Cancer in children and teenagers is rare, making up only 1% of all cancer cases in Singapore. About 90 to 100 new cases of childhood cancers are detected in children less than 15 years old here each year. Remarkable progress has been made in curing infants, children, teenagers, and young adults with cancer. With advancements in technology, drug therapy and treatment methods, some childhood cancers such as acute leukaemia, lymphoma, kidney cancer and germ cell cancer have an 80% cure rate.
Cancer is a disease that starts from the body's cells. The body is made up of many cells. Normally, cells grow and divide to produce more cells only when the body needs them. This process keeps the body healthy. When cells keep dividing even when new cells are not needed, the extra cells from a mass of tissue, called a growth or tumour. Tumours can be benign or malignant.
Benign tumours are not cancer and do not spread to other parts of the body. They can be removed and usually do not grow back.
Malignant tumours are cancer. These cells divide without any order and can damage surrounding tissues and organs. It can also spread (metastasise) to other parts of the body.
As the body is made up of cells, cancer can originate anywhere.
The most common type of cancer seen in children is leukaemia, which accounts for 35% of all childhood cancers seen. In Singapore, we have also seen children suffer from:
As leukaemia is the most common type of childhood cancer, we would like to tell you a little bit more about it.
Leukaemia occurs when the marrow overproduces immature white blood cells called blast cells. Normally, the bone marrow contains a small number of blast cells. However, when they become the dominant cell, leukaemia is diagnosed.
Symptoms of leukaemia are pallor, tiredness, bleeding or bruising and recurrent fevers. These symptoms can last from days to months, and may not always be caused by cancer. It is important to see a doctor about these symptoms as only a doctor can make a diagnosis.
Leukaemia is diagnosed with a bone marrow aspiration, which is performed under sedation. It involves inserting a needle into the back of the hip bone to withdraw a small amount of bone marrow, which is examined under a microscope to look for excessive blast cells. After a diagnosis is made, other tests such as a spinal tap is performed to look for leukaemia cells in other parts of the body.
Chemotherapy, an anti-cancer drug, is used to cure leukaemia. After the initial stage, chemotherapy is typically given at an outpatient setting. Sometimes, radiation may also be necessary. Treatment for leukaemia usually lasts about 2 years.
Bone marrow transplants (BMT) are also sometimes used to treat leukaemia. It is usually performed for children with high-risk leukaemia, or those who have a relapse. The transplant may be autologous, i.e. from the child's own cells, or allogeneic, which are cells donated by another person. If the cells are donated by an identical twin, it is a syngenic transplant. During a BMT, healthy stem cells are infused into the body to replace cells that have been destroyed by very high doses of chemotherapy and / or radiation.
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