Another blog post focusing on childhood
cancer today! This time I’m going to be breaking down the diagnosis and
treatment of childhood cancer.
As my family is well aware, there is a
wide range of syndromes that run in families which can lead to an increased
risk of a child developing cancer. Li Fraumeni Syndrome is just one of them and
it was this syndrome that led to my cousin being diagnosed with cancer three
times in his short life. When Georgie was a baby and was diagnosed with cancer
for the first time, my uncle asked his doctors if it was linked to his mother,
who had died a few months before. The doctors told my uncle it was just a
horrific coincidence and nothing to do with genetics. It wasn't until Georgie was
fifteen and diagnosed with the cancer that killed him that we discovered he has
Li Fraumeni Syndrome and it had probably been inherited from his mother. It
took a while for Georgie to be diagnosed this time and we have to live with the
fact that had we have known he had LFS, he may have been diagnosed a lot
quicker and this could have saved his life. Unfortunately for us, we will never
know.
Luckily, huge advances have been made
in recent years and more and more people are having genetic testing and genetic
counseling to see if they have any inherited factors that could increase their
risk of developing cancer. For example genetic testing for families with a
history of retinoblastoma has become standard procedure which is a huge step
forward.
Please do read my blog post about gene
mutations for more information on this.
As I have said above, huge and
significant advances have been made in relation to childhood cancer, especially
when it comes to treatment and mortality rates. This is mainly down to the introduction
of standardized protocols in clinical trials as well as the centralization of
care.
There are many organisations and groups
who co ordinate trials into childhood cancer and look into various issues
surrounding it. These include the Children’s Cancer and Leukaemia Group (CCLG)
which my friend and fellow ambassador Neil is part of. I’m going to ask him to
do a guest blog post on this subject.
At the moment there are around thirty
groups which have been set up to research specific tumour types and other
disciplines surrounding childhood cancer.
There are twenty one specialist centres
dedicated to looking after children with cancer in the UK and Ireland. These
have been shown to significantly benefit these children by forming a close knit
network. Each of these twenty one units is a centre of excellence and have
multidisciplinary teams of specialists with experiences of treating the specific
tumours seen in children. These centres are:
*Royal
Aberdeen Children’s Hospital
*Royal
Hospital for Sick Children Belfast
*Birmingham
Children’s Hospital
*Royal
Hospital for Sick Children Bristol
*
Addenbrooke’s Hospital Cambridge
*Children’s
Hospital for Wales Cardiff
*Royal
Hospital for Sick Children Edinburgh
*Royal
Hospital for Sick Children Glasgow
*St
James’ University Hospital Leeds
*Leicester
Royal Infirmary
*Alderhey
Children’s Hospital Liverpool
*Royal
Manchester Children’s Hospital
*Great
Ormond Street Hospital
*University
College London Hospital
*Royal
Victoria Infirmary Newcastle
*Queens
Medical Centre Newcastle
*Queens
Medical Centre Nottingham
*John
Radcliffe Hospital
*Sheffield
Children’s Hospital
*Southampton
General Hospital
*Royal
Marsden Hospital Sutton
*Our
Ladies Hospital for Sick Children Dublin
Treating
Childhood Cancer:
The
typical treatment for the majority of childhood cancers is surgery, chemotherapy
and radiotherapy. Here is a summary of treatment options of some of the cancers
seen in children:
*Acute
lymphoblastic leukaemia and acute myeloid leukaemia– Usually Chemotherapy
combined with steroids. Donor stem cells or bone marrow can be considered for
patients with resistant ALL or those that have relapsed. Radiotherapy is
sometimes used as well.
*Hodgkins
lymphoma – Sometimes surgery is used to remove the tumour if it is at stage one
but the main treatment is usually chemotherapy and radiotherapy.
*Non-hodgkins
lymphoma – There are many different types of NHL and treatment will depend on
what type the child has. Normally treatment is radiotherapy, chemotherapy and
biological therapy although stem cell and bone marrow transplants can also be
used.
*Brain
and CNS tumours – If surgery is feasible then this is usually the preferred
treatment option but chemotherapy can also be used. If the child is under three
years of age then radiotherapy should be the last resort as it can damage the
child’s still immature brain.
*Neuroblastoma
– if the tumour is localized the surgery is usually the first option.
Chemotherapy before and/or after surgery is also an option as is a stem cell
transplant.
*Retinoblastoma
– Smaller tumours are treated with laser treatment to the eye. Cryotherapy and
thermotherapy are also options for smaller tumours. Larger tumours are usually
treated with chemotherapy, radiotherapy or surgery to remove the eye. A
combination of treatments is sometimes used.
*Nephroblastoma
– Surgery to remove part or the entire kidney is an option as well as chemotherapy
and radiotherapy before and/or after surgery
*Osteosarcoma
– The main treatment option is surgery to remove the tumour and surrounding
tissue. Sometimes amputation is necessary. Chemotherapy is usually used before and
after surgery. Radiotherapy can also be used.
Osteosarcoma
is the cancer that killed Georgie. He had it in his jaw. He had various
treatments throughout his illness. He had his jaw removed and replaced twice
but unfortunately microscopic cells were left behind and the tumour simply grew
back. He also had chemotherapy and photo dynamic therapy amongst many other
treatments.
*Rhabdomysarcoma
– surgery is the main treatment option and chemotherapy or radiotherapy is usually
used before and/or after surgery
Georgie was diagnosed embryonal rhabdomyosarcoma in
the left temporalis muscle on his second birthday. He had a small dent
in the side of his head after it was removed. He had chemotherapy through his “wiggly”
(hickman line) and several other treatments and he managed to beat this cancer,
although he was given a very low chance of surviving the disease.
New treatments such as immunology are being developed
all the time and ways of treating childhood cancer is evolving.
Childhood
cancer survival rates are improving all the time, and more children then ever
are surviving. There is still a hell of a long way to go and unfortunately many
children are still dying, my beautiful cousin included. It is important to know
that there are many people out there dedicated to trying to find ways of
preventing, treating and curing childhood cancer. I am very much looking
forward to the day when childhood cancer becomes a very very rare occurrence.
If you have a
child that is suffering from cancer, or you are a child with cancer, my heart is
with you and I wish you nothing but the best.
For Georgie –
I miss you more and more every single day xxxx
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