Dealing with a cancer diagnosis is a life changing event. Here are some frequently asked questions and common myths around cancer.
When the doctor tells you that your child has cancer, your whole world starts caving in. The first reaction is normally feelings of shock, disbelief, fear and numbness.
“Why us?” is a common question, to which there is no answer. Feelings of guilt are also common. Parents wonder if they could have prevented the cancer. It is reassuring to know that nothing we did or did not do as parents caused our child’s cancer.
You will have to cope with many changes in your life. You will experience very strong emotions, increase your knowledge in areas previously completely unknown to you, develop new skills, change your life plans, re-evaluate your goals and dreams, deal with a loss of control and learn to cope with many unknowns.
Here are some frequently asked questions about cancer.
Cancer begins when a particular cell or group of cells in the body begin to multiply and grow without control. Oncology is the study of these cells. The cancerous cells stop working properly and as their numbers increase, they form a lump or tumour. Eventually, the normal cells will be crowded out and the cancerous cells, if not treated, will take over. When cancer cells break away and spread to other parts of the body they may produce secondary tumours known as metastases.
Not all tumours are cancerous. Tumours are either benign or malignant. Malignant tumours are cancerous cells that invade and spread to other parts of the body. In contrast, benign tumours invade tissues surrounding it and generally do not spread.
The cancers that affect children are generally unique to those that affect adults. In South Africa, one in 600 hundred children is affected by cancer before the age of 16. The encouraging news is that if diagnosed early, 70%-85% of children can be cured. In South Africa, less than half of the children are diagnosed early enough and reach a treatment centre in time. Many are diagnosed too late with an advanced stage of cancer for the treatment to have much chance of success and half are never diagnosed and so receive no treatment.
No one knows what causes childhood cancer, although there are many different theories. A huge amount of research is being carried out worldwide, with studies into a number of possible causes.
Cancer is not contagious, nor, for most cancers, is there any evidence that they are inherited. It is exceptionally rare for a second child in a family to develop cancer unless the family has a known cancer syndrome.
The Paediatric Oncologist is the head of the medical team caring for your child. Oncology (the study of tumours) is a specialist field in medicine and a Paediatric Oncologist is a doctor who specialises in treating childhood cancer.
The most common childhood cancer both worldwide and in South Africa is leukaemia, which accounts for about one third of all cases of childhood cancer. The next most common childhood cancers are brain tumours and lymphomas, followed by embryonal tumours and sarcomas. Click here to find out more about childhood cancer.
Whilst cancer in children is a treatable disease and up to 70% of children can be cured, it remains a complex disease. Treating childhood cancer can be an extremely difficult and trying process, both for the child and the parents.
Paediatric Oncology only uses evidence based and medically approved treatment. International tried and tested protocols are used. The introduction of multi-agent chemotherapy is called a protocol. Protocols are developed as a result of clinical trials in high income countries, leading to the best standard of care. Protocols are specific for each type of cancer and therefore each child will be given different combinations of chemotherapy drugs. The major portion of your child’s treatment will take place in the hospital. Your child’s treatment plan (protocol) will be explained to you in detail by your doctor.
Each type of cancer is different and therefore treated differently. Children’s cancers are treated by surgery, radiotherapy, chemotherapy, bone marrow transplant and immunotherapy. Almost all childhood cancers require chemotherapy as part of treatment. Remember that cancers vary considerably and treatment will vary accordingly.
Diet and nutrition are very important in childhood because children are growing and developing. Good nutrition is particularly important when a child has cancer because the child’s growing body also has to cope with the various treatments and their side effects. The focus should be on preventing or treating cancer-related malnutrition, as prevention is always better than cure.
Not all children react to cancer treatment in the same way. Many children have no problem with nutrition – they are able to eat enough and have the strength and energy to maintain their normal levels of activity. However, some children lose weight, grow more slowly, frequently feel tired or irritable and get infections more easily. These can all be signs of poor nutrition.
