual patient.
The journey through bone cancer treatment can be challenging for both the child and their family. Dr Rani concludes by saying, "Psychological support, including counseling and therapy, is vital in helping children cope with the emotional and mental stress of their diagnosis and treatment. Support groups provide a sense of community and shared experience, offering comfort and advice from others who have faced similar challenges. Family involvement is crucial, as a strong support system can significantly impact the child's overall well-being and recovery."
In a study conducted by Indian Journal of Musculoskeletal Radiology, it was found that of all musculoskeletal neoplasms in India, around 60% were bone tumors. Of these bone tumors, 66% were malignant, 15% were benign, and 19% were non-neoplastic. Bone cancer in children is a complex and multifaceted disease that requires a comprehensive understanding of its causes and treatment options. While genetic and environmental factors contribute to its development, early detection and a combination of surgical, chemical, and emerging treatments offer hope for effective management. With continued advancements in medical research and a strong support system, there is optimism for improved outcomes and a brighter future for children affected by bone cancer.
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Comprehensive Guide To Leukaemia: Types, Symptoms, And Treatment Options
Leukaemia is a type of cancer that affects the blood and bone marrow, which are responsible for producing blood cells. Unlike other cancers that form solid tumours, leukaemia causes an overproduction of abnormal white blood cells. These cells do not function properly and crowd out healthy cells, impairing the body's ability to fight infections and produce red blood cells and platelets. This disease can develop suddenly (acute) or progress slowly over time (chronic), depending on the type of leukaemia.
Importance of Understanding Leukaemia for Early Diagnosis and Treatment
Globally, leukaemia affects millions of people each year, and while it can occur at any age, certain types are more common in specific age groups. According to the World Cancer Research Fund, leukaemia accounts for about 474,000 new cases annually, making it a prevalent form of cancer worldwide.
Leukaemia often goes undiagnosed in its early stages due to vague symptoms such as fatigue, frequent infections, or bruising. By being aware of the signs and understanding the different types of leukaemia, individuals and healthcare professionals can recognise the disease sooner. And it may lead to more successful treatment outcomes. Early diagnosis can make a significant difference, especially for acute forms of leukaemia, which can progress rapidly.
Types of Leukaemia
1. Acute Lymphocytic Leukaemia (ALL)
2. Chronic Lymphocytic Leukaemia (CLL)
3. Acute Myeloid Leukaemia (AML)
4. Chronic Myeloid Leukaemia (CML)
Symptoms of Leukaemia
The symptoms of leukaemia can vary depending on the type and progression of the disease. Common symptoms include
These symptoms can often be mistaken for other illnesses, making early diagnosis challenging. However, if any of these symptoms persist, it is crucial to seek medical advice for further testing.
Treatment Options for Leukaemia
1. Chemotherapy- Chemotherapy is one of the most common treatments for leukaemia. It involves using drugs to kill cancerous cells or stop their growth. Chemotherapy can be administered orally or intravenously, depending on the type and stage of the disease.
2. Targeted Therapy- Targeted therapies, like TKIs used in CML treatment, focus on specific genetic mutations that cause leukaemia cells to grow uncontrollably. These therapies are less likely to harm healthy cells and have transformed the prognosis for many patients.
3. Radiation Therapy- Radiation therapy uses high-energy rays to destroy cancer cells. It may be used in combination with other treatments or when leukaemia has spread to other parts of the body.
4. Bone Marrow Transplant- In some cases, patients may require a bone marrow transplant (also known as a stem cell transplant) to replace diseased bone marrow with healthy donor cells. This treatment is often used for patients with high-risk or relapsed leukaemia.
5. Immunotherapy- Immunotherapy helps the body's immune system recognise and destroy cancer cells. This emerging treatment option is showing promise, particularly in patients with difficult-to-treat forms of leukaemia.
Leukaemia is a complex and varied disease, with different types affecting individuals based on age, genetics, and other risk factors. While the prognosis can vary depending on the type and stage of leukaemia, advancements in treatment are offering new hope to patients worldwide.
These Early Signs Of Lung Cancer Are Often Missed, Oncologists Say
Lung cancer is the second-leading cause of cancer death in the United States after skin cancer, according to the American Cancer Society. The disease is to blame for about 1 in 5 cancer deaths, and the ACS estimates more than 125,000 people will die from it this year.
