[Special Topic on Children’s Cancer]Approximately 44% of every 100,000 children are diagnosed with cancer. Early detection and early treatment have a higher cure rate for childhood cancer than for adults.

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Text: He Jianxing’s “Medical Knowledge” Edited by: Liang Yingxiu

(Kuala Lumpur News) Whenever cancer patients are mentioned, most people think of adults, and few think of children. Compared with adults and the elderly, children are indeed much less likely to develop cancer, but this does not mean that there is no need to pay attention to childhood cancer.

For children suffering from cancer, not only the treatment, but also the cure rate and disease control are better than those of adults. Therefore, if treatment can be given in time, more children with cancer will benefit in time.

In developed countries such as Europe and the United States, 8 out of 10 children with cancer can be cured. Compared with 20 and 40 years ago, the number of children with cancer has indeed increased, but the increase does not mean that the situation is becoming more serious. From a doctor’s point of view, this This is because scientific and technological progress has led to the prosperity of medicine. Therefore, with the help of more advanced screening methods, doctors are able to detect cancer in children early.

The factors that cause cancer in children are the same as those in adults or the elderly, that is, external environmental factors, cell gene mutations, and a very small part of genetic factors (about 5% to 10%), but the latter two are more common, and the former is usually a special situation. For example, Hiroshima and Nagasaki, Japan, were attacked by atomic bombs during World War II. Not only did they cause serious casualties and damage to buildings at the moment of the explosion, many surviving children suffered from serious health problems after the war. Blood tumors, this is because they are all severely affected by radiation, so this tragedy occurs. In addition, environmental factors also include air and water pollution, such as in an environment where people smoke.

Understand the formation of cancer through animation

Pediatric consultant Dr Vivian Thong Siew Peng pointed out that the human body is composed of different cells. Normal cells will divide in a normal sequence, but “disobedient” cancer cells will divide rapidly. A simple metaphor is a fixed space. Of course there is no problem if you just store some things, but if a lot of things are suddenly added, the space cannot be loaded. Think of it like cancer cells in the human body. Once these cancer cells increase in a short period of time, the surface of that part will swell. , this is an example of the so-called cell gene mutation; as for genetic factors, one important point must be clarified, that is, having two children in a family does not mean that the eldest baby will suffer from cancer, and the little baby will also definitely suffer from cancer. Two children It is very rare for both people to get cancer.

“A few years ago, a Japanese anime called “Working Cells” became very popular. In addition to the first and second episodes, there is also a sequel. Its content is about the daily work of various cells in the human body after being anthropomorphized, such as red blood cells responsible for logistics operations or The formation of cancer cells is mentioned in one of the units of white blood cells that fight against foreign enemies. As a pediatrician, I would encourage parents and children to learn about the formation of cancer through this animation. Not only can we understand the ins and outs of cancer in a simple and easy-to-understand way, but also It can also bring parents and children closer together.”

So far, scientists have discovered that there are more than 100 types of cancers with different causes and spread in different organs. However, unlike adults, childhood cancers can be mainly divided into two major categories: blood tumors such as leukemia (leukemia) and malignant solid tumors. , the former refers to blood cell cancer, and the latter refers to cancer that occurs in organs, the most common of which is brain cancer. As for other cancers that are common in adults, such as breast cancer or lung cancer, they rarely appear in children.

So are the cases of childhood cancer high? Tang Xiuping said that according to the data of the Malaysian Cancer Society, the incidence of cancer in children is about 44 per 100,000 people. Compared with the two common types of cancer in children, the proportion of blood tumors such as leukemia is 60% to 70%. As for malignant Solid tumors are 30%.

“In addition, unlike adult cancers that can be prevented by taking preventive measures, most childhood cancers are caused by cell gene mutations and genetic factors. External environmental factors will only occur under certain circumstances, such as the nuclear radiation environment mentioned above. The cancer cells produced, so there are no special cancer prevention measures for children, and it is difficult to prevent. However, fortunately, the success rate of treatment, cure and disease control of children’s cancer is very high, as long as it is detected and diagnosed in time. treatment, which is another piece of good news for childhood cancer.”

Hepatitis B HPV vaccine helps children prevent cancer

“Although there are no specific public health measures to prevent childhood cancer, according to our country’s vaccination plan, there are at least two vaccines that can prevent childhood cancer, including hepatitis B vaccine and human papillomavirus (HPV). ) vaccine, the latter is also commonly known as the cervical cancer vaccine, which is used to prevent HPV.”

She said that the hepatitis B vaccine was originally developed to reduce the risk of hepatitis B infection from the mother to the fetus, because hepatitis B can cause liver cell necrosis and sclerosis, and eventually form liver cancer.

“As for the HPV vaccine, it has only been included in the national immunization plan in the past 4 to 5 years. One of its functions is to prevent cervical cancer. The people suitable for vaccination with the HPV vaccine are women aged 9 to 45 years old. Currently, the health The Ministry of Education has stipulated that every female in junior high school (13 years old) must receive the HPV vaccine.”

