DONATEPEDIATRIC HEMATOLOGY AND ONCOLOGY SERVICES
Overview
Pediatric Hematology Oncology Services is for children with Cancer and Blood Diseases. This specialized service comprises of Pediatric Hematology Oncology, Outpatient Clinics and Day Care Unit, Inpatient Wards and Bone Marrow Transplantation Unit.
The Department of Pediatric Hematology Oncology at RGCIRC is unique in India, as it offers comprehensive Oncology Care to all children up to the age of 18 years. It is a place, where doctors send some of their most challenging and sick patients. The
Department has a dedicated team of experts in the field of Pediatric Hematology / Oncology. The team constituted by experienced Pediatric Oncologists, Hematologist, Pediatric Onco Surgeon, Radiation Oncologist, Pediatric Oncology Residents and Nurses, Child Psychologist and Playroom Teachers’ who works hard to ensure that best care is delivered to every child. Children with all types of Hematological and Solid Organ Malignancy receive specialized Oncology services here. The various type of Cancers treated in the Department includes Leukemia (ALL, AML, CML), Lymphomas (Non-Hodgkin’s and Hodgkin’s), as well as all Pediatric solid Tumors like Neuroblastoma, Wilms Tumor, Bone and Soft Tissue Sarcoma, Brain Tumor, Hepatoblastoma, Testicular and Ovarian Tumors etc. Patients with different Hematologic problems like severe Aplastic Anemia, MDS, Hemolytic Anemias, Chronic ITP, etc are also managed. Recognizing the special needs of children with cancer, the hospital has designated areas for Pediatric patients. In the outpatient area there is a special clinic for children with a separate waiting area and Pediatric Daycare facility (for outpatient short term Chemotherapy and Blood Transfusions) manned by Pediatric Nurses. The in-patient area has two Pediatric wards as well as a Playroom for children. The Bone Marrow Transplant unit is well equipped to handle Pediatric Autologous and Allogenic BMT’s and several BM and PBSC transplants have been successfully achieved by the Institute. The service treat all children and adolescents up to the age to 18 yrs, with Leukemias, Lymphomas, Brain Tumors, Bone and Soft Tissue Sarcomas, all other Pediatric Solid Tumors in addition to a variety of Hematological Conditions like Immune Thrombocytopenia, Thalasemia, Inborn Errors of Metabolism and Bone Marrow Failure. Patients have the benefits of comprehensive Multispecialty Care including Chemotherapy, Pediatric Surgical Oncology, Radiotherapy and Supportive Services (Pediatric Oncology Treatment, Nurse Co-ordinator, Dietician, Counselor, Teacher and Play Therapist). All these provided by a highly specialized, trained, experienced and dedicated team of experts. BMT unit is well equipped with trained professional physicians, nursing staff and facilities for all kind of stem cell transplant [autologous, allogenic 9 match, unrelated or haploidentical]. Our unit has a dedicated after completion of therapy clinic to take care of health for all those who have successfully completed the treatment. It aims at screening for late effects and emphasizes importance of healthy life style. We are aware that our journey is fraught with difficulties, but we are encouraged by these words of wisdom
Even though the big canvas is bleak,
Let’s concentrate on the little strokes,
That would make the difference
What is Childhood Cancer
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.
Common Childhood Cancers include
Diagnosis and Investigations
- Complete blood count and peripheral smear examination
- Bone Marrow Aspiration and biopsy
- Biopsy from Lymph node or mass
- Radiology (USG, CTscan, MRI, PET SCAN)
Treatment of Pediatric Cancer
The treatment of childhood cancer includes a multidisciplinary and multimodality approach. The various modalities of treatment are Chemotherapy, Surgery, Radiotherapy, Immunotherapy and bone marrow transplant (stem cell therapy). Their combination and sequence varies and depends on age of the child, type, stage and location of tumor.
How is RGCI Different
Renowned for its unwavering commitment to excellence, our department stands as a haven where doctors entrust us with their most complex and critical cases.
At the heart of our success is a dedicated team of distinguished experts in the realm of Pediatric Hematology and Oncology. This formidable ensemble comprises seasoned Pediatric Oncologists, Hematologists, Pediatric Onco Surgeons, Radiation Oncologists, Pediatric Oncology Fellows and Nurses. Collaboratively, they harmonize their expertise to orchestrate the finest care for every child under our wings.
Our holistic approach extends beyond medical intervention. Within our caring embrace, you’ll find a Child Psychologist who skillfully addresses the emotional well-being of our young patients, providing invaluable support to both children and their families. Additionally, our Playroom Teachers ensure that the children maintain a sense of normalcy, engaging them in educational and recreational activities that uplift spirits.
