In Spain 1,100 cases of childhood cancer are diagnosed each year, of which about 350 would be susceptible to treatment with Radiotherapy. In addition, 3 out of 10 children present symptoms of anxiety in the face of the disease.
Technological advances in radiation oncology in recent years have made it possible to administer higher doses of irradiation in an increasingly precise manner, which has contributed to an improvement in the quality of life of cancer patients during and after treatment, and in the therapeutic results of certain types of tumors. These aspects, already important in general oncology, are of particular relevance in pediatric patients.
It is also estimated that close to 50% of children who survive cancer will have some type of sequelae derived from the treatments received, some of which can lead to severe disabilities. It is therefore necessary to improve not only survival rates, but also the technology that makes it possible.
Diagnosis of childhood cancer
One of the problems of childhood cancer is the difficult localization of these tumors, the presence of irregular and complex volumes, as well as cases that require imaging verification of technical precision in each of the treatment sessions. Now, however, Tomotherapy “provides promising data on acute toxicity and reliability and feasibility, i.e., it reduces immediate side effects and, more importantly, long-term sequelae,” says Dr. Matute Martín, radiation oncologist and head of the IMOncology Tomotherapy Unit.
Another problem is the early diagnosis of childhood cancer, since the symptoms must be known exactly. In addition, other diagnostic possibilities other than cancer are often considered and must be ruled out.
Treatment of childhood cancer
One of the radiotherapy techniques used to treat children with cancer is tomotherapy, an image-guided technique that allows the radiation to be adjusted to the shape of the tumor thanks to the combination of a CT scanner and a linear accelerator in the same equipment. According to Dr. Matute, Tomotherapy is an effective and safe treatment, especially for tumors of the Central Nervous System (brain and spinal canal), the second most common type of childhood tumors in our country (representing 21.5%, according to the Spanish Registry of Childhood Tumors). This technique has achieved excellent results in terms of survival and toxicity in the doctor’s unit.
According to Dr. Matute, high-tech equipment in radiation oncology is gradually being incorporated into the therapeutic approach in pediatrics. “Treatments are being individualized and adapted to each case, improving therapeutic results,” explains the doctor, who assures that this approach requires the collaboration of a team of highly qualified and coordinated professionals: anesthesiologists, medical and radiation oncologists, radiophysicists, specialized nurses, technicians and psycho-oncologists.
Another possible technique for treating childhood cancer is radiosurgery, both for malignant and benign tumors, as well as for arteriovenous malformations. According to Dr. García García, it is an optimal therapeutic alternative in certain patients because of its dosimetric characteristics and the greater preservation of healthy tissue that is achieved with it.
My child has cancer, how do we deal with it?
In 2014, figures showed that 3 out of 10 children with cancer had symptoms of anxiety in the face of the disease. Even so, more than half usually show signs of adaptation, growth and positive psychosocial development.
According to the psycho-oncologist of IMOncology FOUNDATION, Carmen Yélamos, 52% of children present an adaptive disorder, 17% depression and 30% anxiety.
Children do not fear cancer in the same way as adults do. The most important thing is for parents to gather all the information about the diagnosis and treatment, and about their needs and emotions in order to be able to accompany the child throughout the process. The truth is that parents are sometimes worse at coping with the diagnosis and treatment than the children themselves. The most difficult thing is often to know how to talk to them about the disease. It is necessary to do it with sincere, simple and easy to understand explanations. On the other hand, parents should not close themselves off from asking specialists for help, since they also have to express their emotions.
Cancer seen by age
The age at which a child is diagnosed with cancer influences how he or she experiences it:
- Younger children feel separation anxiety, fears of abandonment and pain, and fear of the unknown. In addition, they feel a sense of guilt, as if the disease were a punishment. Up to the age of 5, children perceive cancer as just another disease. But between 6 and 9 years of age, the child understands the concept of the disease better, so parents must be prepared to talk about it. It is best not to hide information from them and to tell them the steps to follow.
- Pre-teens and adolescents are more concerned; they know what they have and want to know what is going to happen to them. It is essential to create a climate where the adolescent feels listened to and understood, and where he/she feels that he/she still has certain responsibilities. It is necessary to continue with their school education and maintain contact with their friends.
How to talk to children about cancer
It is important to talk to children about cancer, and to know how. Their ability should not be underestimated. IMOncology FOUNDATION developed in 2014 a decalogue on how to talk about cancer with your child. In general, a mixture of reassurance and affection is necessary. The main recommendations are:
- Gather all the information to be able to respond to their needs and questions. Do not hesitate to go to specialists.
- Give sincere and simple explanations gradually.
- Seek proximity, looking him/her in the face or maintaining contact.
- Answer questions honestly, never lie, even if you resort to a , or .
- Encourage the child to ask questions.
- Use their language.
- Convey to them that the illness is not a punishment for something they have done.
- Show them that they can count on them and that they will be with them for the duration of the illness.
- Inform them of the steps to follow, especially between 6 and 9 years of age, when children understand better what they have.
- Talk openly about it.