Cancer, from the citizens’ perspective, is a life-threatening illness that is more common in elders. It can always be attributed to contaminated living conditions (e.g. air pollution, radiation), inferior living habits (e.g. smoking, drinking alcohol), etc. However, apart from adults, children facing cancer also deserve attention.
There are an average of 1838 children’s cancer cases a year, and around 1 in every 420 boys and approximately 1 in every 490 girls in the UK will be diagnosed with cancer by age 14 as estimated. (Cancer Research UK, 2024). In the writer’s hometown, the number is lower. In Hong Kong, an average of 180 children contract the disease each year – about one child in every 10,000. (Children’s Cancer Foundation, 2024) While breast and lung cancer are most common in adults, leukaemia, brain tumour, and lymphoma are the most prevalent types of cancer children encounter. (Children’s Cancer Foundation, 2024) Since the 1970s, when most children diagnosed with cancer had little hope of survival, cure rates have grown dramatically thanks to the advancement of treatment. As a result, the number of survivors has also significantly increased. (Children’s Cancer Foundation, 2024) The cure rate of childhood cancer has rocketed by 4 times from a mere 20% in the 1960s to 84% nowadays. (Children's Cancer and Leukaemia Group,2024) Treatment of children’s cancer falls under three main categories --- chemotherapy, radiotherapy, and bone marrow transplantation. For chemotherapy, the doctor prescribes a combination of anti-cancer drugs administered orally and by injection. In addition to that, some patients may also require radiation to kill the cancer cells. Bone marrow transplantation is always considered the last line treatment given that finding a match bone marrow is difficult, not to mention the high risk of the operation for such a young child. As a long-term volunteer in a foundation and charity providing support to these children, it is pleasing to see how the improvement in treatment has hugely boosted the cure rates. Nevertheless, the side effects are worrying. They lead to inconvenience to children’s development and lack of self-confidence. Bone fracture has always been a commonplace but concerning side effects of steroids. It restricts the daily physical activities of children. The difference between them and other children may also hurt their self-esteem. Another alarming side effect is the increase in ocular pressure and steroid-induced glaucoma. As symptoms of glaucoma are difficult to define by children, it may already result in severe vision loss when the glaucoma is diagnosed. As pharmacists, we play a pivotal role in the healthcare system, including supporting these children and their families. A cancer diagnosis can sometimes be the first time a parent has had to give their child any medicines, apart from paracetamol. Treatment of paediatric cancer still relies heavily on chemotherapy drugs, whether administered by mouth or via intravenous infusion. (Children's Cancer and Leukaemia Group,2020) The effectiveness of the chemotherapy depends on the medication adherence. We have the responsibility to ensure children receive the medication accurately. We are also responsible for highlighting the possible common mild side effects and alarming symptoms they should stop and find the doctor straightaway. For example, in patients’ counselling, we can recommend lifestyle changes, including supplementation with calcium and vitamin D, diet, and proper exercise. These can slow the rate of bone loss. (Guise TA, 2006) Another way to assist them as a pharmacist is to join the research team. Pharmacists can apply their pharmacological knowledge and be involved in new chemotherapy research and review of international treatment options. This is also my motivation to study pharmacy. These children do need our help and support. They deserve a chance to live their lives. Not only can they grow as other children do, but they can also be the leading icons and professionals in their sector. For example, in Hong Kong, “Outstanding Little Life Warriors Award'' awardee, Yu Chui Yee, is a Paralympics gold medalist in fencing. Many awardees are now doctors and medicine students who aim to contribute to society and help patients. (Little Life Warrior Society, 2019) It is great to see how the advancement in treatment has saved so many lives and we are all looking forward to more children to be benefited. References: Cancer Research UK (2024) ‘Children's cancer statistics’, in Cancer Research UK [Online]. Version. Available at: https://www.cancerresearchuk.org/health-professional/cancer-statistics/childrens-cancers#heading-Three (Assessed: 29 January 2024) Children's Cancer Foundation (2024) ‘Childhood Cancer Facts & Figures’, in Children's Cancer Foundation [Online]. Version. Available at: https://www.ccf.org.hk/en/information/childhood_cancer_facts_and_figures/ (Assessed: 29 January 2024) Children's Cancer and Leukaemia (2024) ‘Survival rates’, in Children's Cancer and Leukaemia [Online]. Version. Available at: https://www.cclg.org.uk/survival-rates (Assessed: 29 January 2024) Children's Cancer and Leukaemia (01 Sep 2020) ‘Back to basics: The pharmacist’s role in treating childhood cancer’, in Children's Cancer and Leukaemia [Online]. Version. Available at: https://www.cclg.org.uk/contact-magazine/the-pharmacists-role-in-treating-childhood-cancer (Assessed: 29 January 2024) Guise TA (2006) ‘Bone loss and fracture risk associated with cancer therapy’, in The oncologist, 11(10), 1121–1131. [Online]. Version. Available at: https://doi.org/10.1634/theoncologist.11-10-1121 (Assessed: 26 January 2024) Little Life Warrior Society (2019) ‘The 4th "Outstanding Little Life Warriors Award" Awardees’, in Little Life Warrior Society [Online]. Version. Available at: https://www.llws.org.hk/pages/hk/Info.aspx?10_42_0_10202_ (Assessed: 29 January 2024) Written by Tim Chan
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