Pediatric Diseases
Overview
Childhood Cancer is a catastrophic disease, if untreated it is potentially fatal. It afflicts all communities. Based on recent data, it is estimated that 10 – 12 children per 1, 00,000 population will develop cancer every year. Hence in India, with a population of over a billion, it is roughly estimated that about 50,000 children develop cancer each year and many either go undiagnosed or without adequate treatment. Of these, a mere 15 – 20% i.e. 10,000 children are able to reach a cancer unit. And among the latter 40 to 50% i.e. 5,000 children drop out of treatment. Most children therefore die without proper therapy. This is the reason that lay public, as well as many in the medical fraternity believe that cancer is potentially incurable in India.
It is worthwhile knowing that of the 8.5 lakh cases of cancer that occur annually in India, only 3 – 5 % occur in children. These cancers are very fast growing but also very sensitive to proper treatment. Although treatment is complex and often long, cure is a very realistic and practically achievable goal. Although the actual number of children who develop cancer is small, the cure rate is high and total number of productive life years saved by curing these children is significantly high and therefore the effort in treating appropriately is all the more worthwhile and fulfilling.
Acute Lymphoblastic Leukemia (ALL)
At RGCIRC we are treating largest number of children and adolescents with ALL in the private sector in India. Having treated more than 600 children so far, we have excellent survival rates. This has been possible with the use of contemporary treatment protocols backed with excellent supportive care. Furthermore application of recent advances has permitted more than 80% patients to be treated without radiotherapy to the brain with outcomes comparable to developed countries.
Acute Myeloid Leukemia (AML)
Treatment of AML is one of the biggest challenges to any Pediatric Oncology unit. Infection is the biggest killer. Therefore, coordinated efforts of clinical team, nursing staff and infection control team are crucial to reduce morbidity and mortality. At our centre, we have intensive chemotherapy regimen for AML along with appropriate risk stratification to accurately identify children likely to be benefitted with bone marrow transplant.
Hodgkin Lymphoma
- Risk and response based approach so as to choose optimum treatment for every child.
- Have excellent cure rates with a focus to reduce treatment associated late effect.
- Outpatient treatment so as not to disrupt the schooling and routine activities.
Non Hodgkin Lymphoma
- State of art treatment with one of the most successful protocols.
- Intensive treatment matched with excellent supportive care infrastructure to support that.
- Incorporation of immunotherapy to improve outcome.
- Short course multi agent chemotherapy with a focus to reduce use of alkylating agents and avoid radiotherapy.
Osteosarcoma
- Multidisciplinary care involving Pediatric oncologist, musculoskeletal onco-surgeon, and physical / occupation therapist.
- Most recent protocol with incorporation of high dose methotrexate and avoiding use of alkylating agent.
- 90% undergo limb salvage procedures.
- Equipped with option of all conventional and modular prosthesis.
Ewings Sarcoma
- Multidisciplinary care involving Pediatric oncologist, musculoskeletal onco-surgeon, radiotherapist and physical / occupation therapist.
- Contemporary interval compressed chemotherapy protocol.
- Radiotherapy using most advanced techniques to target desired area and spare normal structures.
- Limbs salvage procedures wherever feasible.
Rhabdomyosarcoma
- Rhabdomyosarcoma is a type of cancerous tumor that arises in the soft tissue, such as muscles.
- Rhabdomyosarcoma can occur throughout childhood and may be present at birth.
- Rhabdomyosarcoma in children differs from the form of the disease typically seen in adults.
Neuroblastoma
Neuroblastoma is a very rare type of cancerous tumor that almost always affects children. Neuroblastoma tumors generally develop in the adrenal glands (located on top of the kidneys), where neuroblasts are most commonly found. But neuroblastoma can also begin in or spread to other areas.
Wilms tumor
Wilms tumor is a solid cancerous tumor of the kidney that arises from immature kidney cells. For most children with Wilms tumor, no clear cause is known. Certain environmental factors (such as contact with toxic chemicals) may increase the risk of developing this disease, but more research is needed.
Retinoblastoma
Retinoblastoma is a rare cancer of the retina, the thin membrane on the inside back of the eye that is stimulated by light. Retinoblastoma is usually diagnosed before a child reaches the age of 4.
Brain Tumor
Children are not just small adults. When a child has a brain tumor, you need specialized medical experts who understand how to protect your child’s growing body, as well as fight the disease.
Monitoring late effects after completion of therapy
Planning meeting for the After completion of Therapy Clinic (ACT)
After completion of therapy (ACT) clinical to monitor growth and development, cardio pulmonary status and screening for endocrinal dysfunction based on disease and treatment.
Multi- specialty care in coordination with oncologist, endocrinologist, psychologist and other specialists Is required.
Reinforcing healthy life style measures