She said that according to the World Health Organization (WHO), children are defined as 6 to 18 years old. However, in addition to those over 12 years old, the high-risk group for childhood cancer also includes the age group from newborn babies to 3 years old. The most common cancer type in the latter group is leukemia. It is mainly called blastoma. The blastoma is named according to which organ or system it is in. For example, if it is in the liver, it is called hepatoblastoma. If it is in the kidney, it is simply called nephroblastoma.

“As for the common cancers in children over 12 years old, bone sarcoma is a malignant bone tumor that originates from bone cells and can occur in any bone in the body. In addition, non-Hodgkin’s lymphoma (Non- Hodgkin Lymphoma (NHL) is also a common cancer type in this group, which refers to lymphomas other than Hodgkin’s lymphoma.”

So how can parents help their children reduce the risk of childhood cancer? She said that in addition to the previously mentioned vaccinations such as the hepatitis B vaccine to prevent liver cancer, or the HPV vaccine to prevent cervical cancer, it is also crucial to give children a nutritious and balanced diet and moderate exercise.

Pregnant women should not ignore detailed prenatal check-ups

In fact, you can integrate exercise into your life by taking some small steps. For example, if you live in an apartment, take the stairs instead of the elevator, or park your car farther away from your destination when you go out, thereby increasing the chance of walking. , these are all methods of exercise worth considering.

Another point that cannot be ignored is the prenatal check-up of pregnant women. Take cancer in newborn babies as an example. Cell deformities, mutations, and cancer occur when the embryo is formed. At present, obstetrics and gynecology have a very detailed physical examination of the mother, starting from 13 weeks of pregnancy to 18 weeks of pregnancy. Detailed examinations can be carried out at 22 weeks or 22 weeks. If there are deeper or shallower abnormal images found during the prenatal examination, it should be followed up continuously. Even after the baby is born, whether it is a benign tumor can be detected immediately to avoid unnecessary harm to the baby. health damage.

Observe from life

Catch cancer in time

In Malaysia, childhood cancer is the second leading cause of death among children after accidental death, and is also the leading cause of death among children and adolescents worldwide.

Many times parents cannot accept the moment when a doctor tells them that their child has cancer. However, in fact, if parents can pay more careful attention to the details of life, they can find out early whether their children have the possibility of cancer.

Tang Xiuping pointed out that usually after a child is born, parents will take him to the pediatrician for follow-up consultation, including vaccinations, etc., and more attention must be paid to the physical examination, including height and weight, including whether the child’s height and weight are within the normal level. Pay attention to whether there are any developmental delays, such as whether brain development is inhibited.

Cancer is mostly related to genetic mutations in cells

“Parents must maintain close contact with their pediatrician, because in order to detect whether their child has cancer in a timely manner, the parents’ observation and the doctor’s professional diagnosis are the key. Both are indispensable, and one cannot fight alone.”

In addition to the doctor’s professional diagnosis, parents can observe from several aspects in daily life. Here are some common examples:

1. Pay attention to whether you often have foot pain, knee pain or joint pain, or whether the pain makes you cry late at night (or symptoms of osteosarcoma);

2. Pay attention to lack of appetite and inability to keep up with your weight (this can be an early symptom of any disease, including cancer);

3. Bruises easily occur without collision;

4. Frequent gum bleeding without any reason;

5. Often have sudden fever for several days;

6. There are red rashes in many parts of the body during the fever;

7. The child’s belly appears swollen (after ruling out roundworms).

(The following 5 conditions have similar symptoms to leukemia)

8. A lump appears in the neck or crotch (after ruling out infection or related to lymphoma);

9. Vision is affected, such as cross-eyes, superimposed vision, and frequent squinting;

10. Keep stumbling while walking;

11. Complaint of tinnitus;

12. Hearing is not sharp.

(The above indicators are common symptoms of brain cancer among malignant solid tumors, mainly tumor pressure and optic nerve.)

During the physical examination, detailed family medical history must be provided

The formation of childhood cancer is mostly related to cell mutations and genetic factors, but symptoms are not caused overnight. Therefore, as long as parents pay more attention, timely detection can be achieved.

Tang Xiuping reminded that when parents take their children for a physical examination, they must also inform their family history in detail, such as whether anyone in the family has had cancer, and the doctor responsible for the physical examination must also conduct several screening tests to confirm or exclude the possibility of cancer. sex.

Treatment methods can be mainly divided into 5 categories

So what are the treatment options? Up to now, cancer treatment methods for adults or children can be mainly divided into 5 categories, namely surgical resection, radiotherapy (radiotherapy), chemotherapy (chemotherapy), targeted drugs and immunotherapy, of which the first 3 are the most common in cancer treatment. In addition, since COVID-19 has been raging around the world, the method of stimulating immune cells to deal with the virus through vaccines has also been paid attention to by researchers. That is whether similar vaccines can be developed in the future with the purpose of preventing the emergence of cancer cells. It is still unclear. Too early.