What truly sets us apart is our resolute dedication to ensuring the best care possible for each and every child. We navigate the intricate landscape of pediatric oncology with precision, compassion, and an unyielding commitment to brighter tomorrows for our young heroes.
Discover hope, experience expertise, and find solace in the care we deliver.
Childhood Cancer: Risk Factors
Genetic Factors: Some children may inherit genetic mutations that increase their risk of developing cancer.
Family History: Having a family history of cancer, especially in close relatives such as parents or siblings, can increase a child’s risk of developing cancer.
Certain Genetic Syndromes: Some genetic syndromes, such as Down syndrome, Li-Fraumeni syndrome, neurofibromatosis, and Beckwith-Wiedemann syndrome, are associated with an increased risk of pediatric cancer.
Exposure to Radiation: High doses of ionizing radiation, such as those used in radiation therapy for other medical conditions, can increase the risk of cancer in children. Prenatal exposure to radiation may also be a risk factor.
Immune System Suppression: Children with weakened immune systems, such as those who have had organ transplants or are infected with HIV, may have an increased risk of developing cancer.
Drugs: prior exposure to certain chemotherapeutic agents like epipodophylotoxins and alkylating agents predispose patients to second cancers, especially those administered higher cumulative doses. Research into the causes of pediatric cancer is ongoing, and early detection and treatment are crucial to improving outcomes for affected children.
Pediatric Cancer: Prevention and Cure
DO's
- Vaccinations: Ensure your child receives recommended vaccinations. Vaccines can help prevent certain infections that are linked to the development of certain types of pediatric cancers.
- Healthy Lifestyle: Encourage a healthy lifestyle for your child, including a balanced diet rich in fruits and vegetables, regular physical activity, and adequate sleep. A healthy immune system can play a role in preventing cancer.
- Sun Protection: Protect your child's skin from excessive sun exposure. Use sunscreen, protective clothing, and hats to reduce the risk of skin cancer later in life.
- Avoid Tobacco and Smoke Exposure: Keep your child away from secondhand smoke and discourage smoking. Smoking and exposure to tobacco smoke are associated with various types of cancers.
- Environmental Toxins: Minimize exposure to environmental toxins such as pesticides, lead, and other hazardous substances. Be cautious about the products used in your home and ensure they are safe.
- Regular Check-ups: Schedule regular visits to a pediatrician for health check-ups. Early detection and intervention can improve the chances of successful treatment.
- Genetic Counseling: If there is a family history of cancer, consider seeking genetic counseling. Some pediatric cancers can be linked to genetic mutations, and understanding your child's risk factors can help with early detection and management.
- Supportive Care: If your child is diagnosed with cancer, ensure they receive comprehensive and appropriate medical care. This includes medical treatments, psychological support, and proper nutrition
DONT's
- Don't Ignore Symptoms: If your child shows persistent symptoms like unexplained weight loss, frequent infections, or unusual lumps, seek medical attention promptly. Early detection is key to successful treatment.
- Don't Delay Treatment: If your child is diagnosed with cancer, follow the recommended treatment plan provided by healthcare professionals. Delaying or refusing treatment can worsen the condition.
- Don't Rely on Unproven Therapies: Be cautious of alternative or unproven treatments for cancer. Stick to evidence-based treatments recommended by qualified medical professionals.
- Don't Neglect Mental Health: Pediatric cancer can take a toll on a child's mental and emotional well-being. Don't underestimate the importance of emotional support and counseling during and after treatment.
- Don't Isolate: Connect with support groups and organizations that specialize in pediatric cancer. These communities can provide valuable information, resources, and emotional support for both the child and the family.
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Frequently Asked Questions:
Pediatric cancer refers to cancers that occur in children and adolescents under the age of 18. It includes a variety of cancer types that affect different parts of the body.
Leukemia, brain tumors, neuroblastoma, Wilms tumor, lymphoma, and osteosarcoma are some of the most common types of pediatric cancer.
The exact causes of most pediatric cancers are not well understood. Some genetic factors and environmental exposures may play a role, but in many cases, the cause remains unknown.
Symptoms can vary depending on the type of cancer but might include unexplained weight loss, persistent pain, lumps or masses, fatigue, changes in vision, and prolonged fever.
Diagnosis often involves a combination of physical exams, blood tests, imaging (such as X-rays, MRIs, and CT scans), and sometimes biopsies.
Survival rates vary widely depending on the type of cancer and stage at diagnosis. Advances in treatments have improved survival rates over the years, with some types having high cure rates.
