Advancements in the treatment of childhood leukemia

Advancements in the treatment of childhood leukaemia since the turn of the century (2000)

Introduction

            Diagnosis of cancer among children can be quite a shock and bad news to the parents. However, cancers are not common to children and teenagers, although the trend has been changing currently. This can be attributed to the changes in lifestyle in relation to feeding habits among other practices and habits. Currently, cases of childhood leukemia have been reported to be on the rise, hence being such a terrifying experience both to the parents and the affected child. Leukemia, being a type of blood cancer, affects the white cells of blood, leading to excessive production of abnormal white blood cells in the bone marrow. The abnormal white cells are then released to the bloodstreams while at the same time crowding the bone marrow. However, these cells fail to perform their roles of protecting the body properly, hence exposing the patient to attack by other diseases. Progression of leukemia leads to interference in the production of platelets and red blood cells. The cancer also leads to anemia due to insufficient number of red blood cells and problems of bleeding. Currently, researchers estimate that, of all cancers affecting children in the US, leukemia accounts for approximately 25% with approximately 2000 children being diagnosed with the disease yearly (Sullivan, 2004). Leukemia can be classified into acute and chronic form. Chronic forms of leukemia develop very slowly and are rare forms of cancer. There exist various categories of acute leukemia, fast growing and most common form of leukemia in children. Pediatric leukemia can occur and be diagnosed at any age, but mostly occurs in children between the age of 2 to 6 years and occurs more often in male than in female children (Sullivan, 2004).

Signs and symptoms of childhood leukemia

            Blood platelets are responsible for blood clotting. Low quantities of platelets lead to excessive bleeding especially when the child is bruised (Sullivan, 2004). When leukemia cells collect in the liver, kidneys, intestines and the spleen, these organs tend to enlarge leading to persistent abdominal pains. It is the pain that results to loss of appetite, leading to apparent weight loss (Sullivan, 2004). The leukemic blasts and cells crowd the bone marrow resulting to pain in the bones and joints. The cancerous cells of leukemia surround the bone marrow, hence insufficient production of red blood cells. Absence of sufficient number of red cells causes anemia, where the child appears tired, pale and will always breathe faster in order to take in larger amounts of oxygen to compensate for the low oxygen carrying capacity by the few red cells produced (Sullivan, 2004). Dyspnea refers to a difficulty in breathing as a result of blockage of the throat and the breastbone. Leukemia cells collect in the thymus gland located under the breastbone and around the throat, hence causing a difficulty in breathing. In case a child experiences a persistent cough and painful breathes, then the situation calls for immediate medical attention (Sullivan, 2004).The core function of lymph nodes is to filter the blood. During this process, leukemia cells collect in the nodes and causes swelling around the under arms, groin chest and the neck. While dealing with swollen lymph nodes in children, it is advisable to seek medical attention since one can hardly distinguish response to some sort of infection and the reaction as a result of leukemia (Sullivan, 2004). A child suffering from leukemia is exposed to low immunity, hence opportunistic infections that might be persistent. Although the blood count of that child may show high number of white cells, those cells may be immature and deformed; therefore not in a position to fight infections and provide a strong immune system to the body. Poor immunity leads to the child experiencing some difficulty in recovering from simple infections and may also develop some unusual infections (Tomlinson & Kline, 2010).

Treatment of childhood leukemia and its advancements since turn of the century

            Over years, there existed standard treatments for childhood leukemia. With time, there have been clinical trials to ascertain the safety and effectiveness of new treatment methods as compared to the standard ones (Lovell, Winter, Morrissy & Weinstein, 2005). Scientific methods have been applied in testing these new methods, and a close follow up on the health progress of the participants is recommended. To take advantage of the new developments in the field of treatment, health practitioners recommend that all children suffering from pediatric leukemia should seek treatment in specialized cancer health centers. Apart from a multidisciplinary team of doctors that have extensive experience in treating these children, pediatric cancer centers offer extra support to children and their families (Tomlinson & Kline, 2010). Special programs and activities such as therapists, nutritionists and counseling programs among others equip the child’s family with coping strategies while at the same time improving the patient’s quality of life. While making the decision on the mode of treatment, cancer patients, with the help of a medical professional are advised to take into consideration various factors (Lovell, Winter, Morrissy & Weinstein, 2005). For instance, the patient has to have adequate knowledge on his or her type of cancer (Reaman & Smith, 2011). This will be crucial while choosing the type of treatment plan that ranges from surgery to different forms of therapy. The patient also has to understand the goal behind the type of treatment plan chosen, as some methods are aimed at slowing, stopping or eliminating the cancer.  Different treatments have different risks associated to them, hence calls for the patient to put into consideration of this factor before deciding on the type of treatment (Reaman & Smith, 2011). The first choice of treatment could fail, hence it would be crucial for the patient to consider a second or even a third option. Various transformations have taken place in the field of treatment of childhood cancer. These transformations have led to emergence of forms of treatment that have proven to be successful.