These statistics are grim, but there's a reason why lung cancer often progresses past the point where it's treatable: Early signs of lung cancer are often missed (or nonexistent).
"Most patients may not have symptoms unless it has spread or unless there is evidence it is metastatic or there is involvement of major structures," says Dr. Amna Sher, a medical oncologist at Stony Brook Cancer Center.
Early diagnosis can significantly improve a person's chances of survival. For instance, the five-year survival rate for the most common type of lung cancer, non-small cell lung cancer, which includes adenocarcinoma, squamous cell carcinoma and large cell carcinoma, is 65 percent if diagnosed while it's still localized (in other words, it hasn't spread elsewhere in the body).
Those numbers drop to 37 percent if it spreads to structures near the lungs, like the lymph nodes, and just 9 percent if it spreads to more distant areas of the body, such as the brain.
It's a lot to take in. But the bottom line is this: "If lung cancer can be diagnosed at an early stage, the patient will have more treatment options and a better chance of remission," says Dr. Xiuning Le, a V Foundation clinical scholar at the University of Texas' MD Anderson Cancer Center. "It is extremely important to detect lung cancer as early as possible."
But how? Doctors shared commonly missed early signs of lung cancer and what to do if you're concerned.
Commonly missed sign
A persistent or worsening cough is a commonly missed early sign of lung cancer, Sher says.
"It warrants an evaluation if someone has a new or persistent cough … which has been ongoing for several weeks or months, especially in a high-risk patient with a strong history of smoking," she says. "For example, you got a course of antibiotics, but it's been two months, and you're still coughing — seek medical attention."
Sher says doctors often see patients come in with months of a persistent cough, but an abnormal X-ray prompts a deeper dive into the cause of the issue.
Easy to dismiss
Le and another expert agree that a chronic cough is an easy-to-miss sign of lung cancer. Part of the problem: Chronic coughs are often similar to other diseases, including those at a higher risk for lung cancer — primarily smokers — may already have.
"Most — but not all — cases of lung cancer are associated with a prior tobacco smoking history," says Dr. Brett Bade, the director of the Lung Cancer Screening Program at Northwell Lung Insitute in New York. "Tobacco smoking is a risk factor for both lung cancer and lung disease. Chronic obstructive pulmonary disease, for example, can also cause a chronic cough and shortness of breath. People may attribute their symptoms to their lung disease or prior tobacco use."
In other words, patients may be used to coughing and consider it normal.
Even people without a history of smoking or lung disease may chalk a persistent cough up to something else, and usually, something less severe.
"Patients may think it's just an upper respiratory infection or virus," Sher says. "It may be seasonal. Patients have allergies. If you're around patients with kids, you're exposed to all these viruses and may think you just didn't get better."
Other overlooked signs
A persistent cough isn't the only early sign of lung cancer that's easy to overlook.
"Since the lungs don't have many pain receptors, most symptoms of lung cancer are related to the tumor's involvement of a local structure or another organ," Bade says. "For example … shortness of breath may develop if the tumor involves the airway. Similarly, if the tumor spreads to a bone, the involved bone becomes painful."
Bade says that other common signs of lung cancer a patient may not recognize include: fatigue, hoarseness, chest pain, bone pain, reduced appetite and weight loss.
Diagnosis, treatment
Doctors will biopsy the involved site to diagnose lung cancer.
"Frequent biopsy sites include the lungs, lymph nodes in the neck or chest or drainage of fluid from around the lungs," Bade explains. "If other organs are involved, your doctor may recommend a biopsy of those sites; examples might include the liver, the adrenal gland or a bone."
Le says that several factors determine a patient's lung cancer treatment plan, mainly: the type of lung cancer, the cancer's stage, and genetic and immunological features of the specific patient.
"In general, surgery, radiation and systemic therapies are all effective treatments for lung cancer," Le says. "There are many different options within the (therapy) class."
A care team will work with a patient on the best option for their specific case.
If you're concerned about lung cancer, talk to your doctor.
"Early recognition and early treatment is the key to longer lung cancer survival," Le says. "If you have new symptoms or suspect you are eligible for lung cancer screening, you should discuss it with your doctor."
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