“Surgical resection, radiotherapy and chemotherapy are not difficult for parents to understand. After all, these three treatments have been used for many years, but targeted drugs and immunotherapy are relatively new. In fact, there are already many targeted drugs today, which are effective in treating childhood cancer. It is also very helpful. Its importance is that the chemotherapy drugs used in the past also destroyed good cells when killing cancer cells. Therefore, children will have different side effects such as hair loss, dry skin, poor gastrointestinal absorption and short growth, etc. , and targeted drugs can attack cancer cells without ‘dealing with’ good cells, allowing them to survive and reduce side effects.”

She said that unlike adults or the elderly who have to consider “living with cancer” after suffering from cancer, if children’s cancer can be removed surgically, the most ideal approach is to directly remove it, which can avoid the recurrence of cancer cells. “According to data, the prognosis of childhood cancer is much better than that of adults. For example, if leukemia can be controlled well, the chance of avoiding recurrence can be as high as nearly 90%, and if brain cancer can be detected and treated in time, the surgical success rate is more than 85%. “

2 out of 4 cancer patients survive more than 10 years

Therefore, we must advise parents not to give up when they learn that their children have cancer, and not to underestimate their children’s vitality, because they can be braver little warriors than adults, but they must be detected and treated early.

Due to the advancement of science and the advancement of medicine, humans can use different weapons when facing different diseases. According to data, 50 years ago, only 1 out of every 4 cancer patients could survive for more than 10 years, and the quality of life was also poor. However, now due to cancer research, 2 out of 4 cancer patients can survive for more than 10 years. In 10 years, the quality of life has also greatly improved.

“The reason for such significant changes is the continuous work of scientific researchers on cancer research, such as the development of instruments or methods that can timely screen for the presence of cancer, and then targeted targeted drugs and other treatments. And scientific researchers Looking at the next 10 to 20 years, we hope that 3 out of 4 cancer patients will survive for more than 10 years.”

As for childhood cancer, it is also a key research object for scientific researchers. The reason is that it is still not possible to accurately find out the cause of childhood cancer. For example, why among two children in the same family, the eldest brother is fine but the younger brother has cancer?

Parents encouraged to support cancer research in our country

Tang Xiuping has met with children and parents who have recovered and listened to them talk about the years when they were fighting cancer. For example, it took a long time to wait for a formal diagnosis. Looking at the experiences of children with cancer today, she has to say that cancer research is really important. It is great because it allows doctors to detect the presence of cancer early and treat it in the right way, thus improving the survival rate of patients.

Therefore, as a pediatrician, she encourages parents to support more cancer research in our country, because many times these studies are conducted by non-governmental organizations (NGOs), and the cost of research has always been a heavy burden, which is urgently needed by the public. Only in this way can they continue their research.

In addition, it is worth noting that the relationship between scientific researchers and clinicians is closely related. Through the information that doctors are exposed to in clinical settings, scientific researchers can develop more useful methods. For example, scientific researchers can understand that cancer patients do not want to seek medical treatment because they are worried about their health. Know how to seek medical treatment, worry about transportation and medical expenses, etc.

A mobile phone smart program (APP) has been developed. As long as the tumor part (on the surface of the body) is photographed and uploaded, researchers can use the photo to diagnose which type of cancer it belongs to and whether the cancer patient should go to which hospital. Seeking medical treatment in the hospital is not only another good news for cancer patients, but this technology was developed by the my country Cancer Research Center together with a national medical center in China for adult nasopharyngeal cancer.

5% to 10% of cancers are hereditary

Question 1: Is cancer hereditary?

Answer 1: Only a small proportion (5% to 10%) of cancers will be passed on to the next generation due to parents’ genes. Most of them are still caused by acquired factors. Therefore, this also draws a very important message, that is, as long as you can grasp With enough cancer prevention knowledge, you can prevent cancer well and effectively.

Cancer is not a contagious disease

Question 2: Is cancer contagious?

Answer 2: Cancer is not a contagious disease, so it is never contagious. Therefore, if you know that someone around you has cancer, you can give him a hug and encourage him to move on.

Eating fast food does not directly cause cancer

Question 3: Will eating fast food cause cancer?

Answer 3: This is a myth held by many people. From the perspective of nutritional value, it is undeniable that fast food is not only rich in saturated fat, but also fried food, which is not good for children’s health. However, it is still acceptable if eaten occasionally. So just maintain a balanced diet.

Although fast food does not directly cause cancer, if it is eaten for a long time, it will cause physical burden such as obesity, which is equivalent to putting oneself at a higher risk of cancer. Therefore, for children, it is better to eat less.

Answer: Dr. Tang Xiuping

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