1. Chemotherapy

Chemotherapy is the method that was widely utilized in the treatment of cancer, and considered by most professional as the conventional mode of treatment. This method advocates for the use of drugs to kill, stop or retard the rate of the growth of cancer cells. Drugs can be administered directly into blood streams through injections or medication could be taken orally (Tomlinson & Kline, 2010).

2. Surgery and radiotherapy

Children with tumors as a result of leukemia end up undergoing some form of surgery to get rid of the tumors. An oncologist surgeon removes the entire tumor and the margin leaving healthy cells behind. In case any microscopic tumor is left, chemotherapy and radiotherapy are recommended to kill the cells. Cancer cells can also be killed through the use of high energy X-rays and other chemical particles such as photons. External beam radiation therapy is the commonly used method today and involves emission of radiations from an external machine. Although there are negative effects of this treatment, they disappear immediately the treatment is over (Halperin & Ovid Technologies, Inc. 2011).

3. Immunotherapy and stem cell transplantation

Biological therapy boosts the body’s natural immune system for it to fight the cancer. Immunotherapy includes right proportions of diet to enable the body fight the cancerous cells or administration of immune boosters produced in the laboratory. Immune boosters administered to the body include interferon, cancer vaccines and monoclonal antibodies (Reaman & Smith, 2011). In a stem cell transplant, the infected bone marrow is removed and replaced with hematopoietic stem cells. These cells are found in the bloodstreams and the bone marrow. Initially, bone marrow was the common type of transplant but the trend has shifted to stem cell transplant that does not involve the actual bone marrow tissue. A recommendation of the transplant is initiated after consultation with the patient and his or her family to discuss on various issues on this type of treatment. This method is effective as it helps destroy cancer cells surrounding the bone marrow, but can be enhanced if used together with chemotherapy (Lovell, Winter, Morrissy & Weinstein, 2005).

4. Palliative care and support

Various side effects are associated with the treatment of all forms of cancer. Initially, patients were used to seeking the conventional treatment but never thought of other ways through which they could deal with the negative effects of medication. Palliative care and support ensures relieve if not complete removal of symptoms and side effects suffered by the patient. Palliative care and support advocates for the support of the patient’s emotional, social and physical needs. Before embarking on a treatment, parents are advised to talk with a cancer specialist to know the possible side effects and the type of supportive care options available (Reaman & Smith, 2011).

Effects of cancer treatment of childhood leukemia

            Various advancements in the field of cancer treatment have lead to lengthening a patient’s life. This has been witnessed where most children who suffered from leukemia are now living into adulthood. Pediatric leukemia survivors stand at some risk due to effects of the cancer treatment, hence a close follow up and monitoring is necessary even after completion of the treatment (Sullivan, 2004). Researchers noted that survivors of leukemia stand a higher risk of developing other types of cancers later in life. However, patients are advised to have a balance when evaluating benefits of treating the life threatening leukemia and risks of contracting second cancers. Most of the long term effects of cancer treatment are as a result of utilization of chemotherapy, whereas radiotherapy affects parts of the body exposed to radiations. Children exposed to radiations have their brains affected in such a way that their learning ability gets affected and are more often likely to suffer from psychological problems (Halperin & Ovid Technologies, Inc. 2011). With stem cell transplants, such children being shorter in height while at adulthood, but the problem can be eliminated through treating those children with growth hormones.

Conclusion

            Over years, cancer has not been common among children, a trend that has taken another direction currently. The rising number of cancer cases among children can be attributed to changes in lifestyle and feeding habits. However, pediatric cancers are quite common among children but the problem can be dealt with given the right form of treatment. There have been various developments since the turn of the 21^st century (2000) in the treatment of leukemia among children; therefore linking the developments to the high number of survivors. Initially, chemotherapy was the commonly used form of treatment, but this has changed with time. Other methods such as stem cell transplants, surgery, palliative care and radiotherapy among others can now be used to treat childhood leukemia. In addition, more than one treatment methods can be used concurrently to increase efficiency of the medication.

References

Halperin, E. C., & Ovid Technologies, Inc. (2011). Pediatric radiation oncology.    Philadelphia: Wolters             Kluwer Health/Lippincott Williams & Wilkins.

Lovell, W. W., Winter, R. B., Morrissy, R. T., & Weinstein, S. L. (2005). Lovell and Winter’s        pediatric orthopaedics. Philadelphia: Lippincott Williams & Wilkins.

Reaman, G. H., & Smith, F. O. (2011). Childhood leukemia: A practical handbook.           Heidelberg: Springer.

Sullivan, N. A. (2004). Walking with a shadow: Surviving childhood leukemia. Westport,   Conn: Praeger.

Tomlinson, D., & Kline, N. E. (2010). Pediatric oncology nursing: Advanced clinical         handbook. Heidelberg: Springer.