February is a special month every year not because of the one extra day we get in a leap year every four years, but this is the only month in which we can all take part in raising awareness on cancer on two different days. The World Cancer day is organized by the Union for International Cancer Control (UICC) on 4th February, which is a global campaign that focuses on educating people about cancer and brings hope and positive spirit. The UICC has launched a 3-year campaign – I am and I will – and 2021 marks the final year of the campaign that is geared towards driving positive impact globally by raising awareness on preventable cancer deaths. The International Childhood Cancer Day (ICCD), celebrated on 15th February, is another worldwide campaign that raises awareness on childhood and adolescent cancers and provides support to children affected by cancer. The symbol of growth and renewal – Tree of life – is a three-year ICCD campaign that runs through 2023 which aims to send a positive and powerful message that childhood cancers can be cured and survivorship can be achieved.
Cancer affects any part of the body and all individuals irrespective of age and gender. Abnormal changes in the genes cause seemingly normal cells in the body to start growing in an uncontrolled fashion, resulting in a lump or mass of cells. In the advanced stages of the disease, the abnormally growing cells get the ability to migrate from where they originally started growing and spread to other organs such as lung, liver, and brain in the body – making it a metastatic disease that is often difficult to treat.
Cancers can be broadly categorized into two main types based on their origin – solid tumor and hematological cancer. A solid tumor is one in which the abnormal cell growth in a tissue leads to the formation of solid mass or lump. Hematological cancers on the other hand arise in the blood and because blood is liquid, uncontrolled growth of blood cells do not form lumps.
In children, the most common types include acute lymphoblastic leukemia, Hodgkin’s lymphoma, Wilms tumor, Burkitt lymphoma, and retinoblastoma. Cancer is a leading cause of death among young children with about 300,000 new cases diagnosed every year and the cost of caring for a child with cancer amounts to $800,000 USD. For a list of tumors that have high prevalence in children, see table below. While it is difficult to know the exact reason of why one has cancer, research has given us some clue about certain risk factors that predisposes to cancer. Unlike adults, where lifestyle and environmental factors such as unhealthy diet, smoking, or tobacco usage can play a large role in developing cancer, these factors are least likely to lead to tumor development in children. On the other hand, inherited or acquired genetic mutations, exposure to radiation, infections such as HIV and Epstein Barr Virus, and prior cancer treatment have all been linked to pediatric cancers.
The above table highlights the fact that treatment can increase the likelihood of survival of children affected with cancer with the overall 5-year survival rate reaching 84.5% across all childhood cancers. Although gaps in access to healthcare exists, including diagnosis and treatment, which is widened by socioeconomic disparities. For example, in high-income countries such as USA, about 80% of the children with cancer are more likely to get cured, whereas in low and middle-income countries, the cure rates precipitously drop down to 20%. In low- and middle-income countries, children and their families lack access to healthcare that keeps proper diagnosis and an early and effective treatment out of reach for many children. Realizing this challenge, the World Health Organization has launched a cancer initiative in 2018 with the goal of attaining a survival rate of atleast 60% among children by 2030. While this requires a collective effort from individuals, scientific community, governmental institutions and all other stakeholders, let us all support this ambitious goal by coming together as a community and raising awareness on childhood cancer – Together, all our actions matter.