By Dr Nitin Sood
Leukemia is the most common type of cancer in children, adolescents and young adults, according to the Leukemia and Lymphoma Society. Leukemia is a cancer of the blood and white blood cells. White blood cells form part of the body’s immune system, which helps to defend against infection. When white blood cells are affected by leukemia, abnormal cells are overproduced and released into the blood, overcrowding the body. Abnormal white blood cells form in the bone marrow. They quickly travel through the bloodstream and crowd out healthy cells. This raises the body’s chances of infection and other problems. As tough as it is for a child to have cancer, the upside is that most children and teens with childhood leukemia can be successfully treated. The type someone is diagnosed with determines the treatment option.
Who is at risk?
The risk for childhood leukemia increases if your child has an inherited disorder such as Down Syndrome, an inherited immune system problem, a sibling with leukemia, especially an identical twin or a history of being exposed to high levels of radiation, chemotherapy, or chemicals such as benzene (a solvent).
What are the early signs and symptoms?
While it is difficult to spot the symptoms, one should look out for early signs such as fatigue, fever and night sweats which can be easily mistaken for flu. Moreover, due to lack of healthy blood cells, bruising is common in leukemia patients. Other signs are when a child develops pain in their legs or lower back, repeated infections, swelling in the abdomen, face, arms, underarms, sides of neck, or groin, swelling above the collarbone, loss of appetite or weight loss, headaches, seizures, balance problems, or abnormal vision, vomiting, rashes and gum problems.
How is it diagnosed?
Diagnosis of leukemia can only be confirmed through laboratory tests, including blood tests, bone marrow samples and genetic tests. Blood tests are done to count the number of each type of blood cells in the body: red cells, white cells and platelets. Unlike the cancer of lung or breast, which involve the size of individual tumors, it is not possible to place a “stage diagnosis” on leukemia because the affected cells are already spread in the body. However, for some types of leukemia, it is possible to classify them as low, standard or high-risk.
What are the treatment options?
The treatment of leukemia varies depending on the patient and type of leukemia they have. Acute leukemia (fast developing) is usually curable with standard treatment, such as chemotherapy. Chronic leukemias (slow developing), are often incurable but treatable. For some forms of chronic leukemia, targeted treatments are available which help in long-term control of these cancers.
Advice for parents
Engage in a candid conversation with the treating doctor and other members of the cancer care team about the best treatment options for your child. The survival rates for most types of childhood leukemia have improved over time and treatment is also more accessible now. Children respond better to cancer therapy than adults. Their bodies also tolerate the treatment better.
(The writer is Associate Director, Medical and Haemato Oncology , Cancer Institute, Medanta, The Medicity.)
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