Treatment options may include surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, and stem cell transplantation. Treatment plans are individualized based on the type and stage of cancer.
Common side effects can include nausea, vomiting, hair loss, fatigue, weakened immune system, and long-term effects on growth and development.
Depending on the age at diagnosis and the treatment received, pediatric cancer can impact physical, emotional, and cognitive development. Educational and psychosocial support are important for affected children.
With refinements in diagnostics and advances in therapeutics and supportive care the overall survival of childhood malignancy has increased tremendously over the past few decades. Over 70% children and adolescents with cancer survive 5 or more years from diagnosis in many centres and are effectively cured of the disease. This is however at the cost of increased morbidity in the form of various long/late effects of cancer treatment. Long term side effects are those complications of treatment that occur during therapy and persist even after the treatment is over. Late effects appear months or years after the completion of treatment. It is estimated that a third to half of childhood cancer survivors will experience a late/long term effect of cancer therapy. The complications of cancer therapy are protean and range from impairment in growth and development, neurocognitive/ psychosocial deficits, cardiopulmonary compromise, endocrine dysfunction, GI dysfunction, musculoskeletal sequel, fertility problems, and second malignancies.
Hence it is important for all survivors of childhood cancer to have lifelong annual check-up. The aim of long-term follow-up is to facilitate timely diagnosis and appropriate management of late adverse effects, thereby reducing the frequency of severe complications. Several models of long-term follow-up care have been developed to address this need. Guidelines for Longterm followup have been laid down by the Children’s Oncology Group, Scottish Intercollegiate Network, United Kingdom Children’s Cancer Study Group (UK CCSG) and the Dutch Children’s Oncology Group (DCOG; Sieswerda et al) and more details may be obtained from their respective websites.
Yes, research is continuously conducted to improve understanding, diagnosis, and treatment of pediatric cancers. New therapies and approaches are being developed to enhance outcomes and reduce side effects.
Supporting families can include providing emotional support, offering practical help with daily tasks, raising awareness about childhood cancer, and donating to reputable organizations focused on pediatric cancer research and support.
Remember that specific questions and concerns should always be discussed with medical professionals experienced in pediatric oncology.
Usually Pediatrician examines the child after taking history from parents. Doctor looks at general health including signs of disease such as lumps or nodes. He also does neurologic examination. Pediatrician then conducts certain tests depending on the signs and symptoms.
Featured Doctors
Dr. Gauri Kapoor
Pediatric Hematology and Oncology
Currently, she is Director and Head of Department of Pediatric Hematology - Oncology, Rajiv Gandhi Cancer Institute & Research Centre. She joined RGCIRC in May 1997 and developed the Department of Pediatrics to its current premier status. National Board of Examination recognizes the Department for fellowship training of 2 post graduates in the subspecialty every year since 2008.
Dr. Sandeep Jain
Pediatric Hematology and Oncology
Dr. Sandeep Jain is a leading Pediatric Hematologist-Oncologist in India, with more than 10 years experience in this field. His primary area of interest is hematological & non hematological malignancies in children and adolescents including bone marrow transplant for various benign and malignant indications.
Dr. Shalini Mishra
Paediatric Surgical Oncology
Dr. Shalini Mishra is one of the few Pediatric Surgical Oncologists in India exclusively practicing in this field. She has a vast experience of more than 15 years in Pediatric Surgery including pediatric surgical oncology, pediatric urology, pediatric thoracic surgery and neonatal surgery. She routinely performs surgeries for solid tumors in children and adolescents like Wilms tumor, neuroblastoma, rhabdomyosarcoma, malignant germ cell tumor, Primitive neuroectodermal tumor (Ewing's sarcoma), testicular/ ovarian tumor hepatoblastoma and other soft tissue sarcoma.She also conducts periodic hands-on training courses of chemoport insertion for doctors coming from all over India.
Dr. Payal Malhotra
Pediatric Hematology and Oncology
Dr Payal has about 10 years of experience in the field of pediatric hematology oncology and BMT. After completing her post-graduation in pediatrics, she perused as a senior resident in department of pediatric hematology oncology and BMT at Sir Ganga ram hospital -New Delhi, which marked the beginning of her oncology career . Thereafter she joined Rajiv Gandhi cancer institute and research Centre as a national board fellow and completed her professional training with flying colors. She then got the GLOBE scholarship at Dana farber cancer institute at Boston, USA and did her short rotatory fellowship there. She also received St jude viva scholarship at Singapore 2018 and was also awarded My child matter scholarship at SIOP 2021. She has over 20 publications to her name in national and international journals and is a Teaching Faculty for NBE PHO Program.
