Dr. Aabaji Thatte Seva Aur Anusandhan Sanstha





By  Dr. Pankaj Dwivedi
Sr. Consultant Ped. Onco & BMT
National Cancer Institute, Nagpur
On 28 August 2018

In the previous blog, we have seen a glimpse of the basics of childhood cancer. In this blog, we will discuss common queries parents or caregivers have while their children are on treatment.

Parents of children diagnosed with cancer have anxiety, lots of worries, and many questions on their minds. It is quite obvious and they are keen to know how to tackle problems during this difficult journey of cancer treatment.

Will my kid survive?

The very first query is “will my kid survive or not”? Fortunately, most of the pediatric malignancies are treatable with a good outcome, provided cancer diagnosed early and treatment start as early as possible. The outcome depends on multiple factors such as - the type of cancer, extent of disease, and availability of treatment. So, my answer may not be uniform to all the parents and it varies from child to child.

Why my child?

Parents usually ask “what went wrong that only my kid is having cancer? Or, did we miss something?” This is a very relevant question related to the causes of childhood cancer. Many etiological factors play role in childhood cancer, some congenital disorders, for example, children with Down’s syndrome have higher chances of blood cancers as compared to children without Down’s syndrome. This is because of defects in genes that regulate the production and functions of blood cells.

Likewise, some inherited defects in genes also make children susceptible to cancers. Genetic factors play a significant role in causing cancers in children. Other factors like radiation exposure, few drugs during pregnancy might play role in changing normal cells to cancer cells. Many times etiology is not known in childhood malignancies.

My kid is prescribed chemotherapy, what should I do?

Few parents are keen to know what they should do while the child is receiving chemotherapy. To understand what to do and what not to do, first, we should have an idea about chemotherapy.

1. What is Chemotherapy?

These are drugs that kill cancer cells. They can be given through veins, skin, or can be taken by mouth. The good thing about chemotherapy agents is they kill cancer cells but bad thing is that these drugs suppress our immune system. So, kids receiving chemotherapy are prone to infections. For healthy kids, one spike of fever may not be alarming but for this special population, it may be a sign of severe infection.

2. How to Prevent Infection?

In my view, prevention of infection is the most important part of cancer treatment, and hand hygiene is the most effective way to prevent it. Other than this, early consultation with a physician is suggested. In case there is a subtle sign of infection like fever, cough, cold abdominal pain, loose motion, and bleeding from any site post-chemotherapy; just see your physician without delay. This will reduce the chances of serious infections.

3. What should be the diet?

Chemotherapy generally reduces appetite, causes nausea and vomiting, so main aim during this phase is to maintain good nutrition, I advice parents to give freshly prepared food and there should not be not much restriction as far as variety of diet is concerned.
In fact, after planning of chemotherapy we arrange counseling session of parents with infection control nurses, nutritionist especially dealing with kids who are suffering with cancer.

4. What are the side effects of chemotherapy?

Before starting treatment parents are counseled regarding the adverse effects of chemotherapy.

These can be classified as -

  1. Acute or just after the introduction of chemotherapy that includes nausea and vomiting.
    To prevent these untoward effects antiemetics are prescribed routinely.
  2. Few days after chemotherapy patients may develop oral ulcers, diarrhea.
  3. There may be a decrease in blood counts, loss of hair, and pigmentation of nails and skin.

If a patient develops adverse effects of chemotherapy, consult the treating physician immediately as few conditions need urgent attention and may require hospitalization.

As discussed earlier, decreased counts make children prone to various infections. Late effects also include growth as well as mental retardation. Chemotherapy also affects the adverse function of various organs like the heart and kidney. This requires regular follow-up and various screening tests.

There are a lot of queries the caregiver has regarding prognosis, disease management, outcome, and cost involved in the treatment. Our next blog in the series will cover common queries patients and parents have during their treatment.

If readers wish to share or ask their queries, please mail the author with your comments, suggestions, and questions.