Delhi-based Aaryan Vohra was not even five years old when he was diagnosed with blood cancer. Initially, his parents thought it was just a common childhood illness as he was falling ill too often. But one day, when his fever crossed 106°F and his haemoglobin dropped to 3, they panicked and rushed him to the hospital.
A bone marrow test revealed the truth. Today, studying law at a private college in Faridabad, 20-year-old Vohra proudly calls himself a cancer survivor. Vohra’s mother Monica Vohra said that early leukaemia detection made all the difference.
“Parents have no idea that blood cancer is curable. Today, the country not only has the best possible treatment, but financial support too. What is needed is early detection,” said Vohra, who in 2012 launched ‘Leukemia Crusaders,’ which has provided over 5,500 underprivileged children initial bridge money so that parents can start treatment early, which increases the chances of cure.
“While in Western countries, the survival rate from blood cancer is 90%, in India it is much lower. The reason is only a lack of awareness, as parents don’t know it is treatable and curable,” said Vohra, who is the managing trustee of the NGO. She said there is fear associated with blood cancer but not much knowledge. “Due to lack of awareness, people turn to alternative medicine, which could cause much damage,” she added.
Dr Deepak Bansal, professor at Advanced Paediatrics Centre, PGI, Chandigarh, said, “Many childhood cancers are curable. Treatment depends on the type of cancer and may include chemotherapy, surgery, radiotherapy, targeted therapy, immunotherapy, or combinations of these treatments. A few require stem-cell transplantation also.”
A recent article in The Indian Journal of Medical Research (IJMR), published on behalf of the Indian Council of Medical Research (ICMR), states that “survival outcomes for childhood cancer in India have improved over the past few decades, resulting in a growing population of survivors.”
“It has been achieved through increased awareness among the physicians, early referral and diagnosis, appropriate staging and risk stratification, improved delivery of therapy, and increased availability of paediatric oncologists. Advances in surgical techniques, radiation therapy, and supportive care – including safe transfusion practices, effective antiemetics, and antimicrobial agents – have further contributed to improved outcomes,” said the article, which was co-authored by Dr Bansal.
Experts said what is not known is that children tolerate chemotherapy better than adults, and the cures in childhood cancers are also better than cancers occurring in adults. Despite treatment being available, most patients arrive late because of delayed diagnosis or referrals from paediatricians.
Dr Vasudeva Bhat K, HoD of paediatric oncology, Kasturba Medical College, Manipal Academy of Higher Education, Karnataka, said that for certain childhood cancers like Hodgkin’s Lymphoma and Wilms tumour, cure rates are as high as 90-95%. “However, in India, the cure rates are 10-15% lower in our country due to delayed presentation and higher rate of infections.”
But, he added that it is not that India is not equipped to treat childhood cancer.
“The treatment is on par with the developed world, and most treatment protocols are adapted from high-income countries. India has all the modalities of cancer treatment, including chemotherapy, surgical and radiation oncology expertise. While most of these facilities are located in tier 1 cities, tier 2 and 3 cities are also seeing a lot of comprehensive cancer care centres coming up,” Dr Bhat added.
Nutrition also plays a huge role in a child’s cancer treatment and subsequent recovery. WHO’s CureAll framework — an operational guide designed to support countries in building and scaling up sustainable national childhood cancer programmes as part of WHO Global Initiative for Childhood Cancer — recognises that poor nutritional status increases infection risk, treatment-related toxicity and treatment abandonment.
According to Purnota Dutta Bahl, founder and CEO of Cuddles Foundation, which works with government and charity cancer hospitals to provide trained paediatric oncology nutritionists, “Nutrition is part of the treatment, not something that comes after it.”
“A child’s body needs enough calories and protein to tolerate chemotherapy, heal between cycles and resist infection.” What is important to know is that good nutrition can help a child stay on treatment, complete it, and come out of it stronger.
According to Poonam Bagai, Founder and Chairman, CanKidsKidsCan, a national society for change for childhood cancer in India, childhood cancer is highly curable, yet too many children in India are diagnosed late or leave treatment unfinished because their families cannot afford to continue.
For India to meet the WHO Global Initiative for Childhood Cancer, which aims for at least 60% survival by 2030, a target recognised at the 80th UN General Assembly, children must have timely access to diagnosis, treatment and continued support, regardless of where they live.