Every year, 16 to 18 out of 100 000 children worldwide are diagnosed with cancer. Leukemias, brain tumors, lymphomas, as well as kidney, eye, bone and soft tissue tumors are the most common cancer diagnoses in this age group. Cancer diseases tend to be more aggressive and fast spreading in children compared to adults. Fortunately, in most cases they also react more favorably to the treatment, states Prof. Dr. Funda Çorapçıoğlu, a leading Pediatric Oncology specialist in Turkey working at ACIBADEM Maslak hospital. With effective treatment, more than 70% of cancers in children are curable, and survival rates exceed 90% for some types. Prof. Çorapçıoğlu’s expert advice to parents facing cancer diagnosis of their child is to focus on hope rather than sorrow, trust their doctors and avoid misleading information provided in internet forums.
The causes for developing cancer in children are yet unknown. Prof. Dr. Funda Çorapçıoğlu explains: “Environmental factors are important in adult cases but there is no proven relation with children. We know that some cancers are hereditary in children; however, this is a small share of all cases.” Therefore, the prevention of cancer in children is not possible. Since prevention is not an option, early detection is essential for successful outcomes.
The first signs and symptoms of cancer in children are nonspecific and can easily be ignored. However, parents should pay attention to fatigue, pallor and ecchymotic rash on the skin that could be suspicious for leukemia, says Prof. Dr. Funda Çorapçıoğlu. Lymphadenopathy (swelling of the lymph nodes) in the neck, under the arms and in the groin region is suspicious of lymphoma. Extended abdomen or mass found in the belly can be a finding of lymphoma, neuroblastoma or Wilms tumor. Blood in the urine can also be a sign of Wilms tumor which is a rare type of kidney cancer in childhood, and is also known as nephroblastoma. Headache, vomiting, difficulty in walking, misaligned eyes are frequently seen symptoms of brain tumors. “Sometimes even one-sided nasal congestion can be a finding for rhabdomyosarcoma in this region in early childhood. A finding of white reflex when light is shown on the pupil of the eye can suggest retinoblastoma,” the pediatric oncology specialist explains.
The biggest difference of childhood cancer from adult is that there is curative intent for therapy, states the pediatric oncologist of ACIBADEM. Tumors use to progress faster in children but the treatment response is also much better.The main treatment modalities are chemotherapy, surgery and radiotherapy. One or more of them can be used, and treatment plans are tailored according to the tumor types: “For example, only chemotherapy is used for non-Hodgkin lymphoma. Surgery and radiotherapy play a greater role for brain tumors. “
There are a lot of developments in surgery and radiotherapy techniques in the last 20 years, comments Prof. Çorapçıoğlu. Stem cell transplantation is also among the important advancements. On the other hand, there are new agents and treatment schedules in chemotherapy applied on children. The highlight in the last 5 years is targeted chemotherapy, the pediatric oncology expert states. “These therapies target signals emitted from tumors and their cells, and kill them. This is a very new approach in oncology,” she explains. Prof. Funda Çorapçıoğlu believes that in the future chemotherapy will be not only tumor-targeted but also highly personalized according to the patient’s features, such as metabolism, immunity and genetics. Nowadays, the average survival rate of childhood cancer is around 70%. Some deep-seated brain tumors still present a challenge and thus the survival rates in brain tumors treatment are between 50 and 60%. Meanwhile, for some lymphomas in early stage the cure rate exceeds 90%, the ACIBADEM expert states. Since childhood cancers are relatively rare, parents should address experienced medical centers providing the most up-to-date treatments for better outcomes.
Children with cancer and their families have special needs. The treatment process usually takes between 6 months and 1 year, with most of them spent in hospital. No child is ever prepared for this tough experience. Stress, anxiety and fear can be devastating for the little patients and their families even years after the treatment is completed.Prof. Funda Çorapçıoğlu believes that a key part of her job is bringing these children back to society in their best possible condition, without emotional scars caused by the disease or its treatment. Years ago, Prof. Çorapçıoğlu together with her colleagues and students prepared a small book for sick children and their parents. “This is the story of one child with a cancer diagnosis. The book explains the treatment periods to children,” the pediatric oncologist explains. Just like any other book for children, this one uses simple language, color pictures and comes to a happy ending.
In pediatric oncology, happy ending requires teamwork, says Prof. Dr. Funda Çorapçıoğlu. The treatment process might involve many experts, and all of them including the nurses must be specialized in pediatric cases. Growing bodies need a different approach. At the Pediatric Oncology Department of Acibadem Maslak hospital, called Badem (from Turkish – almond), cancer treatment is planned in coordination with specialists in radiology, nuclear medicine, pathology, radiation oncology, surgery and neurosurgery, all of them teaming-up to draft a personalized plan for every single case, applying the latest technology and treatments. During the treatment process, there is a school available for children admitted in the ward. Many of its patients are coming from all over the world. “We embrace all children from around the world, Turkish or foreigners,” says Prof. Çorapçıoğlu. Because every child diagnosed with cancer deserves the best medical care available today.
Prof. Dr. Funda Çorapçıoğlu, a pediatric oncology specialist with over 25 years of experience and more than 2000 treated patients, says that seeing the recovery of children with cancer and happiness in their mothers’ eyes drives her in her tough job. Recently, a young family with their little baby entered her office. The experienced doctor examined the baby carefully and was happy to find that there was nothing to cause serious concern: the baby needed only antipyretic. While she was writing the prescription, Prof. Çorapçıoğlu learned that the baby’s name was the same as her own – Funda. Then, the father asked if he looked familiar to her. It turned out that she had cured his cancer a long time ago, when he was still a little boy. The young father had come with his family to thank the woman who once saved his life, and his little daughter was named after her.
For all parents who are currently facing cancer diagnosis of their child, the Acibadem expert gives precious advice: “Please be sure that cancer treatment in children is hopeful. Yes, the diagnosis is very difficult but parents should believe only the doctor and real information. They should not confuse their minds with internet and feel sorrow. They should only pay attention to chemotherapy, radiotherapy and surgery, not internet forums, please!”