Childhood cancers are prevalent within society. However, not many are known about how it develops. Most recently, Parkway Cancer Centre Singapore, Paediatric, Haematology and Oncology specialist Dr Anselm Lee shared his thoughts on the topic and his research done in Hong Kong.
A peculiar disease that only affects children
According to the Sarawak Children’s Cancer Society (SCCS), each year, an average of 70 children in Sarawak are diagnosed with childhood cancer. The most common types of cancer diagnosed in children ages 0 to 14 years are leukaemia, brain and other central nervous systems (CNS) tumours, and lymphomas.
Speaking on the topic during a webinar held recently, Dr Anselm Lee from Parkway Cancer Centre Singapore shared his insights regarding the matter. As a specialist in paediatrics, haemotology and oncology, Lee said that looking after children with cancer and blood disease is not an easy job, and 30 years ago, it was even harder.
Emphasising the difference between childhood cancer and adult cancer, Lee said it was like comparing an orange to an apple. “They are completely different from each other. The way childhood cancer develops is different because of the cell growth in terms of size, how they mature in terms of complexity, and the development in terms of function.”
The talk ‘Are cancers in childhood similar to those in adults — Symptoms and Signs?’ organised by the Lions Club of Kuching Allamanda in collaboration with Canhope Kuching, and sponsored by Parkway Cancer Centre also saw Lee explaining to the virtual audience how childhood cancer have a rare occurrence compared to adult cancer.
“In Singapore, every one case of childhood cancer equals to almost 200 cases of adult cancer. Adult cancer is mostly related to lifestyle and diet as its risk factors. Meanwhile, childhood cancer is not known and hereditary factor is only involved in less than two percent of the cases. From a scientific perspective, we still do not know why the great majority of cancers happen in children,” Dr Anselm added.
Childhood cancer — symptoms and treatments
In adults, the most common are breast, colon, lung and liver cancers. According to Lee, these cancers, while common, do not occur amongst children. On the other hand, the most common types of childhood cancer comprises leukaemia, brain cancer, lymphoma, neuroblastoma and others. “These are peculiar diseases only seen in children,” he added.
With over 30 years of experience as a paediatric oncologist, Lee disclosed that symptoms for these cancers can vary. “From fever to aches in the knee, some children may also show lethargy. While these are common signs and symptoms in childhood cancer, they are also common signals for other childhood illnesses.”
As there are no fixed patterns for recognition, these symptoms are often dismissed. “The good thing is, childhood cancer can be cured but it needs the right treatment from the very beginning.” Just like symptoms, treatments for childhood cancer varies. With the options between surgery, chemotherapy, radiotherapy and target therapy, each cancer heals differently.
Nonetheless, Lee advises parents to follow treatment options and chemotherapy regimens set by the child’s respective oncologist. “Do not study too much from the internet because there are a lot of misinformation tossed around online. As a doctor, I know many have a bad perception towards chemotherapy and even surgery. But many a time, these are life-saving treatments for a child.
“The right treatment at the right time is the fundamental principle, not only to help the child but also increase their chances of survival,” he added. Remarkable development and breakthrough habe been seen throughout the decades, not only for adults, but also for children.
When either one is diagnosed, the malignancy of each case is serious. Nonetheless, for every treatment, what is expected of the outcome is prolonged life expectancy.
Lee opined that for adults, when given 10 or more years of survival, then the treatment is considered a good one. “However, for childhood cancer, if given the probability of 10 years for survival, that is a lousy treatment. In childhood cancer treatment, we are aiming at a normal life expectancy where a child can carry on in life independently.”
Ending his session, Lee once again stressed that childhood cancer and adult cancer are different. “Children cannot be considered as small adults. Therefore, childhood cancer is a unique disease by itself. Treatment and outcome are also different from that of adult cancers.”
A study done by Lee and his team in 2002 in the path of understanding why do childhood cancer occur, Lee and 12 other doctors conducted a study in 2002 entitled “Is the timing of exposure to infection a major determinant of acute lymphoblastic leukaemia in Hong Kong?”.
“We looked into the families of the patients. We visited every household and measured the radiation activity on walls, the electromagnetic field inside and outside the house. We also measured water substances and the parents’ occupations. Then, we did the same to the next-door family with children but no cancer,” he shared.
Through that observation, Lee and his team yielded the same results all around — that the observation did not conclude the possibility of childhood cancer. “This meant that cancer in children had nothing to do with radiation, water substances, electromagnetic field and parent’s occupation.”
However, the study did produce a variable shared by Professor Dr Mel F Greaves where he used the hygiene theory. “We realised that children with leukaemia have a pattern of getting an infection later in life compared to children without. I believe that any human immune system that has not been exposed to infection earlt in their life may go wrong later on, when they catch the same infection.”
Further evidence suggested that children placed into daycare earlier will have their immune system maturing fast in the right time.
