The simple ways to detect signs of cancer in children

The simple ways to detect signs of cancer in children

By Stevie Emilia

JAKARTA (JP): Nunuk A. Prabowo is unable to say how she felt
upon learning that her five-month-old daughter, Frida, tested
positive for leukemia four years ago.

"We weren't ready for the reality. We wanted to scream in
disbelief ... I broke down many times when I saw Frida lying
helpless in (the hospital's) isolation room with a drip attached
to her head," Nunuk said.

It never crossed her mind that her third child could have such
a serious disease. At first, she thought that Frida had simply
caught a sore throat from her sick sibling.

But after the infant came down with a high fever every six or
seven hours, even after taking her medicine, Nunuk sensed that
something was wrong. "She refused breast milk. She would sleep
most of the time," Nunuk said.

After several tests, including a bone marrow biopsy at Cipto
Mangunkusumo General Hospital, a hematologist confirmed that
Frida had leukemia.

Frida was then taken to Amsterdam for treatment, where, for at
least four months, the infant went through a high dosage therapy
to stop the cancer from spreading to her brain. The side effect,
it turned out, was torturous: The skin on Frida's bottom peeled
off, and seemed like it was scorched. Anytime she was cleaned up,
she would scream in pain.

After completing the therapy, Frida's treatment was continued
at St. Carolus hospital in Central Jakarta for about a year. "Now
Frida is four years and four months old. She's healthy,
beautiful ... I never stop praying that my daughter will continue
to be well," Nunuk said.

Nunuk shared her experience with participants of a seminar
about recognizing the signs of cancer in children.

The seminar was jointly organized by the Indonesian Childhood
Cancer Foundation, the Indonesian Oncologists Association, the
University of Indonesia's School of Medicine and Cipto
Mangunkusumo General Hospital. It was held last Saturday at Klub
Rasuna in South Jakarta.

According to psychologist Ninuk Widyantoro, most parents feel
shocked, panicked, stressed and angry when they learn that one of
their children has cancer.

"Such feelings are understandable, natural and human. Allow
the feelings to linger for a while, cry if necessary, but don't
let them go uncontrolled. The sick children need treatment.
Feeling sad will not solve the problem," Ninuk said.

She suggested that parents seek as much information as they
can, including the necessary steps that should be taken, types of
treatment and their side effects and where to go for
consultations.

She advised that when collecting information the parents
should be accompanied by a friend who will take notes, help find
doctors, psychologists or somebody who has had a similar
experience. The companion is necessary in case the parents are
too distressed to think clearly.

In facing the bitter truth, members of the family, especially
husbands and wives, should keep their spirits high and discuss
the matter openly. They should not allow the sick child to see
their distress.

"It's also important to tell the child about their disease,
using language they can easily understand," Ninuk said.

Symptoms

According to hematologist and oncologist Djajadiman Gatot of
the University of Indonesia's School of Medicine, it is difficult
to spot cancer in children at an earlier stage because generally
children do not have any specific complaints.

"The cause of cancer in children is not known. But according
to studies and research, cancer happens due to a combination of
genetic and ecogenetic (environmental) factors," he said.

Cancer, he added, could be cured, although in some cases
treatment might have to sacrifice certain organs, such as the
eyes and kidneys.

"There's no exact figure on the number of children with cancer
in Indonesia. But it has been predicted that the number will not
be too different from the overall figure, which is about 2
percent to 4 percent of the number of people with cancer," said
Djajadiman.

Last year, it was estimated there were about 17.5 million
people with cancer. That number is predicted to increase to 30
million in 2015.

He said there were some cancers which commonly affected
children, but that the most common were leukemia, brain tumors,
retinoblastoma, malignant lymphoma, Wilms tumors,
rabdomiosarcoma, and osteosarcoma.

"Leukemia is the most common of all. It represents about 25
percent to 30 percent of overall cancers in children. It mostly
occurs in children between the ages of three and six, with boys
outnumbering girls," Djajadiman said.

Brain tumors

Among the symptoms of leukemia that parents should be aware of
are unclear fevers, abnormal bleeding and hard or swollen
stomachs.

Brain tumors, be they metastastic or not, are thought to
damage the central nervous system. Symptoms include headaches,
problems with speech and balance, blurred sight, changes in
behavior and declining alertness.

Retinoblastoma -- a malignant tumor of the retina that
develops during childhood -- is the most visible eye cancer found
in children between six months to two years old. Both girls and
boys have the same risk of developing this disease. Symptoms
include a white spot at the center part of the eye, which shines
when there is light.

Malignant lymphoma, or a tumor of lymphoid tissue, occurs
mostly in children between five to seven years of age, with boys
being at highest risk, three to one. Symptoms include swelling of
the lymphoid tissue in neck, armpits or thigh areas, without
signs of infection. If the swelling is inside the intestine,
symptoms include stomachaches, constipation and fever.

Neuroblastoma, a malignant tumor formed in embryonic ganglion
cells, occurs mostly in newly born babies up to four-year-old
children. Boys are more likely to get it than girls. Symptoms
depend on the tumor's location but usually the early symptoms are
hard to notice. If it is in the backbone, it may put pressure on
the spine and cause paralysis.

Wilms tumor, a malignant tumor of the kidney, primarily
affects three-and-a-half-year-old children. Boys and girls have
the same risk of developing this cancer. Symptoms include
bleeding when urinating and an uncomfortable feeling in the
stomach.

Ostoesarcoma is a sarcoma of the bone. It is the most common
bone cancer in children with high occurrence in those between 10
and 20 years of age. Its symptoms include progressive swelling
along with pain and fever.

"If parents see those symptoms in their children, consult a
doctor right away to find out whether it is cancer or not.
Sometimes, there's also a need to perform certain tests to
confirm the diagnosis," Djajadiman said.

Cancer treatments for children are about the same as those for
adults -- a combination of operations, radiotherapy and
chemotherapy, he added.

"Treating children with cancer will not only prolong their
lives, but more importantly put the disease into remission. But
again, it all depends on the type of cancer, the stage of the
disease when diagnosed and the treatment.

"If, after undergoing thorough medical treatment, children
live for at least five more years, then the possibility of the
cancer going into remission is higher," he said.