Most of your child’s treatment will take place in hospital. Hospital stays can vary from several days to several weeks at a time. This will depend on: the type of cancer; the type of treatment; how your child responds to treatment; and your child’s general condition. It is wise to be prepared for long stays in hospital and to make the necessary arrangements with your employer and for the care of family members at home. The ward and your child’s room will become like a second home to you for the duration of your child’s illness and treatment. You will get to know the staff on the ward very well and they will become a valuable source of support for you and your family.
Your child’s age and ability to understand what is happening will determine what you tell them and how they cope with the cancer and its treatment. We know it is hard to tell your child the truth about the illness and its treatment, but it is far better that you do this. A very young child may not understand what is happening or why they have to go to hospital and have certain treatments. They may find it hard to cope with the situation, refuse to come to hospital and refuse to have a treatment that they find unpleasant. The doctors and hospital staff understand this situation well.
Your child should continue to attend school as much as possible if their physical condition allows for it and if their doctor has given the go ahead. The teachers should be made fully aware of your child’s condition and the possible side effects of treatment, such as hair loss, lack of energy and stamina, weight loss or weight gain etc. If your child has a central venous line, their teachers also need to know about it and how it may affect your child’s ability to participate in certain activities, such as sport. Most schools are very understanding and will do everything possible to support your child. CHOC has a Back to School book, which is a guide to teachers offering information about the child’s illness, how to support the child and what to tell other pupils. Ask your CHOC volunteer or social worker for a copy, or download it here. Visit the child’s school as soon as possible to discuss the situation with the teacher(s).
Yes, recurrence (relapse) of cancer is the reappearance of cancer at the same site, near the initial site or in other parts of the body. This can occur during treatment or after what was believed to be successful treatment of the cancer.
Palliative and end-of-life care are two aspects of childhood cancer that are the most difficult to discuss. Although the cure rate for childhood cancers is at 80%, to a parent, the other 20% is a real fear. This is a natural reaction to the very difficult circumstances you are in, where always looking on the bright side is extremely hard and potentially unrealistic. Your worst fears have come true; you are now faced with the knowledge that your child is going to die from cancer and that you will outlive your own child.
Here are some common myths around childhood cancer
Fact: Cancer is not contagious.
Cancer cannot be spread from one child to another. We isolate children with cancer as their immunity is low and are vulnerable to infections.
Fact: There is no known cause for most childhood cancers.
At least 95% of the cancers in children occur spontaneously. Since the triggers of most childhood cancers are unknown, preventive measures are limited. Thus far, studies suggest that there is nothing a child or parent has done to induce cancer, and therefore, should avoid doing in order to prevent childhood cancer.
Fact : Most childhood cancers are curable.
For example, in Acute Lymphoblastic Leukaemia, which is a common form of Leukaemia in Singapore, 3 in 4 children will be cured with chemotherapy alone. A successful cure depends on receiving the current-day standard therapy, a positive attitude and determination to overcome cancer.
Fact : Children with cancer can still lead a normal childhood.
Children with cancer can lead a normal childhood. Many children return to normal school life after treatment. In other cases, the children and their families adapt and modify their lifestyle to achieve normalcy. This becomes much easier with care, understanding and support from family, teachers, friends and other caregivers.
Fact : Not all tumours are cancerous.
Tumours are either benign or malignant. Malignant tumours are cancerous cells that invade and spread to other parts of the body. In contrast, benign tumours invade tissues surrounding it and generally do not spread.
Fact: The cancers that affect children are generally unique to those that affect adults. In South Africa, one in 600 hundred children is affected by cancer before the age of 16. The encouraging news is that if diagnosed early, 70%-85% of children can be cured.
In South Africa, less than half of the children are diagnosed early enough and reach a treatment centre in time. Many are diagnosed too late with an advanced stage of cancer for the treatment to have much chance of success and half are never diagnosed and so receive no treatment.
Fact: Cancer is a very hard subject for anyone to talk about but it is necessary to talk about it. We need to create awareness regarding the signs and symptoms of childhood cancer in order to ensure people get medical attention early because early detection saves lives. Finding out you have cancer can be overwhelming, not only for you, but also for your friends and relatives. People often don’t know what to say.
If you have any other questions or concerns, please contact your regional CHOC office.
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