I have a 6 year old niece who was just diagnosed with stage 2 ALL. She has been living with congenital heart disease. Would her heart condition affect the effectiveness of the chemotherapy and stem cell transplant? Can those treatment options even be considered with her heart defect?
For ALL the stages are grouped into Standard or Low risk (SR); Intermediate Risk (IR); and High risk (HR). The most common type of ALL in children are Standard/Low Risk (SR). Up to 90-98% of children with ALL-SR are cured from their leukemia with chemotherapy alone. Stem cell transplant is only needed if the leukemia relapses multiply or in certain high risk leukemia. Some of the chemotherapy drugs, e.g. doxorubicin, used as apart of the treatment for ALL, can affect the way that the heart functions, hence we usually do a baseline and follow-up ultrasound of the heart called Echocardiogram to look at the heart function before these drugs are given and during and after treatment is completed. Depending on your niece’s exact congenital heart disease type and the current heart function status, and her ALL, your oncologist will discuss with you on how to proceed, and on the options available.
Hi Doctor Aung,it has been 6 months since my son went for surgery for a benign brain tumor. He has been complaining about getting painful headaches these days. He also says his sight is blurry. He is 8 years old this year. Does this sound like a relapse to you? Or is it a common side effect of the surgery?
Brain tumors are the second most common type of cancer in children. There are many subtypes of brain tumors in children, for example: astrocytoma, low grade glioma, high grade glioma, medulloblastoma, ependymoma, or germ cell tumor. Treatment differs depending on the exact type of tumor- e.g. surgery only, or additional treatment such as chemotherapy and radiation therapy. Even after surgery, benign’ brain tumors still need monitoring by the Pediatric Oncologist or Pediatrician and by MRI brain scans, frequently especially during the first 2 years, and less frequently later on until five years from diagnosis. Depending on the ‘specific type of benign tumor’ that your child had, as he is having some complaints, it will be good to see your Pediatric Oncologist or Pediatrician and consider a repeat MRI of brain with IV contrast.
What are the chances of cure and recovery for stage 2 Wilms’ tumor in a child? My daughter was diagnosed with it. She has undergone radiotherapy and also surgery. She is about to start on her chemotherapy. What is the gold standard of treatment?
Afternoon, Dr Aung. My 8 year old daughter has swelling in several areas of her body such as the abdomen, arms and neck. Is this a symptom of leukemia? She also often complains about joint pain. What check should I bring her to do?
My 13 year old daughter is currently in remission from ALL. Would she be prone to other types of cancer in the future?
Because of major advances in treatment, many children with ALL are cured and continue to live normal lives into their adulthood.
The risk of developing a second cancer depends on several factors: type of chemotherapy drugs (e.g. cyclophosphamide, nitrogen mustard, doxorubicin, etoposide) that the child received for treatment of their first cancer, whether they received radiation esp. at a young age, and those who have a family history of cancers (inheritable mutations). For ALL there is a small risk of developing a second cancer.
All children who have survived their cancer should have yearly follow-up beyond the first 5 years after treatment is completed, into their adulthood. Be sure to report to your doctor if there are any of these symptoms such as: easy bruising or bleeding, fatigue, paleness, blood in urine or stool, bone pain, lumps, persistent headaches, etc.
Doctor, after having a bone marrow transplant, my son’s reflexes has become a bit slow. He always seems lost in his thoughts and responds very slowly to conversation or touch. Is this normal? Do you think I need to consult a psychologist?
Providing good mental health for children undergoing treatment for cancer is often missed. It is always good for a psychologist/psychiatrist or a social work counselor to also be a part of the treatment team just like the nurses and doctors. Having said that, Bone marrow transplant (BMT) has many different side effects depending on the underlying cancer diagnosis, type of conditioning regimen (chemotherapy used before the infusion of stem cells) and the child’s baseline physical condition prior to BMT. It is best to discuss in detail your concerns together with your Transplant physician.
Pilocytic astrocytoma is a low grade or slow-growing type of brain tumors. It is also one of the common brain tumor types in children. It is a highly curable with surgery alone and they rarely metastasize to other parts. Because they are slow growing, your doctor will recommend following up with MRI of the brain for many years.
My daughter has had problems with seizures since she was a toddler. There is also a strong history of cancer in my family. I have done some research on seizures and the research mentioned one of the symptoms of childhood leukaemia is seizures. Is this true? Do I need to be worried and take her in for tests?
Leukemia is a type of cancer that starts in the bone marrow, the factory in our body that makes white blood cell, red blood cell and platelets. Most common symptoms/complaints for leukemia are looking pale, fatigue, bleeding bruising, persistent fevers or limping. Seizures can be one of the symptoms if the leukemia is involving the central nervous system (brain). But is it usually acute, fast and does not take years. I am not sure how long she has had seizures. But it is good to discuss with her pediatrician who is treating her seizures.
If a child is experiencing severe nosebleeds when going through chemo for leukaemia, is it still safe to continue the chemo?
Leukemia itself and treatments given can lower the platelet count that can lead to easy bruising and bleeding. Depending on the extent of bleeding and whether leukemia is in remission, we do proceed with its treatment. If the bleeding is extensive or platelet counts are extremely low, there are times when the child may need platelet transfusion or medicines that help to clot the blood to lower risk of bleeding. It will be good to discuss together with your treating oncologist the options.
What is the early sign of brain tumor in children? My 9 year old son has been telling me about severe headaches lately. He said they make him nauseous. I noticed too that when he stands up from a sitting position, he cannot keep his balance.
Depending on the location of the tumor in the brain, symptoms and signs vary persistent headaches, vomiting especially worse in the morning, balance or vision problems, walking or movement problems, personality changes can all be warning signs. It is important to write down the events in a diary, see your doctor for a detailed history and physical examination and to discuss whether there is a need to do a brain scan such as an MRI.