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Cancer FAQs

These are some frequently asked questions about childhood cancer in Bangladesh

What is cancer?

Cancer is a generic term. It refers to any malignant growth or tumor caused by abnormal and uncontrolled cell division. The cells in the human body are constantly reproducing and replacing themselves. When cancer cells develop, they fight with and often destroy the normal, healthy cells. Once cancer cells begin to accumulate, they sometimes form tumors.

Depending on the organs/ system being affected, there are various types of cancer. Once the irregular behavior of the cells start, it often spreads to other parts of the body through the lymphatic system or the blood stream. When cancer spreads to the other parts of the body it is called metastasis.

How many children get cancer?

In the absence of a formal cancer registry in Bangladesh, based on its own data collection, ASHIC estimates that, across the country, approximately 6,000 children are diagnosed with cancer each year.

Why do children get cancer?

The cause of childhood cancer is still a mystery. It cannot be categorized by age, race, or gender. Electromagnetic waves and environmental influences have often been suspected, but have yet to be linked as a cause. Apart from some rare forms, most childhood cancers are not hereditary.

How is cancer treated in children?

Childhood cancers can be treated with chemotherapy (anti-cancer drugs), radiotherapy, surgery or a combination of the above.

Chemotherapy uses powerful medicine to fight the cancer by killing the bad cells before they multiply. This can be a challenge because cancer cells divide and multiply very rapidly. Radiotherapy uses strong radiation to attack a specific area of cancer cells. The type of treatment used depends on the type of cancer a child has. For instance, for most brain tumors, of the two options, radiotherapy is the preferred mode of treatment.

The goal of treatment(s) is to have the patient go into remission. Remission is when cancer cells are either forced into hiding or killed permanently -hopefully the latter. If bad cells are just hiding, the patient may have a relapse, or come back. Treatment will have to resume from the beginning.

What are some types of cancer that children get?

There are many different types of cancer. However, in Bangladesh there are five most commonly diagnosed cancers. There are 1) Acute Lymphoblastic Leukemia (ALL), 2) Acute Mylegenous Leukemia (AML), 3) Neuroblastoma, 4) Non-Hodgkin’s Lymphoma and 5) Wilms Tumor.

The following gives a rudimentary description of each:

ALL:

ALL is a cancer of the white blood cells, the cells in the body that normally fight infections. There are two main types of white blood cells-lymphoid cells and myeloid cells. ALL affects lymphoid cells.

Leukemia cells are abnormal cells that cannot do what normal blood cells do. The abnormal cells are immature white blood cells that cannot help the body fight infections. For this reason, children with ALL often get infections and have fevers. ALL is also called acute lymphocytic leukemia. It is the most common leukemia in children.

AML:

AML affects various white blood cells including granulocytes, monocytes and platelets. Leukemic cells accumulate in the bone marrow, replace normal blood cells and spread to the liver, spleen, lymph nodes, central nervous system, kidneys and gonads. Essentially it is a quickly progressing disease, in which too many immature blood-forming cells are found in the blood and bone marrow. It is also known as Acute Myeloid Leukemia or Acute Nonlymphocytic Leukemia.

Neuroblastoma:

Neuroblastoma is a tumor arising from particular nerve cells which run in a chain-like fashion up the back of the child's abdomen and chest and into the skull following the line of the spinal cord (neuro = nerve, blastoma = collection of tumor cells). The most common site for the tumor to grow is the abdomen. About 50% start in the adrenal gland above the kidney. Some tumors grow at the back of the chest and occasionally even higher up towards the neck. Much more rarely, the tumor may start in the brain itself.

Non-Hodgkin’s Lymphoma:

Lymphoma is a general term for cancers that develop in the lymphatic system. The lymphatic system is part of the body's immune system. It helps the body fight disease and infection. The lymphatic system includes a network of thin tubes that branch, like blood vessels, into tissues throughout the body. Lymphatic vessels carry lymph, a colorless, watery fluid that contains infection-fighting cells called lymphocytes. Along this network of vessels are small organs called lymph nodes. Clusters of lymph nodes are found in the underarms, groin, neck, chest, and abdomen. Other parts of the lymphatic system are the spleen, thymus, tonsils, and bone marrow. Lymphatic tissue is also found in other parts of the body, including the stomach, intestines, and skin.

In non-Hodgkin's lymphoma, cells in the lymphatic system become abnormal. They divide and grow without any order or control, or old cells do not die as cells normally do. Because lymphatic tissue is present in many parts of the body, non-Hodgkin's lymphoma can start almost anywhere in the body. Non-Hodgkin's lymphoma may occur in a single lymph node, a group of lymph nodes, or in another organ. This type of cancer can spread to almost any part of the body, including the liver, bone marrow, and spleen.

Wilms Tumor:

Primarily occurring in children, Wilms tumor is a cancerous tumor on the kidney. The kidneys are located at the back of the abdominal cavity, to the left and to the right of the backbone. They serve to filter the blood and rid the body of excess water, salt, and waste products.

Also called nephroblastoma, it is the most common form of kidney cancer, although it is totally unrelated to adult kidney cancer.

The kidney develops while the baby is still in the womb. Some kidney cells do not differentiate fully into the various types of cells that make up a mature kidney; generally by the time a child is 3 or 4 years old all cells have properly matured. Sometimes some of these cells begin growing out of control before maturity. The result is a mass of wildly growing primitive, small cells, called Wilms tumor.

Usually Wilms' tumors are one mass in one kidney, but sometimes they are found in both kidneys, or bilateral. Usually Wilms' tumors are not diagnosed until they have become quite large; most are found before they metastasize.

Is there a cure for cancer?

Not one that has guaranteed success. Large sums of money are channeled towards the research but it takes a long time for many of the groundbreaking developments to permeate into Third World countries. Bangladesh still has a long way to go to reach excellence in quality care for children who face cancer. ASHIC hopes that with successful implementation of its future plan for a state-of-the-art cancer research hospital for children, we can affect the survival rate of these children through earlier detection and more effective treatments.

Hs. # 52; Rd. # 3/A; Dhanmondi R/A; Dhaka - 1209; Bangladesh

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