International Childhood Cancer Day

Geneva, 15 February 2023 (TDI): The United Nations World Health Organization (WHO), dedicated this day to children suffering from cancer. It is called International Childhood Cancer Day.

Childhood Cancer

According to reports by WHO every year about 400, 000 children and adolescents develop cancer. The most common types of childhood cancer include leukemias, brain cancers, lymphomas, and solid tumors, such as neuroblastoma and Wilms tumors.

In developed and high-income countries, 80 percent of patients of such kind are cured but in low-income and middle-income countries (LIMCs) the rates of the cured patient are around 30 percent.

Difficult to Detect or Identified

Childhood cancer is not very easy to detect or identified, especially in LMICs where most children face death due to lack of diagnosis, misdiagnosis or delayed diagnosis, obstacles to accessing care, abandonment of treatment, death from toxicity, and relapse.

Most could be cured with generic medicines and other forms of treatment, including surgery and radiotherapy. Its treatment can be cost-effective in all income settings.

About 29 percent of low-income countries report that cancer medicines are generally available to their populations compared to 96% of high-income countries.

There is a need to make continuous improvements in the quality of care, and to inform policy decisions through Childhood cancer data systems.

It is one of the leading causes of death for children and adolescents as the likelihood of surviving a diagnosis of childhood cancer correlates with the country in which the child lives.

In high-income countries, more than 80% of children with cancer are cured, but in many LMICs, less than 30% are cured.

The reasons for lower rates of survival in LMICs include delay in diagnosis, an inability to obtain an accurate diagnosis, inaccessible therapy, abandonment of treatment, death from toxicity, and avoidable relapse.

There is a dire need to Improve access to childhood cancer care, including essential medicines and technologies, which is highly cost-effective, feasible, and can improve survival in all settings.

Causes of Cancer in Children

Cancer begins with a genetic change in a single cell that then grew into a mass or tumor, that invades other parts of the body and causes harm and death if left untreated.

There are no known causes of cancers in childhood, unlike adults. Though very few cancers in children are caused by environmental or lifestyle factors.

Prevention efforts in children should focus on behaviors that would prevent the child from developing preventable cancer as an adult.

Other factors that are risk factors in childhood cancer are chronic infections, such as HIV, Epstein-Barr virus, and malaria, which are risk factors for childhood cancer, particularly relevant in LMICs.

Other causes of infections could increase a child’s risk of developing cancer as an adult, so it is important to be vaccinated.

Especially, against hepatitis B to help prevent liver-cancer and against human papillomavirus to help prevent cervical-cancer.

According to data, 10 percent of all children affected by the disease have a predisposition because of genetic factors, further research is needed to identify factors impacting cancer development in children.

Improving Outcomes of Childhood Cancer

Generally, it is not possible to prevent it in childhood but the effective strategy that could be applied to reduce the burden of cancer in children and improve outcomes is to focus on different procedures.

That includes prompt, correct diagnosis followed by effective, evidence-based therapy with tailored supportive care.

Early Diagnosis

When this disease is identified early then effective treatment could cure it with a greater probability of survival, less suffering, and often less expensive and less intensive treatment.

Improvements could be made in the lives of children with cancer by detecting cancer early and avoiding delays in care. Moreover, specific treatments could be employed such as surgery, radiotherapy, and chemotherapy.

Diagnosis could be made through awareness of symptoms by families and primary care providers, accurate and timely clinical evaluation, diagnosis, staging, and access to prompt treatment.

There is a need to promote programs to promote early and correct diagnosis that have been successfully implemented in countries of all income levels.

The efforts should be collaborative efforts of governments, civil society, and nongovernmental organizations, with vital roles played by parent groups.

Childhood cancer is associated with a range of symptoms: fever, severe and persistent headaches, bone pain, and weight loss, which can be detected by families and by trained primary healthcare providers.

Treatment

Correct diagnosis is significant for the right treatment, standard therapies include chemotherapy, surgery, and radiotherapy.

Children need special attention for their continued physical and cognitive growth and nutritional status, which requires a dedicated, multi-disciplinary team.

But there are issues as supportive care such as access to effective diagnosis, essential medicines, pathology, blood products, radiation therapy, technology, and psychosocial and supportive care are variable and inequitable around the world.

Nevertheless, 80 percent of children could easily be cured with effective and proper treatments.

Palliative Care

Palliative care is essential to relieve symptoms and improves the quality of life. This situation also occurred where not all children can be cured, but the relief of suffering is possible for everyone.

There are different ways of palliative care programs such as those delivered through community and home-based care, providing pain relief and psychosocial support to patients and their families.

WHO Response

WHO launched a program in 2018, Global Initiative for Childhood Cancer with the support of St. Jude Children’s Research Hospital.

The aim is to provide leadership and technical assistance to governments to support them in building and sustaining high-quality childhood cancer programs.

The goal is to achieve a 60 percent survival rate in children by 2030, this represents an approximate doubling of the current cure rate and would save an additional one million lives.

There is also the Cure All Framework accompanied by a technical package developed to support the implementation of the Initiative.

The package helps governments and other stakeholders assess current capacity, set priorities, generate investment cases, develop evidence-based standards of care and monitor progress.

WHO and St Jude Children’s Research Hospital, 2021 launched the Global Platform for Access to Childhood Cancer Medicines, the first of its kind, to provide an uninterrupted supply of quality-assured childhood cancer medicines.

Moreover, WHO and the International Agency for Research on Cancer (IARC) collaborated with the International Atomic Energy Agency (IAEA) and other UN organizations and partners.

The collaboration aims to increase political commitment to childhood cancer control and to support governments to develop high-quality cancer centers.

Furthermore, regional satellites were developed to ensure early and accurate diagnosis and effective treatment and to develop standards and tools to guide the planning and implementation of interventions for early diagnosis, treatment, and palliative and survivorship care, and to improve access to essential medicines and technologies.