Childhood cancer, a public health problem in the world

Cancer is one of the leading causes of death of children and adolescents in the world. Every year, globally, more than 400 thousand children are diagnosed with this disease, according to data from the World Health Organization (WHO) and the Pan American Health Organization (PAHO).

In the American continent, it is estimated that there were 32,065 new cases in 2020, in children from 0 to 14 years of age, and 8,544 deaths were recorded in children under 15 years of age; while in Latin America and the Caribbean, the proportion was 20,855 new cases and 7,076 deaths.

WHO-PAHO report that most children with the disease live in low- and middle-income countries, where they face unacceptable inequities in aspects such as early detection, diagnosis, and access to quality treatment and palliative care.

On the occasion of the International Day for the Fight against Childhood Cancer, which is commemorated on February 15, pediatric oncologist Marta Margarita Zapata Terrés, professor and tutor of the Master's and Doctorate Program in Medical Sciences at the Graduate Studies Division of the Faculty of Medicine (FM) of the UNAM, points out that in infants, leukemias, which originate in the bone marrow, are more frequent; then brain tumors and then lymphomas, tumors that originate in the lymph nodes.

Then several tumors develop in any part of the body: bone, muscle, liver, and various organs. In general, they produce common symptoms of which we are not very alert, that is why it is essential to be informed. Cancer in childhood is the first cause of death by disease. This makes it a public health problem in Mexico and the world in which we must be involved; besides, with early detection, some types are curable in 90 percent of the cases.

Warning signs

In leukemia, fever, pallor, and bone pain are present. The important thing is to give it importance, as moms and dads, if these symptoms last more than a week, then it is necessary to consult a pediatrician. Prolonged headaches (even with the use of analgesics), visual disturbances such as blurred vision or double vision, dizziness, and walking complications are associated with brain tumors. In these cases, there is an urgent need to see a doctor.

Lymph node lymphomas and other tumors such as bone tumors are associated with pain and an increase in volume in that area of the body. When those lumps we have in the neck, armpits, and groin swell more than one centimeter, they should be studied, because they can grow due to an infection, but also due to cancer. Being ill-considered allows physicians to detect childhood cancer in early stages.

The diagnosis of childhood cancer cannot be made by the pediatrician or first contact family physician, but the first symptoms can be detected to refer the patient to a pediatric oncologist, who is the specialist. It is important that as adults, we believe in children. "If they tell us that they feel bad, that they don't want to eat or that they have a headache, we should not think that they are lazy or that they are manipulating us because many times these behaviors of adults delay early diagnoses".

Curable cancers

Of the cancers manifested at any age, childhood cancer represents only five percent of the cases and is one of the most curable. In countries where there is a quick referral and early access to curative treatments, there are diseases such as retinoblastoma that have a one hundred percent cure rate; others such as lymphomas also have a very high cure rate; even leukemias in some cases have a rate of over 90 or 95 percent, which is very good.

These children, in most cases, will not become adults with cancer. Long-term follow-ups have been done all over the world and there are many survivors. Less than 10 percent of childhood tumors are associated with cancers in adulthood. The main measures for early detection are education, that is to say, at a societal level, and especially doctors, parents, and teachers should be aware that cancer exists in childhood.

Communication between hospitals, because sometimes there is a suspicion of cancer but there are numerous intermediate steps that it takes to be sent to an oncology area. These patients with suspicions should have facilities to reach a tertiary hospital, where a diagnosis can be confirmed or ruled out.

International Childhood Cancer Day is commemorative to raise awareness that this disease exists so that we commit to small actions that can change the course of these patients. In September 2018, the WHO issued the global initiative on this issue, to address inequalities in countries to achieve early treatments. It seeks to achieve at least 60 percent survival of children with cancer by 2030 and reduce suffering for all. Consequently, to increase the capacity of nations to provide quality services to patients and to prioritize childhood cancer at the national, regional, and global levels.