Chandigarh: The future of most of the children suffering with childhood cancer seems to be bleak in low- and middle-income countries, or LMICs with a study pointing out that roughly one in 15 minor patients receiving cancer treatment die from treatment-related complications itself.
The research published in The Lancet Oncology said that treatment-related mortality in LMICs has been reported in up to 45 per cent of children having cancer, while the figure is between 3 and 5 per cent in high-income countries. The researchers conducted the meta-analytical study of 501 articles describing treatment-related mortality in paediatric patients, aged 0 to 21 years, with cancer in LMICs.
The study said that although treatment-related mortality has come down in upper-middle-income countries over time, it remains unchanged in LMICs, stressing an urgent need for targeted supportive care interventions to reduce global disparities in childhood cancer survival.
The study estimated the treatment-related mortality at 6.82 per cent, accounting for 30.9 per cent of overall mortality. Further, mortality from treatment complications was found to be 14.19 per cent in low-income countries, 9.21 per cent in lower-middle-income countries, and 4.47 per cent in upper-middle-income countries, expressing its inverse relation with country income.
Around 90 per cent of children with cancer live in LMICs, where 5-year survival is lower than 20 per cent.
The 501 articles identified and chosen for meta-analysis were published between Jan 1, 2010, and June 22, 2021.
Though the study does not specifically mention treatment status country-wise,  as per the government data,  approximately 70,000 new cases of childhood cancers are diagnosed in India annually.
“We have a high survival rate of 75-80%,” said doctors from the AIIMS pediatric oncology division in Delhi which last month celebrated Childhood Cancer Survivor Day. "Approximately 250 patients complete their treatment at our centre every year and are registered at the survivor clinic," said Dr Rachna Seth, professor in the department of paediatrics at AIIMS.
She explained that if other problems such as cardiac dysfunction, neurocognitive deficit, metabolic syndrome, or fertility-related issues arise after cancer treatment, they are addressed through consultations with the respective specialists.
Dr Sima Das, Director - Oculoplastic and Ocular Oncology, Dr Shroff’s Charity Eye Hospital talked about the survival rate in Retinoblastoma, a type of eye cancer that afflicts an estimated 1,500-2,000 children annually. Almost 50% of them have an advanced tumor on presentation and tend to succumb to the disease. However, if diagnosed early on, the survival rate for retinoblastoma can be as high as 90-95%.
She said that nearly 50% of patients present with advanced retinoblastoma. Additionally, nearly 50% of all children diagnosed die of retinoblastoma in India.” The hospital has started the Canvas of Hope to address the need for integrated care and strong referral systems to successfully treat patients. Dr Sima attributed mortalities to lack of treatment or abandoning treatment mid-way. This is mainly due to financial constraints, lack of access to quality healthcare facilities and refusing enucleation (removal of the eye which is necessary when the disease is advanced).”