Cancer in Children

Childhood cancer is different from adult cancer — in types, biology, and treatment response. Roughly 50,000-75,000 children are newly diagnosed with cancer in India each year. With modern treatment, around 80% of childhood cancers can be cured — but in India, cure rates are lower than they could be because of late presentation and treatment drop-out. Both are addressable.

Commonest childhood cancers in India

• Acute lymphoblastic leukaemia (ALL) — by far the commonest.
• Acute myeloid leukaemia (AML).
• Brain tumours.
• Lymphomas (Hodgkin and non-Hodgkin).
• Neuroblastoma.
• Wilms tumour (kidney).
• Retinoblastoma (eye).
• Osteosarcoma, Ewing sarcoma (bone).
• Rhabdomyosarcoma (muscle).

Warning signs — the PARENT pneumonic

• P — Persistent fever, fatigue, pallor.
• A — A new lump or lymph node; abdominal mass.
• R — Red or white pupil in a photograph (retinoblastoma), bone pain, bleeding.
• E — Enlarging node, limb, abdomen; eye changes.
• N — Neurological change — unsteady walking, morning headache with vomiting, new squint.
• T — Treatment-unresponsive fever, "TB-like" symptoms that don't improve.

What to do

• Any of these, persistent, deserves a paediatrician's evaluation — don't let the diagnosis be delayed by months of empirical treatment.
• Lymph-node TB vs lymphoma is a common diagnostic fork in India — make sure both are considered before committing to treatment.
• Prompt referral to a paediatric oncology centre changes outcomes dramatically.
• Trust the multi-disciplinary team — paediatric oncology outcomes at experienced Indian centres are excellent.

Don't stop treatment in the middle

Treatment abandonment — stopping before the full course — is the single biggest reason Indian childhood cancer survival lags behind high-income countries. Reasons include cost, travel, misinformation, and exhaustion. Many NGOs (CanKids, Cuddles Foundation, Indian Cancer Society, St Jude India ChildCare Centres, and others) provide free accommodation, food, transport, and financial help to families — speak to the hospital social worker. Ayushman Bharat PM-JAY and state schemes cover most paediatric cancer treatment at empanelled centres.

During and after treatment

• Nutrition, infection control, vaccines (modified), school and normalcy where possible.
• Long-term follow-up — for late effects (growth, heart, fertility, second cancers).
• Emotional support for child and parents; peer support groups help.