Childhood Cancer is a catastrophic disease, if untreated it is potentially fatal. It afflicts all communities. Based on recent data, it is estimated that 10 – 12 children per 1, 00,000 population will develop cancer every year. Hence in India, with a population of over a billion, it is roughly estimated that about 50,000 children develop cancer each year and many either go undiagnosed or without adequate treatment. Of these, a mere 15 – 20% i.e. 10,000 children are able to reach a cancer unit. And among the latter 40 to 50% i.e. 5,000 children drop out of treatment. Most children therefore die without proper therapy. This is the reason that lay public, as well as many in the medical fraternity believe that cancer is potentially incurable in India.
It is worthwhile knowing that of the 8.5 lakh cases of cancer that occur annually in India, only 3 – 5 % occur in children. These cancers are very fast growing but also very sensitive to proper treatment. Although treatment is complex and often long, cure is a very realistic and practically achievable goal. Although the actual number of children who develop cancer is small, the cure rate is high and total number of productive life years saved by curing these children is significantly high and therefore the effort in treating appropriately is all the more worthwhile and fulfilling.
At RGCI we are treating largest number of children and adolescents with ALL in the private sector in India. Having treated more than 600 children so far, we have excellent survival rates. This has been possible with the use of contemporary treatment protocols backed with excellent supportive care. Furthermore application of recent advances has permitted more than 80% patients to be treated without radiotherapy to the brain with outcomes comparable to developed countries.
Treatment of AML is one of the biggest challenges to any Pediatric Oncology unit. Infection is the biggest killer. Therefore, coordinated efforts of clinical team, nursing staff and infection control team are crucial to reduce morbidity and mortality. At our centre, we have intensive chemotherapy regimen for AML along with appropriate risk stratification to accurately identify children likely to be benefitted with bone marrow transplant.